Factors associated with mortality of premature babies with respiratory distress syndrome put on bubble continuous positive airway pressure at Kamuzu Central Hospital, Lilongwe-Malawi
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Date
2022-06-15
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Kamuzu University of Health Sciences
Abstract
Type of study: Retrospective cross-sectional study
Background: Respiratory distress syndrome (RDS) is a breathing disorder that often
occurs in babies that are born less than 37 gestational weeks (premature babies). It
occurs as a result of immature lung development and the clinical features include
cyanosis, fast breathing chest in drawings, and grunting respirations. One aspect of
management of RDS includes the application of bubble continuous positive airway
pressure (bCPAP) to expand the collapsed alveoli, thereby improving the work of
breathing.
Problem to be studied: The use of bCPAP has shown a decrease in morbidity and
mortality for premature babies on global level, however, in Malawi a significant number
still die despite receiving bCPAP. While studies have examined the factors associated
with mortality of premature babies with RDS who receive bCPAP, few have been done
in Malawi, and none have been conducted at Kamuzu Central Hospital, given it’s a new
intervention. This study will add evidence to how bCPAP can be used effectively to
prevent neonatal death.
Broad objective of the study:
To determine maternal and neonatal factors associated with mortality of
premature babies with RDS put on bCPAP between January 2019 to December 2021 at
Kamuzu Central Hospital in Lilongwe, Malawi
Specific objectives of the study:
To examine maternal factors associated with mortality of premature babies with
RDS put on bCPAP between January 2019 to December 2021 at Kamuzu Central
Hospital in Lilongwe, Malawi
To identify neonatal factors associated with mortality of premature babies with
RDS put on bCPAP between January 2019 to December 2021 at Kamuzu Central
Hospital in Lilongwe, Malawi
Methodology: This study is a retrospective, cross sectional study conducted in the
neonatal unit at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi. This study will
employ retrospective chart reviews of premature neonates to collect both maternal and
neonatal factors that can be associated with mortality for premature babies receiving
bCPAP. The study population are the premature neonates with RDS that were put on
bCPAP at KCH neonatal unit between January 2019 and December 2021.The risk
factors will be derived from careful review of the literature with consideration of the
routine data collected during the neonate’s hospital stay. Data extraction sheet will be
used for data collection. Data will be imported into Stata 16 software package andregression analysis will be performed to identify the statistically significant factors
associated with mortality for this population.
Expected findings and dissemination: Given the high rate of premature birth in
Malawi, the results of this study have the potential to significantly impact neonatal
outcomes This study addresses why premature neonates are still dying in Malawi,
despite receiving bCPAP. Understanding of these factors will be used to inform changes
that will help to improve outcomes of premature babies with respiratory distress
syndrome put on bCPAP. The findings of this study will provide evidence to identify
premature neonates on bCPAP who are at risk of dying and support a change in
interventions to prevent neonatal death. Results will be disseminated to COMREC,
KCH, CPAP project through Ministry of Health and an open access publication in a
journal.