Facteurs de risque et pronostic hospitalier des nouveau-nés de faible poids de naissance (poids de naissance inférieure à 2500grammes) à l’hôpital gynéco-obstétrique et pédiatrique de Yaoundé, Cameroun

Summary: Introduction: Low birth weight (LBW) neonates have a high morbidity and mortality especially in developing countries. Aim: Identify the risk factors for LBW neonates and outcome following admission in the hospital. Methodology: Retrospective, descriptive, case control study on 980 LBW babies and 980 controls on hospital records of neonates hospitalized in the Yaounde Gynaeco-Obstetric and Paediatric hospital from May 2003 to December 2008. Results: Out of 4712 neonates admitted in the neonatology unit within the study period, 980 were LBWs giving a prevalence of 20.79%. The incidence of LBWs varied over the years with a peak of 32.24 to 37.45% observed between 2003 and 2004, and dropping thereafter to 13.13% in 2008. Hypotrophic premature neonates (85.6%) were more frequently observed than those born at term (14.4%), and occurred respectively at 6.3%, 24.2%, 55.1% and 14.4% for gestational ages of less than 28, 28–32, 32–36, and 37weeks or more. Hypotrophic prematures were significantly more than hypotrophic term neonates with a prevalence of 85.6% against 14.4% (P <0.001). Gestational ages ranged from 26 to 42weeks of amenorrhea, and birth weights from 960 to 2472grams. Significant risk factors were: mother''s age less than 20years, low level of education, primiparity, prenatal visits less than four, multiple pregnancies, malaria, urogenital infections, hypertension, and anemia during pregnancy. The mortality rate was 37.7%, with 79.04% of the deaths occurring in the early neonatal period. Risk factors for death were: multiple pregnancies, very LBWs, grand prematurity, deliveries in lower level health facilities, transfers from other health facilities, and an Apgar score less than 7 in the first minute (58.2%) and fifth minute (62.6%). Mortality was highest in the premature neonates with neonatal sepsis the leading cause of death, followed by neonatal asphyxia, and congenital malformations. Conclusions: The survival of low birth weight neonates can be improved upon by educating the young girl at reproductive age on the necessity for adequate follow-up of pregnancy and providing health facilities with well-trained health personnel and equipment for the proper management of LBW neonates. [Copyright &y& Elsevier]