Survival and Determinants of Mortality among Extremely Low Birth Weight Newborns in a Tertiary Hospital in Burkina Faso

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Résumé

Introduction: Neonatal mortality remains a major global public health challenge.
Extremely low birth weight (ELBW) newborns (<1000 g) represent the
most vulnerable group, particularly in low-resource settings. This study aimed
to evaluate hospital survival and identify determinants of mortality among
ELBW newborns hospitalized in a tertiary hospital in Burkina Faso. Methods:
A retrospective analytical cohort study was conducted in the neonatal unit of
Yalgado Ouédraogo University Hospital between October 2021 and September
2024. All newborns with a birth weight <1000 g and an exploitable medical
record were included. Survival probabilities were estimated using the Kaplan-
Meier method. Determinants of mortality were identified using multivariate
logistic regression. Results: A total of 110 ELBW newborns were included. The
mean birth weight was 810 g (range 500 - 990 g) and the mean gestational age
was 29 weeks (22 - 34 weeks). Overall hospital mortality was 71%. Kaplan–
Meier analysis showed survival probabilities of 72% at 24 hours, 48% at 7 days,
and 29% at 28 days. The median survival time was 4 days. Independent factors
associated with mortality were male sex (OR 3.92 [1.34 - 11.49]), respiratory
distress (OR 3.39 [1.14 - 10.04]), while birth weight ≥900 g was associated with
improved survival (OR 0.20 [0.05 - 0.87]). Conclusion: Survival among ELBW
newborns remains extremely limited in this resource-constrained setting.
Strengthening perinatal care, early respiratory support, and neonatal intensive
care capacities is essential to improve outcomes.

Mots-clés

Extremely Low Birth Weight Infants, Neonatal Mortality, Prematurity, Survival Analysis, Low-Resource Setting, Burkina Faso