PREVALENCE, RISK FACTORS AND OUTCOMES OF LATE PRETERM AND EARLY TERM NEONATES COMPARED TO FULL-TERM BORN AT GARISSA COUNTY REFERRAL HOSPITAL

Abstract

Late preterm neonates (LPNs) and early term neonates (ETNs) represent substantial proportions of global births. Despite this, the prevalence, risk factors, and neonatal outcomes within these subgroups are understudied in Garissa County, Kenya. The purpose of this study was to determine the prevalence, establish risk factors associated with late preterm, and early term births relative to full-term, their neonatal outcomes, and predictors of their survival at Garissa County Referral Hospital. Utilizing a prospective cohort study design, this research employed convenience sampling to enroll LPNs, ETNs, and full-term neonates (FTNs) as a control group. After obtaining informed consent, data was collected at five distinct time points: days 1, 3, 7, 14, and 28 of neonatal life. A range of maternal and fetal factors, along with neonatal outcomes, were captured using pre-tested, validated structured questionnaires. Data were entered, cleaned, and analyzed using Statistical Package for the Social Sciences version 27 and STATA version 17. Various statistical tests such as Chi-square, independent sample t tests, and Kruskal-Wallis were applied to determine significant differences. Multinomial and ordinal logistic regression models were used to identify potential risk factors, while Kaplan-Meier survival analysis was used to estimate neonatal survival rates. The findings of this study revealed that LPNs, ETNs and FTNs have a prevalence of 8.47%, 11.86% and 9.2%, respectively. Maternal related risk factors associated with birth of LPN, ETN and FTN were maternal age (P=0.042), occupation (P=0.024), ethnicity (P=0.021), religion (P=0.016) and absence of previous abortion/still birth/premature deliveries (P = 0.015). Birth weight was significantly associated with LPN (P=0.00), while FTN had significantly higher likelihood of delayed initiation of breastfeeding (P=0.038) but were less likely to have feeding difficulties compared to LPN and ETN (P=0.012). However, the survival rates were remarkably high across all groups, with 100% for LPNs, 98.7% for ETNs, and 98.2% for FTNs. In conclusion, the study provides vital insights into the prevalence, risk factors, and neonatal outcomes for LPN’s and ETN’s in Garissa County. It further establishes that there is increased likelihood of delay in initiation of breastfeeding among FTN compared to their LPN and ETN counterparts. Nevertheless, the survival rate remains high across all categories. This study underscores the need for targeted interventions to improve outcomes for these vulnerable populations. Key words: Late Preterm Neonate; Early Term Neonate, Full Term Neonate; Morbidity, Mortality, Survival, Garissa