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Table 2 Mortality of newborns treated at the facility before and after the transition

From: Improved referral and survival of newborns after scaling up of intensive care in Suriname

 

Period 1 (N = 320)

(July 2014–March 2015)

Period 2 (N = 281)

(April 2015–December 2015)

Relative Risk (95% CI)

P-value

N

%

N

%

Overall mortality

Total at AHP (per 1000 live births)a

23.4

 

13.2

 

0.56 (0.36–0.90)

0.02

Total at facility

55/320

17.2

30/281

10.7

0.62 (0.41–0.94)

0.02

 Total early neonatal mortality

29/320

9.1

18/281

6.4

0.70 (0.40–1.24)

0.23

 Total late neonatal mortality

26/320

8.1

12/281

4.3

0.53 (0.27–1.02)

0.06

 Inborn

42/284

14.8

20/217

9.2

0.62 (0.38–1.03)

0.07

 Outborn

13/36

36.1

10/64

15.6

0.43 (0.21–0.89)

0.02

 Newborns with NICU level care

52/159

32.7

29/172

16.9

0.52 (0.35–0.77)

<0.01

Gestational age-specific mortality

<28 weeks

6/16

37.5

8/13

61.5

1.64 (0.76–3.53)

0.20

28–32 weeks

12/48

25.0

5/47

10.6

0.43 (0.16–1.11)

0.08

33–36 weeks

14/114

12.3

4/100

4.0

0.33 (0.11–0.96)

0.04

≥37 weeks

20/132

15.2

8/110

7.3

0.48 (0.22–1.05)

0.07

 Missing

3

 

5

   

Birth weight-specific mortality

<1000 g

10/26

38.5

8/23

34.8

0.90 (0.43–1.90)

0.79

≥1000–1499 g

13/48

27.1

6/33

18.2

0.67 (0.28–1.59)

0.36

≥1500 g

30/242

12.4

16/221

7.2

0.58 (0.33–1.04)

0.07

 Missing

2

 

0

   

Cause-specific mortality

Sepsisb

19/96

19.8

8/109

7.3

0.37 (0.17–0.81)

0.01

 Early-onset sepsis

10/44

22.7

3/59

5.1

0.22 (0.07–0.77)

0.02

 Late-onset sepsis

9/52

17.3

5/50

10.0

0.58 (0.21–1.61)

0.29

Perinatal asphyxia

12/38

31.6

2/30

6.7

0.21 (0.51–0.87)

0.03

Prematurity complicationsc

7/157

4.5

5/148

3.4

0.76 (0.25–2.34)

0.63

Congenital malformationsd

12/42

28.6

9/35

25.7

0.90 (0.43–1.88)

0.78

Othere

5

 

6

   
  1. AHP Academic Hospital Paramaribo, NICU neonatal intensive care unit
  2. aIncluding deaths at the delivery room (13 before and 6 after the transition)
  3. bIncludes: newborns with clinical suspicion, treated with antibiotics for 7 days, raised c-reactive protein levels, and positive blood culture
  4. cIncludes: respiratory insufficiency or pneumothorax with RDS and extreme prematurity, necrotizing enterocolitis; intraventricular hemorrhage
  5. dIncludes: diaphragmatic hernia, congenital heart defects, gastro-intestinal anomalies and neurological malformations
  6. eIncludes: persistent pulmonary hypertension of the neonate (PPHN), pneumothorax, cardiac tamponade, and kernicterus