Document Detail


Outcomes of 28+1 to 32+0 weeks gestation babies in the state of Qatar: finding facility-based cost effective options for improving the survival of preterm neonates in low income countries.
MedLine Citation:
PMID:  20644688     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In this retrospective study we did a comparative analysis of the outcome of 28(+1) to 32(+0) weeks gestation babies between the State of Qatar and some high income countries with an objective of providing an evidence base for improving the survival of preterm neonates in low income countries. Data covering a five year period (2002-2006) was ascertained on a pre-designed Performa. A comparative analysis with the most recent data from VON, NICHD, UK, France and Europe was undertaken. Qatar's 28(+1) to 32(+0) weeks Prematurity Rate (9.23 per 1,000 births) was less than the UK's (p < 0.0001). Of the 597 babies born at 28(+1) to 32(+0) weeks of gestation, 37.5% did not require any respiratory support, while 31.1% required only CPAP therapy. 80.12% of the MV and 96.28% of CPAP therapy was required for <96 hours. 86.1% of the mothers had received antenatal steroids. The 28(+1) to 32(+0) weeks mortality rate was 65.3/1,000 births with 30.77% deaths attributable to a range of lethal congenital and chromosomal anomalies. The survival rate increased with increasing gestational age (p < 0.001) and was comparable to some high income countries. The incidence of in hospital pre discharge morbidities in Qatar (CLD 2.68%, IVH Grade III 0.84%, IVH Grade IV 0.5%, Cystic PVL 0.5%) was less as compared to some high income countries except ROP >/= Stage 3 (5.69%), which was higher in Qatar. The incidence of symptomatic PDA, NEC and severe ROP decreased with increasing gestational age (p < 0.05). We conclude that the mortality and in hospital pre discharge morbidity outcome of 28(+1) to 32(+0) weeks babies in Qatar are comparable with some high income countries. In two thirds of this group of preterm babies, the immediate postnatal respiratory distress can be effectively managed by using two facility based cost effective interventions; antenatal steroids and postnatal CPAP. This finding is very supportive to the efforts of international perinatal health care planners in designing facility-based cost effective options for low income countries.
Authors:
Hussain Parappil; Sajjad Rahman; Husam Salama; Hilal Al Rifai; Najeeb Kesavath Parambil; Walid El Ansari
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Publication Detail:
Type:  Journal Article     Date:  2010-06-11
Journal Detail:
Title:  International journal of environmental research and public health     Volume:  7     ISSN:  1660-4601     ISO Abbreviation:  Int J Environ Res Public Health     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-20     Completed Date:  2011-06-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101238455     Medline TA:  Int J Environ Res Public Health     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  2526-42     Citation Subset:  IM    
Affiliation:
NICU Women's Hospital, Hamad Medical Corporation, Doha, Qatar. drhussainparappil@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Continuous Positive Airway Pressure
Cost-Benefit Analysis / economics*,  statistics & numerical data
Developing Countries
Female
Gestational Age*
Great Britain
Humans
Infant Mortality / trends*
Infant, Newborn
Infant, Premature*
Intensive Care Units, Neonatal
Lung Diseases / rehabilitation
Poverty / economics*,  statistics & numerical data
Pregnancy
Pregnancy Outcome / economics*
Qatar
Retrospective Studies
Socioeconomic Factors
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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