Incidence, Risk Factors and Mortality of Hospitalization Among Late Preterm Neonates at Jinja and Kayunga Regional Referral Hospitals, Eastern Uganda, Prospective Study

Abstract

Background In Uganda, prematurity is the main cause of newborn fatalities, accounting for 41% of all annual newborn deaths. There are limited studies in Uganda that have explored preterm births. This study aimed to assess the incidence, risk factors for admission and outcomes of late preterm Neonates at Kayunga and Jinja Regional Referral Hospitals (KRRH and JRRH). Methods This was a prospective cohort study in which late preterm babies were enrolled at birth. Late preterm neonates (born at 34 weeks and 0 days through 36 weeks and 6 days) at KRRH and JRRH during the study period were enrolled. They were followed up from the time of birth till 4 weeks of life for hospital admission and mortality. Modified Poisson regression in stata version 14 was done to determine the significant risk factors. Results In this study, we enrolled 329 late preterm neonates. Slightly more than half were males (59.9%). The distributions in the gestational ages slightly increased with gestation age with 31.9%, 33.4% and 34.7% born at 34, 35 and 36 weeks of gestation respectively. Of the 329 late preterm neonates enrolled in this study, 72 were admitted, representing an incidence proportion of 21.9% (219 admission per 1,000 live late preterm births). In the multivariable analysis, maternal age between 35–45 years, monthly income less than 200,000 Uganda shillings, less than two antenatal care visits, duration of labour greater than 24 hours, and presence of perinatal complications were significant. The overall mortality rate was 1.8% and admission mortality of 8.3%. Conclusion The incidence of hospital admission among late preterm Neonates was high with maternal and neonatal factors being significant at multivariate analysis. More research with longer follow up should be done to assess the long-term outcomes among late preterms.