Impact of the use of surfactant and Nasal CPAP in the reduction of mortality among very low birth weight pretermbabies in Ile-Ife, south westernNigeria

Abstract

Abstract: Background: Respiratory distress syndrome causes
significant morbidity and death
especially among very low birth
weight babies. Though the use of
CPAP and surfactant have been
shown to improve survival, these
interventions were scarcely available in the past. This study aimed
at comparing the clinical outcomes of preterm babies with
RDS delivered at the Ife Hospital
Unit of the Obafemi Awolowo
University Teaching Hospitals
Complex at two different periods.
Objective: To compare the birth
weight specific mortality rates and
overall mortality rates of preterm
babies with RDS between two
periods in the neonatal ward of
the Ife Hospital Unit of
OAUTHC.
Methods: A retrospective study
comparing outcomes of 92 babies
with RDS at GA 26 to 33+6 weeks
between January 2015 and May
2016 and managed with intranasal
oxygen alone to 104 babies of
same gestational age characteristics between January 2019 and
May 2020 who were managed with
CPAP/surfactant.
Results: The mean weight and
gestational age of the babies respectively were 1.36 (±0.37) kg
and 31.14 (±2.3) weeks in
2015/2016 and 1.35 (±0.322) kg
and 30.95 (±2.24) weeks in
2019/2020. The overall case fatality rate and birth-weight specific
mortality rates for ELBW, VLBWand LBW were 33.7%, 62.5%,
35.2% and 9.1% in 2015/2016 and
18.3%, 58.3%, 15.5% and 9.7%
respectively in 2019/2020.
Conclusion: While the use of
CPAP and the administration of
surfactant clearly show improved
survival among very low birth
weight babies who are at increased
risk of death from RDS, this was
not the case for extreme low birth
weight babies.
Keywords Very low birth weight,
surfactant, CPAP, preterm mortality, respiratory distress syndrome,
low-cost