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Newborn Transport Practices: Influence on Newborn Survival in Benin City, Nigeria

Received: 11 July 2020    Accepted: 27 July 2020    Published: 20 August 2020
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Abstract

Objective: To assess the transfer process, modes of transportation, distances covered to access care, condition on arrival, and outcomes of newborns admitted to hospital in Benin City, Nigeria. Methods: This was a cross sectional survey of all consecutively presenting neonates to the children’s emergency unit over a 12-month period. Their demographic information, antepartum and perinatal antecedents, clinical information, main complaint, and co-morbidities were noted on a structured questionnaire. Other information gathered included transfer process, mode of transport, distance covered to reach facility, interventions during transport, condition on arrival, and outcome. Data were analyzed using descriptive statistics, frequencies, and chi-square comparisons; significance was set at P<0.05. Results: Responsible persons for 115 babies—73 males and 42 females—completed the questionnaire. Of the newborns, 62 (53.9%) were of normal birth weight and 43 (37.3%) of low birth weight; of these 37 (32.2%) were preterm. Most cases arrived from peripheral hospitals without referral notes or prior contact with the receiving hospitals. There was no organized pre- or intra-transfer stabilization or medical interventions. Patients came mainly with relatives (89%) or healthcare workers (10%). They arrived in private cars (81%), and were not kept in warm clothes. Distance covered was 10-20 km for more than 50% and over 100 km for less than 8%. Perinatal asphyxia was the commonest reason for transfer (14%). Lower gestational age and cyanosis on presentation significantly affected survival, as only 13 of 25 (52%) with cyanosis and 23 of 37 (62.2%) preterm babies survived. Overall mortality was 30/ 115 (26.1%), and preterm mortality was significantly higher at 14/37 (37.8%). Conclusions: The neonatal transfer process is poorly developed. Prior contact with receiving hospitals is infrequent. Staffing, monitoring, and stabilizing interventions during transfer of sick newborns are inadequate. Transfer mode might have affected survival of preterm infants in particular.

Published in American Journal of Pediatrics (Volume 6, Issue 3)
DOI 10.11648/j.ajp.20200603.39
Page(s) 346-352
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Neonatology, Newborn Transport, Infant Survival, Nigeria

References
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  • APA Style

    Ikechukwu Richard Okonkwo, Blessing Imuetinyan Abhulimhen-Iyoha, Angela Anene Okolo. (2020). Newborn Transport Practices: Influence on Newborn Survival in Benin City, Nigeria. American Journal of Pediatrics, 6(3), 346-352. https://doi.org/10.11648/j.ajp.20200603.39

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    ACS Style

    Ikechukwu Richard Okonkwo; Blessing Imuetinyan Abhulimhen-Iyoha; Angela Anene Okolo. Newborn Transport Practices: Influence on Newborn Survival in Benin City, Nigeria. Am. J. Pediatr. 2020, 6(3), 346-352. doi: 10.11648/j.ajp.20200603.39

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    AMA Style

    Ikechukwu Richard Okonkwo, Blessing Imuetinyan Abhulimhen-Iyoha, Angela Anene Okolo. Newborn Transport Practices: Influence on Newborn Survival in Benin City, Nigeria. Am J Pediatr. 2020;6(3):346-352. doi: 10.11648/j.ajp.20200603.39

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  • @article{10.11648/j.ajp.20200603.39,
      author = {Ikechukwu Richard Okonkwo and Blessing Imuetinyan Abhulimhen-Iyoha and Angela Anene Okolo},
      title = {Newborn Transport Practices: Influence on Newborn Survival in Benin City, Nigeria},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {3},
      pages = {346-352},
      doi = {10.11648/j.ajp.20200603.39},
      url = {https://doi.org/10.11648/j.ajp.20200603.39},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200603.39},
      abstract = {Objective: To assess the transfer process, modes of transportation, distances covered to access care, condition on arrival, and outcomes of newborns admitted to hospital in Benin City, Nigeria. Methods: This was a cross sectional survey of all consecutively presenting neonates to the children’s emergency unit over a 12-month period. Their demographic information, antepartum and perinatal antecedents, clinical information, main complaint, and co-morbidities were noted on a structured questionnaire. Other information gathered included transfer process, mode of transport, distance covered to reach facility, interventions during transport, condition on arrival, and outcome. Data were analyzed using descriptive statistics, frequencies, and chi-square comparisons; significance was set at PResults: Responsible persons for 115 babies—73 males and 42 females—completed the questionnaire. Of the newborns, 62 (53.9%) were of normal birth weight and 43 (37.3%) of low birth weight; of these 37 (32.2%) were preterm. Most cases arrived from peripheral hospitals without referral notes or prior contact with the receiving hospitals. There was no organized pre- or intra-transfer stabilization or medical interventions. Patients came mainly with relatives (89%) or healthcare workers (10%). They arrived in private cars (81%), and were not kept in warm clothes. Distance covered was 10-20 km for more than 50% and over 100 km for less than 8%. Perinatal asphyxia was the commonest reason for transfer (14%). Lower gestational age and cyanosis on presentation significantly affected survival, as only 13 of 25 (52%) with cyanosis and 23 of 37 (62.2%) preterm babies survived. Overall mortality was 30/ 115 (26.1%), and preterm mortality was significantly higher at 14/37 (37.8%). Conclusions: The neonatal transfer process is poorly developed. Prior contact with receiving hospitals is infrequent. Staffing, monitoring, and stabilizing interventions during transfer of sick newborns are inadequate. Transfer mode might have affected survival of preterm infants in particular.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Newborn Transport Practices: Influence on Newborn Survival in Benin City, Nigeria
    AU  - Ikechukwu Richard Okonkwo
    AU  - Blessing Imuetinyan Abhulimhen-Iyoha
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    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajp.20200603.39
    DO  - 10.11648/j.ajp.20200603.39
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    EP  - 352
    PB  - Science Publishing Group
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    UR  - https://doi.org/10.11648/j.ajp.20200603.39
    AB  - Objective: To assess the transfer process, modes of transportation, distances covered to access care, condition on arrival, and outcomes of newborns admitted to hospital in Benin City, Nigeria. Methods: This was a cross sectional survey of all consecutively presenting neonates to the children’s emergency unit over a 12-month period. Their demographic information, antepartum and perinatal antecedents, clinical information, main complaint, and co-morbidities were noted on a structured questionnaire. Other information gathered included transfer process, mode of transport, distance covered to reach facility, interventions during transport, condition on arrival, and outcome. Data were analyzed using descriptive statistics, frequencies, and chi-square comparisons; significance was set at PResults: Responsible persons for 115 babies—73 males and 42 females—completed the questionnaire. Of the newborns, 62 (53.9%) were of normal birth weight and 43 (37.3%) of low birth weight; of these 37 (32.2%) were preterm. Most cases arrived from peripheral hospitals without referral notes or prior contact with the receiving hospitals. There was no organized pre- or intra-transfer stabilization or medical interventions. Patients came mainly with relatives (89%) or healthcare workers (10%). They arrived in private cars (81%), and were not kept in warm clothes. Distance covered was 10-20 km for more than 50% and over 100 km for less than 8%. Perinatal asphyxia was the commonest reason for transfer (14%). Lower gestational age and cyanosis on presentation significantly affected survival, as only 13 of 25 (52%) with cyanosis and 23 of 37 (62.2%) preterm babies survived. Overall mortality was 30/ 115 (26.1%), and preterm mortality was significantly higher at 14/37 (37.8%). Conclusions: The neonatal transfer process is poorly developed. Prior contact with receiving hospitals is infrequent. Staffing, monitoring, and stabilizing interventions during transfer of sick newborns are inadequate. Transfer mode might have affected survival of preterm infants in particular.
    VL  - 6
    IS  - 3
    ER  - 

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Author Information
  • Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria

  • Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria

  • Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria; Federal Medical Center, Department of Pediatrics, Asaba, Nigeria

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