Transfer of newborns to neonatal care unit: a registry based study in Northern Tanzania
<p>Abstract</p> <p>Background</p> <p>Reduction in neonatal mortality has been slower than anticipated in many low income countries including Tanzania. Adequate neonatal care may contribute to reduced mortality. We studied factors associated with transfer of babies to a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2011-10-01
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| Series: | BMC Pregnancy and Childbirth |
| Online Access: | http://www.biomedcentral.com/1471-2393/11/68 |
| _version_ | 1818792147678134272 |
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| author | Kibiki Gibson S Lie Rolv T Mmbaga Blandina T Olomi Raimos Kvåle Gunnar Daltveit Anne K |
| author_facet | Kibiki Gibson S Lie Rolv T Mmbaga Blandina T Olomi Raimos Kvåle Gunnar Daltveit Anne K |
| author_sort | Kibiki Gibson S |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Reduction in neonatal mortality has been slower than anticipated in many low income countries including Tanzania. Adequate neonatal care may contribute to reduced mortality. We studied factors associated with transfer of babies to a neonatal care unit (NCU) in data from a birth registry at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania.</p> <p>Methods</p> <p>A total of 21 206 singleton live births registered from 2000 to 2008 were included. Multivariable analysis was carried out to study neonatal transfer to NCU by socio-demographic factors, pregnancy complications and measures of the condition of the newborn.</p> <p>Results</p> <p>A total of 3190 (15%) newborn singletons were transferred to the NCU. As expected, neonatal transfer was strongly associated with specific conditions of the baby including birth weight above 4000 g (relative risk (RR) = 7.2; 95% confidence interval (CI) 6.5-8.0) or below 1500 g (RR = 3.0; 95% CI: 2.3-4.0), five minutes Apgar score less than 7 (RR = 4.0; 95% CI: 3.4-4.6), and preterm birth before 34 weeks of gestation (RR = 1.8; 95% CI: 1.5-2.1). However, pregnancy- and delivery-related conditions like premature rupture of membrane (RR = 2.3; 95% CI: 1.9-2.7), preeclampsia (RR = 1.3; 95% CI: 1.1-1.5), other vaginal delivery (RR = 2.2; 95% CI: 1.7-2.9) and caesarean section (RR = 1.9; 95% CI: 1.8-2.1) were also significantly associated with transfer. Birth to a first born child was associated with increased likelihood of transfer (relative risk (RR) 1.4; 95% CI: 1.2-1.5), while the likelihood was reduced (RR = 0.5; 95% CI: 0.3-0.9) when the father had no education.</p> <p>Conclusions</p> <p>In addition to strong associations between neonatal transfer and classical neonatal risk factors for morbidity and mortality, some pregnancy-related and demographic factors were predictors of neonatal transfer. Overall, transfer was more likely for babies with signs of poor health status or a complicated pregnancy. Except for a possibly reduced use of transfer for babies of non-educated fathers and a high transfer rate for first born babies, there were no signs that transfer was based on non-medical indications.</p> |
| first_indexed | 2024-12-18T15:22:38Z |
| format | Article |
| id | doaj.art-b2bc22c629624913be5fb7040b2c4442 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-18T15:22:38Z |
| publishDate | 2011-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-b2bc22c629624913be5fb7040b2c44422022-12-21T21:03:21ZengBMCBMC Pregnancy and Childbirth1471-23932011-10-011116810.1186/1471-2393-11-68Transfer of newborns to neonatal care unit: a registry based study in Northern TanzaniaKibiki Gibson SLie Rolv TMmbaga Blandina TOlomi RaimosKvåle GunnarDaltveit Anne K<p>Abstract</p> <p>Background</p> <p>Reduction in neonatal mortality has been slower than anticipated in many low income countries including Tanzania. Adequate neonatal care may contribute to reduced mortality. We studied factors associated with transfer of babies to a neonatal care unit (NCU) in data from a birth registry at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania.</p> <p>Methods</p> <p>A total of 21 206 singleton live births registered from 2000 to 2008 were included. Multivariable analysis was carried out to study neonatal transfer to NCU by socio-demographic factors, pregnancy complications and measures of the condition of the newborn.</p> <p>Results</p> <p>A total of 3190 (15%) newborn singletons were transferred to the NCU. As expected, neonatal transfer was strongly associated with specific conditions of the baby including birth weight above 4000 g (relative risk (RR) = 7.2; 95% confidence interval (CI) 6.5-8.0) or below 1500 g (RR = 3.0; 95% CI: 2.3-4.0), five minutes Apgar score less than 7 (RR = 4.0; 95% CI: 3.4-4.6), and preterm birth before 34 weeks of gestation (RR = 1.8; 95% CI: 1.5-2.1). However, pregnancy- and delivery-related conditions like premature rupture of membrane (RR = 2.3; 95% CI: 1.9-2.7), preeclampsia (RR = 1.3; 95% CI: 1.1-1.5), other vaginal delivery (RR = 2.2; 95% CI: 1.7-2.9) and caesarean section (RR = 1.9; 95% CI: 1.8-2.1) were also significantly associated with transfer. Birth to a first born child was associated with increased likelihood of transfer (relative risk (RR) 1.4; 95% CI: 1.2-1.5), while the likelihood was reduced (RR = 0.5; 95% CI: 0.3-0.9) when the father had no education.</p> <p>Conclusions</p> <p>In addition to strong associations between neonatal transfer and classical neonatal risk factors for morbidity and mortality, some pregnancy-related and demographic factors were predictors of neonatal transfer. Overall, transfer was more likely for babies with signs of poor health status or a complicated pregnancy. Except for a possibly reduced use of transfer for babies of non-educated fathers and a high transfer rate for first born babies, there were no signs that transfer was based on non-medical indications.</p>http://www.biomedcentral.com/1471-2393/11/68 |
| spellingShingle | Kibiki Gibson S Lie Rolv T Mmbaga Blandina T Olomi Raimos Kvåle Gunnar Daltveit Anne K Transfer of newborns to neonatal care unit: a registry based study in Northern Tanzania BMC Pregnancy and Childbirth |
| title | Transfer of newborns to neonatal care unit: a registry based study in Northern Tanzania |
| title_full | Transfer of newborns to neonatal care unit: a registry based study in Northern Tanzania |
| title_fullStr | Transfer of newborns to neonatal care unit: a registry based study in Northern Tanzania |
| title_full_unstemmed | Transfer of newborns to neonatal care unit: a registry based study in Northern Tanzania |
| title_short | Transfer of newborns to neonatal care unit: a registry based study in Northern Tanzania |
| title_sort | transfer of newborns to neonatal care unit a registry based study in northern tanzania |
| url | http://www.biomedcentral.com/1471-2393/11/68 |
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