The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa

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dc.contributor.advisorHorn, Alan Ren_ZA
dc.contributor.advisorRhoda, Natasha Ren_ZA
dc.contributor.authorNakibuuka, Victoriaen_ZA
dc.date.accessioned2015-12-09T14:45:21Z
dc.date.available2015-12-09T14:45:21Z
dc.date.issued2015en_ZA
dc.description.abstractBackground: International consensus guidelines recommend that term or near-term newborns with moderate or severe hypoxic ischaemic encephalopathy (HIE) should be treated with induced hypothermia within 6 hours of birth, but many of the affected babies are born outside treatment centers. There are conflicting data describing the influence of birth site on outcome after HIE - and no published data from South Africa. Objective: To compare the frequency of abnormal outcome (mortality or abnormal aEEG) before discharge between inborn and outborn infants treated with hypothermia Methods: This was a retrospective analysis of data extracted from a prospectively collated registry of babies with moderate or severe HIE, treated with hypothermia in a tertiary hospital in South Africa, between 1 January 2011 and 31 December 2012. Results: A total of 57 babies were treated with hypothermia of which 23 (40%) were inborn and 34 (60%) outborn. Cooling was initiated earlier among the inborn babies (age 2.3 hours vs. 4.3 hours, p=0.002). Pregnancy complications and abnormal intrapartum fetal heart rates occurred more frequently in inborn infants (65.2 % vs. 24.2 %, p=0.0001 and 47.8% vs. 20.6%, p =0.03 respectively). More outborn babies died or had an abnormal aEEG at 48 hours (32 % vs. 22 %, p=0.556) and fewer outborn babies achieved normal feeding at discharge (22% vs. 38%, p = 0.189), but these differences were not statistically significant. Conclusion: The majority of infants treated with induced hypothermia in an urban/peri-urban setting in South Africa were not born in a cooling centre. There were significant delays in initiating cooling among the outborn babies. Short-term morbidity and mortality were not significantly different in outborn babies but interpretation is limited by the small sample size.en_ZA
dc.identifier.apacitationNakibuuka, V. (2015). <i>The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/15738en_ZA
dc.identifier.chicagocitationNakibuuka, Victoria. <i>"The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2015. http://hdl.handle.net/11427/15738en_ZA
dc.identifier.citationNakibuuka, V. 2015. The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Nakibuuka, Victoria AB - Background: International consensus guidelines recommend that term or near-term newborns with moderate or severe hypoxic ischaemic encephalopathy (HIE) should be treated with induced hypothermia within 6 hours of birth, but many of the affected babies are born outside treatment centers. There are conflicting data describing the influence of birth site on outcome after HIE - and no published data from South Africa. Objective: To compare the frequency of abnormal outcome (mortality or abnormal aEEG) before discharge between inborn and outborn infants treated with hypothermia Methods: This was a retrospective analysis of data extracted from a prospectively collated registry of babies with moderate or severe HIE, treated with hypothermia in a tertiary hospital in South Africa, between 1 January 2011 and 31 December 2012. Results: A total of 57 babies were treated with hypothermia of which 23 (40%) were inborn and 34 (60%) outborn. Cooling was initiated earlier among the inborn babies (age 2.3 hours vs. 4.3 hours, p=0.002). Pregnancy complications and abnormal intrapartum fetal heart rates occurred more frequently in inborn infants (65.2 % vs. 24.2 %, p=0.0001 and 47.8% vs. 20.6%, p =0.03 respectively). More outborn babies died or had an abnormal aEEG at 48 hours (32 % vs. 22 %, p=0.556) and fewer outborn babies achieved normal feeding at discharge (22% vs. 38%, p = 0.189), but these differences were not statistically significant. Conclusion: The majority of infants treated with induced hypothermia in an urban/peri-urban setting in South Africa were not born in a cooling centre. There were significant delays in initiating cooling among the outborn babies. Short-term morbidity and mortality were not significantly different in outborn babies but interpretation is limited by the small sample size. DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa TI - The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa UR - http://hdl.handle.net/11427/15738 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15738
dc.identifier.vancouvercitationNakibuuka V. The influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africa. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/15738en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Paediatrics and Child Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherNeonatologyen_ZA
dc.titleThe influence of birth site on short-term outcomes of encephalopathic newborn infants treated with therapeutic hypothermia at Groote Schuur Hospital, Cape Town, South Africaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPhilen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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