Enweronu-Laryea, C. C.,Nkyekyer, K.,Rodrigues, O. P.
"Enweronu-Laryea, C. C.: University of Ghana","Nkyekyer, K.: University of Ghana","Rodrigues, O. P.: University of Ghana"
Objective: Evaluate the impact of improved neonatal intensive care facilities on survival and referral patterns at a teaching hospital in Ghana.
Study Design: Retrospective cohort comparing birth weight-specific survival and referral pattern of newborns requiring intensive care before and after improvement of facilities.
Result: Improved survival of newborns <2500 g especially those 1000-1499 g (OR = 1.74 (CI 1.38-2.20; P < 0.00001) for inborn, OR = 2.16 (CI 1.36-3.44; P = 0.0006) for out-born). Birth asphyxia, the major indication for >= 2500 g newborn referrals, was associated with reduced survival (OR = 0.56 (95% CI 0.40 to 0.78; P = 0.0004)). There was fourfold increased referral of out-born >= 2500 g.
Conclusion: Improved facilities significantly improved survival of newborns <2500 g, but was of no benefit for newborns >= 2500 g. A scaling-up approach with investments that improve emergency obstetric services, referral systems, human resources and neonatal resuscitation practices will save more newborn lives.
"BIRTH ASPHYXIA","birth weight",inborn,out-born,SURVIVAL,"BIRTH-WEIGHT INFANTS",SURVIVAL