SPECIAL CARE BABY UNIT NEONATAL DISEASE OUTCOMES IN A TERTIARY HOSPITAL IN NIGERIA: 2-YR RETROSPECTIVE CROSS-SECTIONAL ANALYSIS

ABSTRACT BACKGROUND Neonatal diseases contribute significantly to global under-five mortality. The highest neonatal mortality rate in sub-Saharan Africa can be traced to Nigeria. This study aims to evaluate the outcomes of neonatal admissions in a select tertiary hospital in Nigeria. METHODS A retrospective analysis of data collected on 656 neonates admitted in the special care baby unit of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nigeria over a period of 2 years (January 2021and December 2022). Descriptive analysis and inferential statistics were done at p<0.05 using SPSS version 25. RESULTS Median age at presentation was 4 hours (interquartile range 0.5,24) hours. The Median duration of hospital stay was 6 days (interquartile range 3,11). The commonest morbidities were perinatal asphyxia (n=295/656; 45.0%) and prematurity (n=158/656; 24%); while congenital anomalies (n=22/47; 46.8%), perinatal asphyxia (n=73/295; 24.7%) and prematurity (n=35/158; 22.2%) had the highest case fatality rates. Gestational age at birth, duration of hospital stay, place of delivery, and mode of delivery were the variables determined to be statistically associated with outcome of care. CONCLUSION This study showed a mortality of 22.9% (n=150/656) in our study area with perinatal asphyxia (48.7%; n=73/150), prematurity (24.0%; n=36/150), congenital anomalies (11.3%; n=22/150), and neonatal sepsis (6.7%; n=10/150) as the primary causes. This work highlights the need for emergency care of critically ill newborns through financing transition from special care baby unit to neonatal intensive care unit across tertiary institutions in Nigeria. KEY MESSAGES What is already known on this topic Poor outcome of neonatal disease is associated with lack of quality care at birth or skilled care and treatment immediately after birth and in the first days of life. Premature birth, birth asphyxia, neonatal infections and congenital anomalies are the prominent causes of neonatal deaths. What this study adds Case fatality rate, mortality rate and duration of hospital stay were the primary outcomes assessed in a spectrum of neonatal disease. Higher mortality was recorded among neonates within the first 7days of hospital stay. How this study might affect research, practice, or policy (implications) Our work informs the need for transition from special care baby unit to neonatal intensive care unit across tertiary institutions in Nigeria to enable comprehensive care for critically ill neonates or neonates with severe neonatal morbidities. Creates awareness on the need for incorporation of processes that enable safeguarding of neonatal hospital records for tracking of trends and research.