Research Article
Immediate Outcomes of Neonatal Transport in a Tertiary Hospital in South-West of Nigeria
1Department of pediatrics, University of Ibadan, Nigeria
2Department of pediatrics, University College Hospital Ibadan, Nigeria
3Institute of Child Health, University of Ibadan, Nigeria
4Department of pediatrics, Niger Delta University, Nigeria
Received Date: January 31, 2020; Published Date: February 18, 2020
Abstract
Aim: Only a third of deliveries in Nigeria occur in health facilities and a number of sick neonates have to be referred for advanced care. We sought to assess the morbidity and mortality within 24 and 48 hours of arrival among neonates presenting at the University College Hospital, (UCH) Ibadan in relation to the prevailing neonatal transport care practices.
Methods: The pretransport and intratransport care available to 401 neonates presenting in UCH were determined and their respiratory rate, heart rate, SpO2, serum bicarbonate, temperature and blood pressure were checked on arrival. TRIPS (Transport Risk Index of Physiologic Stability) scores were determined and same parameters were reassessed 24 and 48 hours after presentation.
Results: Nineteen babies (4.7%) were brought in dead. The morbidities present on admission were hypothermia (35.1%), hypoxia (28.4%), hypoglycaemia (12.5%), apnoea (9%), acidosis (8.2%), unrecordable blood pressure (16.5%). The median TRIP score on arrival was 17 with 23% having very severe score (>30), severe 19.4%, moderate 24.6% and low 33%. Babies who received oxygen, IVF/breastmilk during transport were more in the low and moderate scores. By 48 hours of admission, 22% had died and those who did not receive IVF/breastmilk had the highest risk of dying (OR 4.67 CI 1.81,12.05).
Conclusion: Neonates presenting at the UCH had significant morbidity and mortality in the first 48 hours of presentation, which was associated with poor pre and intratransport care. It is crucial to emphasize pretransport stabilization and suitable intratransport care in the training of peripheral healthcare workers in resource limited settings in order to improve newborn outcomes.
Keywords: Outcomes; Neonatal; Transport; TRIPS; Nigeria
Abbreviations: CHILD: Child Intervention for Living Drug-Free; WHO: World Health Organization; INL: International Narcotics and Law Enforcement Affairs, US Department of States; GLMM: General Linear Mixed Model; ASSIST: Alcohol, Smoking and Substance Involvement Screening Test; ASSIST-Y: Alcohol, Smoking and Substance Involvement Screening Test-Youth
