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Analysis of care received by very-low-birthweight neonates at Worcester Provincial Hospital in 2018 after implementation of the Western Cape Provincial Peri-viability Decision Support Framework
Thesis (MMed) -- Stellenbosch University, 2022.
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| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2022
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| _version_ | 1867614058650271744 |
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| access_status_str | Open Access |
| author | Van der Merwe, Carine |
| author2 | Slogrove, Amy |
| author_browse | Slogrove, Amy Van der Merwe, Carine |
| author_facet | Slogrove, Amy Van der Merwe, Carine |
| author_sort | Van der Merwe, Carine |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MMed) -- Stellenbosch University, 2022. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/126158 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:45:58.010Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/126158 Analysis of care received by very-low-birthweight neonates at Worcester Provincial Hospital in 2018 after implementation of the Western Cape Provincial Peri-viability Decision Support Framework Van der Merwe, Carine Slogrove, Amy Engelbrecht, Arnold Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. Birth weight, Low -- Worcester (South Africa) Newborn infants -- Mortality -- Worcester (South Africa) Prematurely born children -- Worcester (South Africa) Neonatology -- Worcester (South Africa) UCTD Thesis (MMed) -- Stellenbosch University, 2022. ENGLISH ABSTRACT: Background: A significant proportion of very-low-birthweight (VLBW; <1500g) infants are born at regional hospitals in South Africa (SA) and little is known regarding their care and outcomes. Since 2017, clinicians at regional hospitals throughout the Western Cape (WC) have utilized the WC Department of Health Periviability Decision Support Framework to guide care of VLBW infants. Objectives: To describe care of VLBW infants at Worcester Provincial Hospital (WPH) in 2018, compared to recommendations in the Framework and to secondarily compare differences in shortterm outcomes of VLBW infants managed before (2016) and after (2018) the implementation of these guidelines. Methods: A retrospective cohort study was conducted of all live-born VLBW infants ≤7 days managed at WPH, in 2016 and 2018. Information related to neonatal care was collected from medical records of patients born in 2018 only, and compared with Framework recommendations according to birthweight categories (500-799g; 800-999g; 1000-1499g). Information regarding mortality at discharge and at age 12 months, readmission before age 12 months, and length of neonatal stay was captured for all included neonates. Results were reported using frequencies, percentages, and proportions with corresponding 95% confidence intervals. Results: In total 227 infants were included, of which 115 were born in 2018 and included in the primary objective analysis. Infant and maternal characteristics were similar for the 2016 and 2018 cohorts. Complete framework adherence was achieved in 54% (n=90) of infants 1000-1499g, 42% (n=12) of infants 800-999g, and no infants of 500-799g were managed with complete adherence. Adherence to ≥80% of recommendations was achieved in 69% of infants. For the secondary objectives, survival to discharge (73.2% in 2016 vs 71.9% in 2018) and 1 year (70.5% in 2016 vs 70.4% in 2018) did not change significantly after Framework implementation. Clinically meaningful reductions in neonatal readmissions (30.6% in 2016 vs 23.5% in 2018) and length of stay (33 days in 2016 vs 28 days in 2018) were observed from 2016 to 2018. Conclusions: The majority of VLBW infants at WPH in 2018 were managed with ≥80% adherence to the Framework, but considerable differences in adherence were noted by birthweight categories. A clinically important decreased length of neonatal stay and readmission were observed postimplementation; this in combination with no increase in mortality represents a potential gain for a resource-restricted healthcare system. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2022-11-17T11:45:17Z 2023-01-16T12:53:04Z 2022-11-17T11:45:17Z 2023-01-16T12:53:04Z 2022-08 Thesis http://hdl.handle.net/10019.1/126158 en_ZA Stellenbosch University 56 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Birth weight, Low -- Worcester (South Africa) Newborn infants -- Mortality -- Worcester (South Africa) Prematurely born children -- Worcester (South Africa) Neonatology -- Worcester (South Africa) UCTD Van der Merwe, Carine Analysis of care received by very-low-birthweight neonates at Worcester Provincial Hospital in 2018 after implementation of the Western Cape Provincial Peri-viability Decision Support Framework |
| title | Analysis of care received by very-low-birthweight neonates at Worcester Provincial Hospital in 2018 after implementation of the Western Cape Provincial Peri-viability Decision Support Framework |
| title_full | Analysis of care received by very-low-birthweight neonates at Worcester Provincial Hospital in 2018 after implementation of the Western Cape Provincial Peri-viability Decision Support Framework |
| title_fullStr | Analysis of care received by very-low-birthweight neonates at Worcester Provincial Hospital in 2018 after implementation of the Western Cape Provincial Peri-viability Decision Support Framework |
| title_full_unstemmed | Analysis of care received by very-low-birthweight neonates at Worcester Provincial Hospital in 2018 after implementation of the Western Cape Provincial Peri-viability Decision Support Framework |
| title_short | Analysis of care received by very-low-birthweight neonates at Worcester Provincial Hospital in 2018 after implementation of the Western Cape Provincial Peri-viability Decision Support Framework |
| title_sort | analysis of care received by very low birthweight neonates at worcester provincial hospital in 2018 after implementation of the western cape provincial peri viability decision support framework |
| topic | Birth weight, Low -- Worcester (South Africa) Newborn infants -- Mortality -- Worcester (South Africa) Prematurely born children -- Worcester (South Africa) Neonatology -- Worcester (South Africa) UCTD |
| url | http://hdl.handle.net/10019.1/126158 |
| work_keys_str_mv | AT vandermerwecarine analysisofcarereceivedbyverylowbirthweightneonatesatworcesterprovincialhospitalin2018afterimplementationofthewesterncapeprovincialperiviabilitydecisionsupportframework |