Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa
Background: International consensus guidelines recommend that term or near-term newborns with moderate or severe hypoxic ischaemic encephalopathy (HIE) should be treated with induced hypothermia within 6 hours of birth, but many of the affected babies are born outside treatment centers. There are co...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Department of Paediatrics and Child Health
2015
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613315254976512 |
|---|---|
| access_status_str | Open Access |
| author | Nakibuuka, Victoria |
| author2 | Horn, Alan R |
| author_browse | Horn, Alan R Nakibuuka, Victoria |
| author_facet | Horn, Alan R Nakibuuka, Victoria |
| author_sort | Nakibuuka, Victoria |
| collection | Thesis |
| description | Background: International consensus guidelines recommend that term or near-term newborns with moderate or severe hypoxic ischaemic encephalopathy (HIE) should be treated with induced hypothermia within 6 hours of birth, but many of the affected babies are born outside treatment centers. There are conflicting data describing the influence of birth site on outcome after HIE - and no published data from South Africa. Objective: To compare the frequency of abnormal outcome (mortality or abnormal aEEG) before discharge between inborn and outborn infants treated with hypothermia Methods: This was a retrospective analysis of data extracted from a prospectively collated registry of babies with moderate or severe HIE, treated with hypothermia in a tertiary hospital in South Africa, between 1 January 2011 and 31 December 2012. Results: A total of 57 babies were treated with hypothermia of which 23 (40%) were inborn and 34 (60%) outborn. Cooling was initiated earlier among the inborn babies (age 2.3 hours vs. 4.3 hours, p=0.002). Pregnancy complications and abnormal intrapartum fetal heart rates occurred more frequently in inborn infants (65.2 % vs. 24.2 %, p=0.0001 and 47.8% vs. 20.6%, p =0.03 respectively). More outborn babies died or had an abnormal aEEG at 48 hours (32 % vs. 22 %, p=0.556) and fewer outborn babies achieved normal feeding at discharge (22% vs. 38%, p = 0.189), but these differences were not statistically significant. Conclusion: The majority of infants treated with induced hypothermia in an urban/peri-urban setting in South Africa were not born in a cooling centre. There were significant delays in initiating cooling among the outborn babies. Short-term morbidity and mortality were not significantly different in outborn babies but interpretation is limited by the small sample size. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/15738 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:34:10.861Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2015 |
| publishDateRange | 2015 |
| publishDateSort | 2015 |
| publisher | Department of Paediatrics and Child Health |
| publisherStr | Department of Paediatrics and Child Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/15738 The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa Nakibuuka, Victoria Horn, Alan R Rhoda, Natasha R Neonatology Background: International consensus guidelines recommend that term or near-term newborns with moderate or severe hypoxic ischaemic encephalopathy (HIE) should be treated with induced hypothermia within 6 hours of birth, but many of the affected babies are born outside treatment centers. There are conflicting data describing the influence of birth site on outcome after HIE - and no published data from South Africa. Objective: To compare the frequency of abnormal outcome (mortality or abnormal aEEG) before discharge between inborn and outborn infants treated with hypothermia Methods: This was a retrospective analysis of data extracted from a prospectively collated registry of babies with moderate or severe HIE, treated with hypothermia in a tertiary hospital in South Africa, between 1 January 2011 and 31 December 2012. Results: A total of 57 babies were treated with hypothermia of which 23 (40%) were inborn and 34 (60%) outborn. Cooling was initiated earlier among the inborn babies (age 2.3 hours vs. 4.3 hours, p=0.002). Pregnancy complications and abnormal intrapartum fetal heart rates occurred more frequently in inborn infants (65.2 % vs. 24.2 %, p=0.0001 and 47.8% vs. 20.6%, p =0.03 respectively). More outborn babies died or had an abnormal aEEG at 48 hours (32 % vs. 22 %, p=0.556) and fewer outborn babies achieved normal feeding at discharge (22% vs. 38%, p = 0.189), but these differences were not statistically significant. Conclusion: The majority of infants treated with induced hypothermia in an urban/peri-urban setting in South Africa were not born in a cooling centre. There were significant delays in initiating cooling among the outborn babies. Short-term morbidity and mortality were not significantly different in outborn babies but interpretation is limited by the small sample size. 2015-12-09T14:45:21Z 2015-12-09T14:45:21Z 2015 Master Thesis Masters MPhil http://hdl.handle.net/11427/15738 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences University of Cape Town |
| spellingShingle | Neonatology Nakibuuka, Victoria The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa |
| thesis_degree_str | Master's |
| title | The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa |
| title_full | The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa |
| title_fullStr | The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa |
| title_full_unstemmed | The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa |
| title_short | The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa |
| title_sort | influence of birth site on short term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at groote schuur hospital cape town south africa |
| topic | Neonatology |
| url | http://hdl.handle.net/11427/15738 |
| work_keys_str_mv | AT nakibuukavictoria theinfluenceofbirthsiteonshorttermoutcomesofencephalopathicnewborninfantstreatedwiththerapeutichypothermiaatgrooteschuurhospitalcapetownsouthafrica AT nakibuukavictoria influenceofbirthsiteonshorttermoutcomesofencephalopathicnewborninfantstreatedwiththerapeutichypothermiaatgrooteschuurhospitalcapetownsouthafrica |