Neonatal Outcomes of Preterm Pre-Eclampsia in a Tertiary Hospital in Northern Nigeria

Abstract

Background:
Preterm birth and preeclampsia (PE) significantly contribute to neonatal mortality, which is unacceptably high in Nigeria. The risks faced by a neonate become compounded if delivered prematurely to halt the progression of PE. This study aimed to determine the neonatal outcomes and associated factors in preterm neonates of mothers with PE in a Nigerian tertiary hospital.

Materials and methods:
A descriptive, retrospective one-year review of neonates born to women with preterm preeclampsia who were managed in the inborn Neonatal Unit of the Ahmadu Bello University Teaching Hospital, Zaria. The case folders were identified, and relevant information was extracted. The data were analyzed using SPSS version 21, and p < 0.05 was considered significant for test of association.

Results:

Forty-seven neonates were studied. The mean birth weight of the neonates was 1.6kg ± (0.43), mean gestational age at delivery was 32.9 weeks (±2.2), and 83% were delivered via caesarean section. Neonatal jaundice (72.5%), neonatal sepsis (72.3%), respiratory distress syndrome (40.4%) and anaemia (36.2%) were the leading morbidities. Birth weight was associated with neonatal mortality (p=0.004). Mortality was increased by about three and eleven-fold in neonates born at <32 weeks of gestation and in those that weighed <1500g (OR 3.1, 95% CI 0.7 13.3; OR 10.8, 95% CI 1.9-59.8) respectively. Birth asphyxia and respiratory distress syndrome were more likely to occur in neonates delivered vaginally (p=0.02 OR 7.6, 95% CI 1.5-39.6 and p= 0.04 OR 6.0, 95% CI 1.0-33.9) respectively.

Conclusion:

Vaginal delivery among mothers with preeclampsia was associated with birth asphyxia and respiratory distress syndrome. Very preterm gestation, very low birth weight and vaginal delivery increased the risk of neonatal mortality. The study highlights the compounded risks faced by preterm neonates of mothers with PE and underscores the need for advanced neonatal care to improve survival rates.