Abstract

RIEMER, L; ARGENT, A  and  MORROW, B. Disease profile and outcomes of neonates admitted to the paediatric intensive care unit at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa. S. Afr. j. child health [online]. 2026, vol.20, n.1, pp.34-39. ISSN 1999-7671.  https://doi.org/10.7196/sajch.2026.v20i1.3009.

BACKGROUND: Neonatal healthcare is a key area in reducing global child mortality. Unwell neonates are usually managed in the neonatal intensive care unit (NICU), but may also be admitted to paediatric intensive care unit (PICU). OBJECTIVES: To describe the profile of neonates admitted to a South African PICU and to identify risk factors associated with mortality. METHODS: This was a prospective observational study of patients with a post-menstrual age of <44 weeks admitted to the PICU between November 2018 and October 2019. Associations with mortality were evaluated with univariate and multivariate logistic regression analyses. RESULTS: A cohort of 266 neonates were included, accounting for 18.4% of PICU admissions. Median birth weight was 2 210 g, with an interquartile range (IQR) of 1 397 - 2 995 g. Chronological and post-menstrual age (IQR) at admission was 11 (2 - 28) days and 38 (35 - 40) weeks, respectively. The largest referral source was tertiary NICUs. Surgical admissions accounted for most patients. Congenital abnormalities occurred in 50.4% of the cohort. Neonatal mortality at ICU discharge was 10.9% compared with 3.8% in older patients (odds ratio=3.08, 95% confidence interval 1.89 - 5.02; p<0.001). The most common condition associated with mortality was congenital abnormalities, followed by necrotising enterocolitis and infections. Logistic regression analysis showed that the only variables independently associated with death/palliation were oscillatory ventilation and feeds received. CONCLUSION: Findings on the patient profile of this cohort may help policy-makers and unit managers improve neonatal care, with directions for further research.

Keywords : Neonate; paediatric ICU; preterm births; congenital abnormalities; health policy.

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