A comparative study between the outcome of very low birth weight and low birth weight hospitalized babies

Background: Mortality and morbidity among low birth weight babies are a major public health problem in our country. The objective of care is to protect these infants from these hazards in the first days and weeks of life. It is important to identify risk factors associated with LBW & VLBW. Objective: The present hospital based clinical prospective study was designed to investigate the factors associated with very low birth weight and their comparative morbidity and mortality with that of low birth weight and its adverse outcome. Method: One hundred (100) low birth weight babies were studied, among which 50 were weighed <1500 gm and 50 were 1500-2500 gm who were admitted in the special baby care unit of Dhaka Shishu Hospital during July 2004 to June 2005. Detailed history was recorded from the mother or attendants. Admission weight of the babies was recorded and gestational age was determined by maternal records. Anthropometric indices, socioeconomic status & demographic data were recorded. Informed consent was taken from the participating mothers. Clinical presentation during hospital stay and outcome were compared. Results: VLBW (86%) and LBW (84%) were significantly proportional to the gestational age (p<0.001). Higher incidence of VLBW is significantly related to mode of delivery (p<0.01), trauma during pregnancy (p<0.001) and multiple pregnancy (p<0.05). Abnormal presentation, toxaemia of pregnancy and caesarian section were more common in LBW than VLBW babies. 50.9% of VLBW and 49.1% LBW were admitted only due to their prematurity. Regarding the clinical profile birth asphyxia was more common in LBW babies (57.10%) than VLBW (42.90%) babies which was statistically highly significant (p<0.001). Anaemia, jaundice, sepsis and apnoea were the commonest presentation during hospital stay. Sepsis, apnoea, DIC, NEC and hypothermia were the more common among VLBW babies. The cause of high mortality of very low birth weight was sepsis, necrotizing enterocolitis (NEC), disseminated intravascular coagulation (DIC). Cure rate was higher in LBW (64.60%) babies than that of VLBW (35.40%) babies and death rate was significantly (p<0.01) higher in VLBW (69.23%) than that of LBW (30.77%) babies. Conclusion: Morbidity and mortality from VLBW & LBW will be reduced considerably by proper health education and improved antenatal care, prompt identification, proper referral, better nursing care and management.