Factors associated with clinical outcomes among neonates admitted with acute bilirubin and hypoxic-ischaemic encephalopathies at a tertiary hospital in south-west Nigeria

Figures & data

Table 1: Characteristics of the babies with acute bilirubin and hypoxic-ischaemic encephalopathies

		ABE		HIE
Parameters		n	%	n	%
Sex	Male	31	77.5	38	47.5
	Female	9	22.5	42	52.5
Maturity	Preterm	7	17.5	3	3.8
	Term	33	82.5	77	96.2
Orthodox POD	Yes	26	65.0	49	61.3
	No	14	35.0	31	38.7
Type of referral	Official	13	32.5	35	43.7
	Self-	27	67.5	45	56.3
Maternal education	Low^a	33	82.5	48	60.0
	High^b	7	17.5	32	40.0
Paternal education	Low^a	26	65.0	40	50.0
	High^b	14	35.0	40	50.0
SES^c	III	8	20.0	22	27.5
	IV	24	60.0	44	55.0
	V	8	20.0	14	17.5
Details of social issues	Poor finances	10	25.0	13	16.3
	DAMA threats^d	4	10.0	3	3.7
	Separated parents	2	5.0	5	6.2
	Unmarried parents	2	5.0	6	7.5
	Polygamous family setting	0	0.0	16	20.0
	None	22	55.0	40	50.0
Details of intra-facility challenges	No blood in the laboratory	10	25.0	NA	-
	Parents not available to pay	1	2.5	NA	­-
	Laboratory delays	NA	-	15	18.7
	Lack of funds for drugs	NA	-	5	6.3
	Lack of funds for investigations	NA	-	10	12.5
	Lack of electricity	4	10.0	10	12.5
	Materials for EBT out of stock	2	5.0	NA	-
	No EBT due to poor clinical state	6	15.0	NA	-
	Cannulation for EBT not possible	5	12.5	NA	-
	None	12	30.0	37	46.3
Problem of care	Social issues only	8	20.0	13	16.3
	Intra-facility issues only	18	45.0	10	12.5
	Both social and intra-facility issues	10	25.0	32	40.0
	None	4	10.0	25	31.2
Duration of admission	> 168 hours	16	40.0	61	76.3
	≤ 168 hours	24	60.0	19	23.7

ABE: acute bilirubin encephalopathy; HIE: hypoxic-ischaemic encephalopathy; NA: not applicable; EBT: exchange blood transfusion. ^aLow: primary and secondary education. ^bHigh: tertiary education. ^cSocioeconomic status. ^dDAMA threat: disruption of clinical care due to attempts to discharge baby against medical discharge

Table 2: Factors associated with immediate outcome of 31 babies with ABE*

Parameters		Died (n = 12)	Discharged (n = 19)	Statistics
Orthodox POD	Yes	8 (66.7)	11 (57.9)	χ^2 = 0.241^b
	No	4 (33.3)	8 (42.1)	p = 0.624
TSB checked before referral	No	9 (75.0)	16 (84.2)	χ^2 = 0.392^b
	Yes	3 (25.0)	3 (18.8)	p = 0.531
Delay	Early < 48 hours	5 (41.7)	7 (36.8)	χ^2 = 0.072
	Late > 48 hours	7 (58.3)	12 (63.2)	p = 0.788
Type of referral	Official	5 (41.7)	4 (21.0)	χ^2 = 1.494^b
	Self-	7 (58.3)	15 (79.0)	p = 0.222
Maternal education	High	2 (16.7)	2 (10.5)	χ^2 = 0.241^b
	Low	10 (62.3)	17 (89.5)	p = 0.623
Paternal education	High	6 (50.0)	4 (21.0)	χ^2 = 2.793
	Low	6 (50.0)	15 (79.0)	p = 0.095
Home remedy use	No	5 (41.7)	3 (18.8)	χ^2 = 2.529
	Yes	7 (58.3)	16 (84.2)	p = 0.112
Social issue	Absent	7 (58.3)	11 (57.9)	χ^2 = 0.001
	Present	5 (41.7)	8 (42.1)	p = 0.981
Intra-facility challenges	Absent	1 (8.3)	4 (21.0)	χ^2 = 0.951^b
	Present	11 (91.7)	15 (79.0)	p = 0.329
Issues	Both social and intra-facility	4 (33.3)	6 (31.6)
	Intra-facility only	7 (58.4)	9 (47.4)	χ^2 = 1.478
	None	0 (0.0)	2 (10.5)	p = 0.537
	Social only	1 (8.3)	2 (10.5)
SES^a	III	3 (25.0)	2 (10.5)
	IV	5 (41.7)	13 (68.5)	χ^2 = 2.290^b
	V	4 (33.3)	4 (21.0)	p = 0.318
Intervention	EBT	4 (33.3)	17 (89.5)	χ^2 = 10.922^b
	No EBT	8 (66.7)	2 (10.5)	p = 0.01

*Nine babies with DAMA outcome were excluded.

^aSocio-economic status

^bYates’ correction applied.

Table 3: Factors associated with immediate outcome of 77 babies with HIE*

Parameters		Died (n = 16)	Discharged (n = 61)	Statistics
Orthodox POD	Yes	3 (18.8)	28 (45.9)	χ^2 = 4.208**
	No	13 (81.2)	33 (54.1)	p = 0.04
Type of referral	Official	13 (81.2)	19 (31.1)	χ^2 = 13.423**
	Self	3 (18.8)	42 (68.9)	p < 0.001
Delay	Early < 6 hours	0 (0.0)	11 (18.0)	Fisher’s exact test p = 0.107
	Late > 6 hours	16 (100.0)	50 (82.0)
Care prior to referral	Hot water	0 (0.0)	2 (3.3)
	Injection	10 (62.5)	10 (16.4)	χ^2 = 13.064**
	None	6 (37.5)	49 (80.3)	p = 0.001
Maternal education	High	3 (18.8)	26 (42.6)	χ^2 = 3.334**
	Low	13 (81.2)	35 (57.4)	p = 0.068
Paternal education	High	16 (100.0)	23 (37.7)	Fisher’s exact test
	Low	0 (0.0)	38 (62.3)	p < 0.0001
Social issues	Absent	10 (62.5)	27 (44.3)	χ^2 = 1.069**
	Present	6 (37.5)	34 (55.7)	p = 0.586
Intra-facility challenge	Absent	6 (37.5)	28 (45.9)	χ^2 = 0.363
	Present	10 (62.5)	33 (54.1)	p = 0.547
Issues	Both social and intra-facility	5 (31.2)	27 (44.3)
	Intra-facility only	5 (31.2)	5 (8.2)	χ^2 = 19.151
	None	0 (0.0)	22 (36.1)	p < 0.001
	Social only	6 (37.4)	7 (11.4)
SES^a	III	3 (18.8)	19 (31.1)
	IV	10 (62.4)	31 (50.9)	χ^2 = 1.069**
	V	3 (18.8)	11 (18.0)	p = 0.586

*Three babies with DAMA outcome were excluded.

**Yates’ correction applied.

^aSocioeconomic status.