Post Discharge Outcome of Preterm Infants in a Low-Middle-Income Country
Evelyn Mungyeh Mah1,2, Naiza Ngowo Monono1,3, Daniel Armand Kago Tague1,2, Seraphin Nguefack1,2, Isabelle Mekone Nkwele1, Dany Hermann Ngwanou1, Hubert Desire Mbassi Awa1,4, Andreas Chiabi1,2, F Angwafo III Fru1,2.
1Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaounde, Cameroon,
2Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, Yaoundé Gynaeco-Obstetrics and Pediatrics Hospital, Yaounde, Cameroon,
3Faculty of Health Sciences, University of Buea, Buea, Cameroon,
4Mother and Child Centre of the Chantal Biya Foundation, Yaounde, Cameroon.
Background: The improvement of postnatal care has led to the increase in survival rate of preterm infants in our setting and considering their vulnerability, we set out to assess the morbidity and mortality of preterm infants 12 months after discharge from the neonatal intensive care unit (NICU).
Methods: A retrospective cohort study was done from the 2008 to 2013 at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital and included children born preterm, admitted in the NICU and discharged alive during the study period.
Results: Out of 816 premature infants that were discharged alive from the NICU, only 232 (28.4%) preterm infants discharged alive presented for the routine visits during the first 12 months of life. Among these, 206 (89%) had at least one complication during the neonatal hospitalization period. Postnatal complications were significantly more frequent in infants born before 34 weeks of gestation and in babies with birth weight below 1500 grams (p < 0.001). Up to 72.5% of those who came for routine visits were less than 34 weeks and 86% weighed < 2000g at birth. Seventy-six (32.7%) preterm infants were readmitted within their first year of life and the causes of readmission were respiratory tract diseases in 42 (55%), late neonatal sepsis in 19 (25.0%), malaria in 9 (11.8%) and epilepsy in 6 (7.9%). Neither the gestational age nor birth weight influenced readmission (p = 0.25, p = 0.590 respectively). The smaller the gestational age, the longer the duration of postnatal hospitalization (p <0.001).
Conclusion: Routine follow-up after discharge remains a problem in our setting due to non-respect of appointments. Infants born preterm suffer mostly from respiratory tract diseases during the first year of life.

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