Neurodevelopmental Outcome of Newborns Aged More than 34 Weeks Gestational Age Managed for Birth Asphyxia in Douala (Cameroon): A Single Hospital-Based Study

Background: Perinatal asphyxia is a common cause of mortality and of morbidity including motor and neurodevelopmental abnormalities. The aim of this study was to evaluate the post-hospital outcome of neonates treated for perinatal asphyxia at the Douala Gynaeco-Obstetric and Pediatric Hospital (DGOPH) in Cameroon. Patients and Methods: We conducted a hospital-based cross-sectional study with both a retrospective and prospective data collection, conducted over a period of 3 months and involving neonates above 34 weeks of gestational age who were managed for perinatal asphyxia at DGOPH from August 2015 to February 2020. Socio-demographic, perinatal, motor, nutritional and neuro-developmental out-of-hospital data were recorded. The assessment of the child’s psychomotor development was evaluated through gross motor skills, fine motor skills, language and social contact. We calculated the development quotient (DQ) by dividing the developmental age (DA) by the actual age (RA) of the patient. The data were entered and analyzed using excel and Stata version 15 software. Results: Among the 58 newborns included in our study, males were the most represented (59%). The mean age was 36.5 ± 14.16 months (Extremes: 12 months and 66 months). The majority of patients were born at term (79%), had a birth weight between 2500 and 4000 grams (69%), were resuscitated (95%), and had an Apgar score < 7 at the 5th minute of life (67%). SARNAT stages II and III counted for 48%. Neurodevelopmental abnormalities were found in 25.5% of patients with gross motor delay (mainly tetraparesis) representing 23.5%, fine motor delay 27.5%, impairment in social contact 31% language speech delay. The majority of the children had a normal development quotient (78.4%). Conclusion: The short-term and long-term outcome of newborns who experienced perinatal asphyxia in our setting is marked by numerous impairments in developmental milestones leading to disability.

Reasons for Delayed Breastfeeding Initiation among Newly Delivered Women in Two First-Category Hospitals in Yaoundé, Cameroon

Introduction: Exclusive breastfeeding is fundamental for the good health and development of the mother and the child. According to the World Health Organization (WHO), breastfeeding after childbirth should be initiated within 30 minutes. For a number of reasons, WHO recommendations on guiding principles for infants and young children feeding are often not followed. Objective: To determine the reasons for the delayed initiation of breastfeeding in newly delivered women. Means and Method: We carried out a mixed cross-sectional study over a period of six months from December 1st 2018 to May 31st 2019, at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. We included all mothers with full-term or premature babies weighing ≥ 2000 grams and those whom initiated breastfeeding more than one hour after delivery. The mother’s reasons for delaying breastfeeding initiation were recorded using a dictaphone and data were accurately extracted for analysis. Results: We interviewed 153 mothers. Their mean age was 27.9 ± 6.2 years. The main reasons for delaying breastfeeding initiation were caesarean delivery (22%), the belief in “spoiled milk” (21%), lack of knowledge about the time to initiate breastfeeding (21%), baby asleep (18%), and lack of instruction given to the mother by the health staff (2%). Conclusion: Delayed breastfeeding was common in our context. Improving the quality of breastfeeding involves communication, to break beliefs about spoiled milk, and strengthening mothers’ knowledge for optimal breastfeeding processes in accordance with WHO’s guidelines. The medical staff should anticipate and undertake the early initiation of breastfeeding in babies from mothers who deliver through caesarean section.