Factors associated with respiratory distress in the newborn, Harare maternity hospital, 2013
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Introduction: Globally, 4 million babies die each year in the first four weeks of life, the neonatal period. Neonatal deaths account for nearly 40% of deaths worldwide in children less than five years old. Neonatal Respiratory Distress is among the leading causes of neonatal morbidity and mortality. Previous studies at Harare Maternity Hospital have shown that a ratio of one to three newborns admitted to the neonatal unit was diagnosed with respiratory distress. The objective of this study was to assess factors associated with contracting respiratory distress in the newborn at Harare Maternity Hospital. Methods: An unmatched 2: 1 case-control study (70 cases and 140 controls) was conducted at Harare Maternity Hospital, where all single deliveries occurring during the period under study constituted our study population. A case was defined as any live birth diagnosed with respiratory distress at birth. A control was defined as any live birth with no diagnosis of respiratory distress at birth. All cases on a day were recruited; controls were randomly selected using lottery method. A semi-structured questionnaire was administered to collect data from mothers. Data was extracted from delivery registers and maternity patient record. Results A total of 210 mothers were interviewed. The median age was 28 years for mothers of cases (Q1 22; Q 2 30), 26 years for those of controls(Q 121; Q 3 30). Factors associated with respiratory distress in the newborn were: Prolonged rupture of the membranes for more than 24 hours before onset of labour (OR 6.9; 95% CI 2.57-18.67; p <0.0001 ); Gestational age below 37 weeks (OR 5.74; 95% CI 2.60-12.68; p 0.0001); Low birth weight (less than 2500 grams) (OR 9.75; 95% CI 4.11-23.10; p <0.0001 ). Conclusion Prolonged rupture of the fetal membranes for more than 24 hours before onset of labour was found to be an independent risk factor for respiratory distress in the newborn at Harare Maternity Hospital. Meanwhile, further studies are needed in order to investigate on the causes of premature rupture of the membranes.