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In-hospital neonatal mortality in a level-two hospital in Cape Town, South Africa
Background Neonatal mortality (deaths in the first 28 days of life) is a major contributor to under-5 mortality in South Africa. Many advances in neonatal care have been introduced, but the impact of these interventions has not been studied outside of tertiary academic centers. Objectives To describ...
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| Format: | Thesis |
| Language: | English |
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Department of Paediatrics and Child Health
2023
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| _version_ | 1867613293147848704 |
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| access_status_str | Open Access |
| author | Gabriels, Cindi |
| author2 | le Roux, David |
| author_browse | Gabriels, Cindi le Roux, David |
| author_facet | le Roux, David Gabriels, Cindi |
| author_sort | Gabriels, Cindi |
| collection | Thesis |
| description | Background Neonatal mortality (deaths in the first 28 days of life) is a major contributor to under-5 mortality in South Africa. Many advances in neonatal care have been introduced, but the impact of these interventions has not been studied outside of tertiary academic centers. Objectives To describe neonatal mortality in the neonatal high care unit at New Somerset Hospital in Cape Town, South Africa, over an 8 year period. Methods Neonatal deaths were captured and entered into a database; deaths were coded according to Perinatal Problem Identification Program categories. Results Neonatal deaths from 2011 to 2018 were analyzed, excluding 2014. There were 296 neonatal deaths; median birthweight of neonatal deaths was 1140g (interquartile range (IQR) 790 – 2420g); median gestation was 29 weeks (IQR 25 – 38). Immaturity (132/296, 45%) was the most common cause of death, followed by hypoxia (67/296, 23%) and infections (61/296, 21%). There were 250 (84%) neonatal deaths in the first week of life; there was a trend towards decreasing number of neonatal deaths (from 48 in 2011 to 34 in 2018), and rate of deaths (from 45.2 per 1000 admissions to 28.2 per 1000 admissions). This was driven by decreased deaths due to immaturity; number of deaths due to other causes remained approximately constant. Conclusions We observed decreasing number of neonatal deaths and rate of deaths per 1000 admissions, with the largest decrease due to prematurity. Advances in respiratory care for preterm neonates may have contributed to decreased mortality due to immaturity. Upstream obstetric interventions will be required to address hypoxia-related causes of neonatal mortality. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/37200 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:49.949Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| 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:11427/37200 In-hospital neonatal mortality in a level-two hospital in Cape Town, South Africa Gabriels, Cindi le Roux, David Paediatrics Background Neonatal mortality (deaths in the first 28 days of life) is a major contributor to under-5 mortality in South Africa. Many advances in neonatal care have been introduced, but the impact of these interventions has not been studied outside of tertiary academic centers. Objectives To describe neonatal mortality in the neonatal high care unit at New Somerset Hospital in Cape Town, South Africa, over an 8 year period. Methods Neonatal deaths were captured and entered into a database; deaths were coded according to Perinatal Problem Identification Program categories. Results Neonatal deaths from 2011 to 2018 were analyzed, excluding 2014. There were 296 neonatal deaths; median birthweight of neonatal deaths was 1140g (interquartile range (IQR) 790 – 2420g); median gestation was 29 weeks (IQR 25 – 38). Immaturity (132/296, 45%) was the most common cause of death, followed by hypoxia (67/296, 23%) and infections (61/296, 21%). There were 250 (84%) neonatal deaths in the first week of life; there was a trend towards decreasing number of neonatal deaths (from 48 in 2011 to 34 in 2018), and rate of deaths (from 45.2 per 1000 admissions to 28.2 per 1000 admissions). This was driven by decreased deaths due to immaturity; number of deaths due to other causes remained approximately constant. Conclusions We observed decreasing number of neonatal deaths and rate of deaths per 1000 admissions, with the largest decrease due to prematurity. Advances in respiratory care for preterm neonates may have contributed to decreased mortality due to immaturity. Upstream obstetric interventions will be required to address hypoxia-related causes of neonatal mortality. 2023-03-03T11:17:05Z 2023-03-03T11:17:05Z 2022 2023-02-20T12:46:15Z Master Thesis Masters MMed http://hdl.handle.net/11427/37200 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences |
| spellingShingle | Paediatrics Gabriels, Cindi In-hospital neonatal mortality in a level-two hospital in Cape Town, South Africa |
| thesis_degree_str | Master's |
| title | In-hospital neonatal mortality in a level-two hospital in Cape Town, South Africa |
| title_full | In-hospital neonatal mortality in a level-two hospital in Cape Town, South Africa |
| title_fullStr | In-hospital neonatal mortality in a level-two hospital in Cape Town, South Africa |
| title_full_unstemmed | In-hospital neonatal mortality in a level-two hospital in Cape Town, South Africa |
| title_short | In-hospital neonatal mortality in a level-two hospital in Cape Town, South Africa |
| title_sort | in hospital neonatal mortality in a level two hospital in cape town south africa |
| topic | Paediatrics |
| url | http://hdl.handle.net/11427/37200 |
| work_keys_str_mv | AT gabrielscindi inhospitalneonatalmortalityinaleveltwohospitalincapetownsouthafrica |