Survival of Live Born Babies by Gestational Age and Birth Weight for Age 0-60 days Among Deliveries at SPHMMC.

Abstract

ABSTRACT Background Neonatal death accounts for 40% of deaths under the age of 5 years worldwide. Neonatal mortality and survival predictors vary by country with the availability and quality of health care. Identifying the gestational age and birth weight based out come and survival rate of neonates will help in planning to improve perinatal & neonatal care and services. Objective The main objective of this study was to determine the survival rate and determinant factors of live born babies based on gestational and birth weight at SPHMMC Methodology Secondary data was extracted from BARNARDS study, which was prospective cohort study in which 5000 mothers and their newborns were included to determine the etiologies of early-onset neonatal bacterial infections (days 1-7 of life) and late-onset neonatal sepsis (8-60 days of life). Mothers who present in labor and deliver at St. Paul’s Hospital Millennium Medical College (SPHMMC) in Addis Ababa and their newborns was followed for 60 days after birth. Secondary data was cleaned, recoded and analyzed using STATA version-14.2. For description, frequencies, percentages, and rates were used and, Kaplan Meier curves were used to estimate survival time. Log rank test was fitted to test for the presence of difference in survival among categories of covariates. To identify potential predictors of neonatal survival, Cox-proportional hazard regression model was fitted by successive stepwise backward elimination. Statistical significance was declared at p-value <0.05. Result and conclusion The analysis of this study revealed that 1.5% of mothers had gestational age between 28-31+6 weeks, 16.3% between 32-36+6 weeks, 33.9% between 37-39+6 weeks, 20.1% between 40- 41+6, 27.6% >=42weeks. Over all in this study gestational age based survival at the end of follow-up was: for the gestational age between 28-31+6 weeks 66.9%, between 32-36+6 weeks 93.79%, between 37-39+6 weeks 96.42%, between 40-41+6 weeks 96.96% and for gestational age >=42 weeks survival is 95.79%. And the birth weight based survival of newborns at the end of follow-up was: for those < 1000gm 55.56%,between 1000gm-1499gm 62.43%, between 1500-2499 92.70%, between 2500-3999 96.58% and for birth weight >= 4000gm survival is 99.48%. Overall survival rate of neonates at the end of the follow up was 95.55 %. Birth Weight, Gestational Age, Education status of mother, and Apgar score at 5 minutes are statistically significant risk factors for the survival of a baby at 5% level of significant. Key Words: Survival rate, Birth weight, survival rate