DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20180529

A profile on the spectrum of neonatal mortality and morbidity pattern of extramural neonates in the Specialised Neonatal Care Unit (SNCU) in a tertiary care hospital

Anuradha D., Rajesh Kumar S., Aravind M. A., Jayakumar M., J. Ganesh J.

Abstract


Background: Every year, nearly four million newborn babies die in the first month of life. India carries the single largest share (around 25-30%) of neonatal deaths in the world. Neonatal deaths constitute two thirds of infant deaths in India. 45% of the deaths occur within the first two days of life. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively at the appropriate time. It was further estimated that health facility-based interventions can reduce neonatal mortality by 23-50% in different settings. Facility-based newborn care, thus, has a significant potential for improving the survival of newborns in India. This research has been planned with an aim to study the profile of pattern of admissions in a SNCU and their outcomes following admission and management in the unit.

Methods: All babies referred for neonatal problems (less than 28 days) and admitted in NICU will be included. Both term and preterm babies will be considered. The criteria for admission includes various causes like low birth weight, preterm, birth asphyxia, respiratory distress, hyperbilirubinemia, congenital anomalies, risk factors (maternal, neonatal, prenatal), infections and outcome will be analysed.

Results: Among the 2927 admissions term babies and boys outnumbered. The common causes for admission were birth asphyxia, respiratory distress, low birthweight and preterm. Most babies had an uncomplicated stay. The mortality in the extramural neonates was due to neonatal sepsis, extreme preterm and congenital malformations.

Conclusions: Intensive and interventional management, along with good neonatal monitoring and care can reduce the mortality and improve the survival of low birth weight babies and other treatable problems. Thus, a combined effort of management by pediatricians, nursing care, neonatal intensive care unit can improve the survival rates of neonates.


Keywords


Birth asphyxia, Extramural admissions, Low birth weight, Neonatal mortality, Neonatal sepsis, Respiratory distress

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References


Malik S, Gohiya P, Khan IA. Morbidity profile and mortality of neonates admitted in Neonatal Intensive Care Unit of a Central India Teaching Institute: a prospective observational study. J Clin Neonatol. 2016;5(3):168.

Oestergaard MZ, Inove M, Yoshida S, Mahanani WR, Gore FM, Cousins S, et al. United Nations inter-agency group for child mortality estimation and the child health epidemiology reference Group. Neonatal mortality levels for 193 countries in 2009 with trends since 1990: A systematic analysis of progress, projections, and priorities. PLoS Med. 2011;8:e1001080.

The UN inter‑agency group for child mortality estimation. Levels and trends in child mortality, 1990‑2010; 2011. Available at http://www.healthynewbornnetwork.org/resource/levels‑andtrends-child-mortality‑2011‑report

Bhutta ZA, Black RE. Estimating number of beds required for SCNU Toolkit. Global maternal, newborn, and child health: so near and yet so far. New Eng J Med. 2013;369:2226-35.

Baqui AH, Darmstadt GL, Williams EK, Kumar V, Kiran TU, Panwar D, et al. Rates, timing and causes of neonatal deaths in rural India: Implications for neonatal health programmes. Bull World Health Organisation. 2006;84:706-13.

Jeganathan S, Rsavikmar SA, Tamilmani A, Parameshwari PP, Chinnarajalu AV, Kolkar YB. Neonatal mortality of sick new-borns admitted in a tertiary care teaching hospital in Tamil Nadu, South India. Int J Contemporary Pediatr. 2017;4(2):399-402.

UNICEF. Committing to child survival: a promise renewed. UNICEF Progress Report; 2014. Available at https:// www.unicef.org/publications/files/APR_2014_web_15Sept14.pdf

Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L. Lancet neonatal survival steering team evidence based, cost effective interventions: how many new-born babies can we save? Lancet. 2005;365:977-88.

Mmbaga BT, Lie RT, Olomi R, Mahande MJ, Kavale G, Daltveit AK. Cause-specific neonatal mortality in a neonatal care unit in Northern Tanzania: a registry based cohort study. BMC Pediatr. 2012;12:116.

Kumar M, Paul VK, Kapoor SK, Anand K, Deoraria AK. Neonatal outcomes at a sub-district hospital in North India. J Tropical Pediatr. 2002;48:43-6.

Lawn JE, Cousens S, Zupan J. Lancet neonatal survival steering team: 4 million neonatal deaths: when? Where? Why? Lancet. 2005;365:891-900.

Jehan I, Harris H, Salat S, Zeb A, Mobeen N, Pasha O, et al; Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan. Bull World Health Organisaton. 2009;87:130-8.

New Delhi: Indian Council of Medical Research; 2005. Indian Council of Medical Research. NNPD network. National neonatal perinatal database. Human Reproduction Research Centre Network. Report 2002-2003; 2003:24-37. Available at http://www.newbornwhocc.org.

ICMR young infant study group. Age profile of neonatal deaths. Indian Pediatr. 2008;45:991-4.

Gurubacharya SM, Gurubacharya RL. An overview of neonatal admissions at College of Medical Sciences, Journal. Nepal Paediatr Soc. 2007;27(2):73-4.

Birch MR, Grayson N, Sullivan E. AIHW National Perinatal Statistics Unit. A recommendation for development of a new Australian birth anomalies system: a review of the congenital malformations and birth defects data collection. AIHW (Birth Anomalies Series no. 1) Cat. No. PER 23. Sydney; 2004. Available at https://www.aihw.gov.au/AIHWNPSU

Augustine T, Bhatia BD. Early neonatal morbidity and mortality pattern in hospitalised children. Indian J Maternal Child Health. 1994;5:17-9.