Outcome of Apnea Management With Aminophylline and Associated Factors Among Preterm Infants Admitted to Public Hospitals, Addis Ababa, Ethiopia, 2024: Retrospective Study
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Date
2024-09-18
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Addis Ababa University
Abstract
Background: Prematurity (birth before 37 weeks of gestation) can lead to serious complications. One
such complication is apnea (a temporary cessation of breathing) and this complication can be fatal.
Management of apnea with Aminophylline among preterm babies has shown a promise by stimulating
the respiratory center and improving respiratory function. But evidences on the outcome of
aminophylline use for treatment of apnea in preterm babies is scanty in developing countries, like
Ethiopia.
Objective: This study aimed at assessing the outcome of aminophylline use for management of apnea
and associated factors among preterm infants admitted to public hospitals, Addis Ababa, Ethiopia 2024.
Methods: A facility-based cross-sectional study was conducted among 422 randomly selected preterm
infants who were admitted from Jan 1, 2021- Dec31, 2023. Using a checklist, data were extracted by
reviewing charts. The data were then cleaned, coded, and entered into EpiData 4.6, and subsequently
exported to SPSS version 27 for analysis. Variables with a p-value of <0.25 on bi-variable analysis were
entered into a multi-variable logistic regression analysis. Factors with a p-value of <0.05 were declared
statistically significant.
Result: A total of 415 neonate charts were reviewed successfully. Although the majority of preterm
infants who received Aminophylline for the management of apnea showed improvement, a significant
proportion (32.2%) of them did not survive. The odds of death were higher in preterm neonates with: a
birthweight of less than 1 kg (AOR = 18.9, 95% CI [4.6, 77.9]), a birthweight between 1 kg and 1.5 kg
(AOR = 2.8, 95% CI [1.1, 7.1]), pulmonary hemorrhage (AOR = 3.7, 95% CI [1.2, 11.1]), apnea
episodes after the initiation of Aminophylline (AOR = 2.5, 95% CI [1.2, 5.1]), those who did not receive
nasal oxygen therapy (AOR = 53.1, 95% CI [24.0, 117.3]), and hypoglycemia (AOR = 3.3, 95% CI [1.5,
7.4], p = 0.003) compared to their respective counterparts. Lastly, premature neonates who were treated
with Aminophylline for less than 10 days had 4.8 times higher odds of death compared to those treated
for 10 days or more (AOR = 4.8, 95% CI [2.0, 11.4]).
Conclusion and recommendation: These findings highlight critical risk factors associated with
mortality in preterm infants receiving Aminophylline and underscore the need for targeted interventions
to improve survival outcomes. Based on these findings, we recommend implementing enhanced care
protocols for extremely/very low birthweight neonates, prioritizing early detection and management of
pulmonary hemorrhage, reviewing aminophylline treatment protocols, ensuring universal access to
nasal oxygen therapy, optimizing hypoglycemia management protocols, and conducting further research
in these areas.
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Keywords
Preterm, Apnea of Prematurity, Aminophylline