PT  - JOURNAL ARTICLE
AU  - Anna Karin Ahlsén
AU  - Elinor Spong
AU  - Nomsa Kafumba
AU  - Francis Kamwendo
AU  - Kerstin Wolff
TI  - Born too small: who survives in the public hospitals in Lilongwe, Malawi?
AID  - 10.1136/archdischild-2013-305877
DP  - 2015 Mar 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - F150--F154
VI  - 100
IP  - 2
4099  - http://fn.bmj.com/content/100/2/F150.short
4100  - http://fn.bmj.com/content/100/2/F150.full
SO  - Arch Dis Child Fetal Neonatal Ed2015 Mar 01; 100
AB  - Objective Malawi has the highest estimated preterm birth rate in the world. The survival rate of these babies is not known. The main objective of this study was to demonstrate the short-term survival of infants with birth weight below 2500 g nursed in Bwaila Hospital, a district hospital, and the tertiary level Kamuzu Central Hospital (KCH) in Lilongwe. The specific objectives were to calculate birth weight specific survival rates, compare the two hospitals regarding the chances of survival and review the use of antenatal corticosteroids. Design 1496 babies were included prospectively in the study between June and November 2012. Survival was defined as discharge from the nursery or postnatal ward. Results Survival was 7% for extremely low birth weight infants, 52% for very low birth weight and 90% for low birth weight (1500–2499 g). There was a marked increase in survival from 1100 g. Survival was significantly higher in KCH only for babies weighing below 1200 g. The majority of deaths occurred within the first 3 days of life. Only 98 of the babies had a mother who had received antenatal corticosteroids. Conclusions With the current resources, we suggest focusing efforts on preventing early neonatal deaths in low birth weight infants above 1100 g in the hospitals in Lilongwe. The coverage of antenatal steroids for mothers at risk of preterm delivery can be improved. Further studies are needed on the quality of the obstetric and neonatal care at the hospitals and how to reduce the high rate of preterm birth in Malawi.