Mortality in infants less than 2500 grammes birthweight admitted into a special-care baby unit in Port Harcourt, Nigeria

Physicians studied the mortality rate of low birth weight (2500g) neonates admitted into a special care unit at a hospital in Port Harcourt, Nigeria between January 1984-June 1986. Care consisted of maintaining body temperatures, feeding, and preventing and treating infections. If required, oxygen was only administered in the incubator. 36.3% of all infants admitted to the special care unit during this period weighed 2500g. Those infants that died had lower birth weights, younger gestational age, lower temperatures on admission, and lower temperatures while in the unit than did surviving infants (p.001). Mortality was highest for those infants weighing 1000g (90%) and decreased with increasing birth weight (1000-1500g=51.1%; 1501-2000g=12.4%; and 2001-2499G=3%). In addition, the 1 and 5 minute APGAR scores were significantly lower among neonates who died than those who lived (p0.1 and p.001 respectively). Although infants who died had a significantly lower mean temperature on admission compared to those who survived, there was no significant difference in mean temperatures on admission between those born outside the hospital and those born in the hospital. Another risk factor was place of birth. Neonatal mortality was lower for those infants born in the hospital (9.7%) compared to those not born in the hospital (54%). Since Nigeria does not have specially designed ambulances with sophisticated transport incubators, this high mortality rate could be due to exposure to infection in transport. Nonetheless, it would be easier and cheaper to transfer the mother at risk than her ill neonate. These results demonstrate the importance of prevention of low birth weight rather than improving the facilities for intensive care which is beyond the reach of most developing countries.