Magnitude, Risk Factors, and Outcome of Neonates Who Develop Sclerema Neonatorum at Tikur Anbessa Specialized Hospital and Gandhi Memorial Hospital, Addis Ababa, Ethiopia
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Date
2024-04
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Addis Ababa University
Abstract
Background: The classic description of sclerema neonatorum (SN) is credited to Underwood, who
described it in 1784 and appropriately termed it "skin bound disease." In 1817, Alibert introduced
the term sclerema, derived from the Greek word skleros, meaning hard. Sclerema neonatorum is a
disorder of the subcutaneous fat in debilitated neonates and is considered best as a sign of a poten-
tially fatal underlying disease process and not a specific disease entity.
Sclerema neonatorum is an uncommon severe panniculitis that manifests as a diffuse skin harden-
ing in critically ill, premature, and low-birth weight infants. SN is a disease of the subcutaneous ad-
ipose tissue. It is characterized by hardening of the skin that gets bound down to the underlying
muscle and bone, hindering respiration and feeding and is associated with congenital anomalies,
cyanosis, respiratory illnesses and sepsis.
Objectives: To determine the magnitude, risk factors and outcome of neonates who develop
sclerema neonatorum at TASH and GMH, Addis Ababa, Ethiopia in the year 2023/24
Methods: An institutional based, observational and cross-sectional study with prospective data col-
lection. The study period was from 1st May 2023 to 31st January, 2024 at the NICU of TASH and
GMH. Using single population proportion formula with a 95% level of confidence and 5% preci-
sion the sample size required is 422 but due to the condition being rare convenience sampling
method is used and all neonates who develop the condition during the study period were includ-
ed. Data was entered into Statistical Package for Social Sciences version 26 (SPSS) for subsequent
descriptive statistics where applicable.
RESULT: A survey of 52 neonates who developed sclerema neonatorum, admitted to NICU of
TASH and GMH was done, the majority 41(78.8%) of the neonates end up in death. nearly half
of the neonates 29(55.8%) were 1500-2499 gm at birth. About one-third of neonates (34.6%)
were born at gestational age of 34 – 36+6 weeks, and a quarter (26.9%) born at 32 – 33+6 weeks
CONCLUSION: nearly three-fourth of neonates who developed sclerema neonatorum died
from the condition. Since sclerema neonatorum is a devastating condition prompt diagnosis and
quick intervention is of paramount importance.
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Keywords
Sclerema Neonatorum, Sepsis, Outcome