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Perinatal factors associated with admission to neonatal intensive care unit following cesarean delivery in Kano, northern Nigeria

  • Fatima Usman , Fatimah I. Tsiga-Ahmed , Zubaida L. Farouk , Mahmoud J. Gambo , Alhassan D. Mohammed , Abdullahi M. Mohammed , Hamisu M. Salihu and Muktar H. Aliyu
Published/Copyright: January 19, 2022
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 50 Issue 4

Abstract

Objectives

Cesarean section is the most common obstetric surgical procedure, with associated risks for adverse neonatal outcomes. The interplay of perinatal factors associated with neonatal admissions following cesarean delivery remains poorly understood in developing countries. We examined how perinatal and facility-based factors affect Neonatal Intensive Care Unit (NICU) admission after cesarean delivery in northern Nigeria.

Methods

A prospective cohort study involving 200 women undergoing cesarean section were consecutively enrolled with subsequent follow-up of their infants in the post-natal period. Data were abstracted from the medical record using an interviewer-administered questionnaire. The primary outcomes were NICU admission and intrauterine or early neonatal deaths. Binary logistic regression modelling was used to identify variables independently associated with the outcomes.

Results

Over the study period (six months), there were 200 cesarean sections. A total of 30 (15.0%) neonates were admitted into the NICU following the procedure. No stillbirths or early neonatal deaths were recorded. NICU admission was associated with gestational age (preterm vs. term [adjusted odds ratio, aOR: 18.9, 95% confidence interval (CI): 4.0–90.4]), birth weight (small vs. appropriate [aOR: 6.7, 95% CI 1.9–22.7] and large vs. appropriate birth weight [aOR: 20.3, 95% CI 2.9–143.7]) and the number of indications for cesarean section (≥2 vs. one [aOR: 0.2, 95% 0.1–0.8]).

Conclusions

Prematurity, small and large for gestational age neonates; and indications for cesarean section were associated with increased likelihood of neonatal admission following cesarean delivery. These findings could inform ongoing quality enhancement initiatives to improve NICU admission outcomes at the study site, and other similar settings.

Keywords: cesarean delivery; cesarean section; neonatal admission; neonatal outcome; Nigeria; perinatal factors
Corresponding author: Mahmoud J. Gambo, MBBS, FWACP. Department of Pediatrics, Aminu Kano Teaching Hospital & Bayero University, Kano, Nigeria, Phone: +234 8034503932, E-mail: mahmoudjah@yahoo.co.uk

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: Ethical approval was obtained from the AKTH Research Ethics Committee (BUK/CHS/REC/VI/57).

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Received: 2021-08-11
Accepted: 2021-12-18
Published Online: 2022-01-19
Published in Print: 2022-05-25

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. WAPM Guideline
  3. The use of antenatal corticosteroids for fetal maturation: clinical practice guideline by the WAPM-World Association of Perinatal Medicine and the PMF-Perinatal Medicine foundation
  4. Corner of Academy
  5. Chorioamnionitis has no impact on immunohistochemical expression of IL-6 in placental membranes of the late preterm delivery regardless of the membrane status
  6. Original Articles – Obstetrics
  7. Comparison of cardiac morphology and function in small for gestational age fetuses and fetuses with late-onset fetal growth retardation
  8. Effect of SARS-CoV-2 infection on fetal umbilical vein flow and cardiac function: a prospective study
  9. One year into the SARS-CoV-2 pandemic: perinatal outcome and data on the transmission of 116 pregnant women
  10. Adverse perinatal outcomes of chlamydia infections: an ongoing challenge
  11. Pregnancy outcomes with differences in grain consumption: a randomized controlled trial
  12. Who needs prenatal counselling with a pediatric surgeon? Experience from a large tertiary care university hospital
  13. To evaluate the role of placental human papilloma virus (HPV) infection as a risk factor for spontaneous preterm birth: a prospective case control study
  14. Placental characteristics of selective intrauterine growth restriction with changing patterns in umbilical artery Doppler flow in monochorionic diamniotic twins
  15. Association between cesarean section rate and maternal age in twin pregnancies
  16. Maternal and neonatal outcomes associated with delivery techniques for impacted fetal head at cesarean section: a systematic review and meta-analysis
  17. Experience with direct oral anticoagulants in pregnancy – a systematic review
  18. Nasal bone in fetal aneuploidy risk assessment: are they independent markers in the first and second trimesters?
  19. Effects of music on sleep quality and comfort levels of pregnant women
  20. Original Articles – Fetus
  21. Rarity of fetal cells in exocervical samples for noninvasive prenatal diagnosis
  22. Original Articles – Neonates
  23. Effects of oral stimulation with breast milk in preterm infants oral feeding: a randomized clinical trial
  24. Perinatal factors associated with admission to neonatal intensive care unit following cesarean delivery in Kano, northern Nigeria
  25. Letter to the Editor
  26. Intrapartal fetal decapitation after shoulder dystocia – a forensically acceptable or unacceptable complication?
https://doi.org/10.1515/jpm-2021-0409
Keywords for this article
cesarean delivery; cesarean section; neonatal admission; neonatal outcome; Nigeria; perinatal factors

Articles in the same Issue

  1. Frontmatter
  2. WAPM Guideline
  3. The use of antenatal corticosteroids for fetal maturation: clinical practice guideline by the WAPM-World Association of Perinatal Medicine and the PMF-Perinatal Medicine foundation
  4. Corner of Academy
  5. Chorioamnionitis has no impact on immunohistochemical expression of IL-6 in placental membranes of the late preterm delivery regardless of the membrane status
  6. Original Articles – Obstetrics
  7. Comparison of cardiac morphology and function in small for gestational age fetuses and fetuses with late-onset fetal growth retardation
  8. Effect of SARS-CoV-2 infection on fetal umbilical vein flow and cardiac function: a prospective study
  9. One year into the SARS-CoV-2 pandemic: perinatal outcome and data on the transmission of 116 pregnant women
  10. Adverse perinatal outcomes of chlamydia infections: an ongoing challenge
  11. Pregnancy outcomes with differences in grain consumption: a randomized controlled trial
  12. Who needs prenatal counselling with a pediatric surgeon? Experience from a large tertiary care university hospital
  13. To evaluate the role of placental human papilloma virus (HPV) infection as a risk factor for spontaneous preterm birth: a prospective case control study
  14. Placental characteristics of selective intrauterine growth restriction with changing patterns in umbilical artery Doppler flow in monochorionic diamniotic twins
  15. Association between cesarean section rate and maternal age in twin pregnancies
  16. Maternal and neonatal outcomes associated with delivery techniques for impacted fetal head at cesarean section: a systematic review and meta-analysis
  17. Experience with direct oral anticoagulants in pregnancy – a systematic review
  18. Nasal bone in fetal aneuploidy risk assessment: are they independent markers in the first and second trimesters?
  19. Effects of music on sleep quality and comfort levels of pregnant women
  20. Original Articles – Fetus
  21. Rarity of fetal cells in exocervical samples for noninvasive prenatal diagnosis
  22. Original Articles – Neonates
  23. Effects of oral stimulation with breast milk in preterm infants oral feeding: a randomized clinical trial
  24. Perinatal factors associated with admission to neonatal intensive care unit following cesarean delivery in Kano, northern Nigeria
  25. Letter to the Editor
  26. Intrapartal fetal decapitation after shoulder dystocia – a forensically acceptable or unacceptable complication?
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