DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20183522

A study of early neonatal mortality in a tertiary hospital of Maharashtra, India

Nitin Mehkarkar, Vijay Baburao Sonawane

Abstract


Background: India has a high Neonatal Mortality Rate (NMR) of 31 per 1000 live births and rural being 34 whereas urban being 17 (2011). Two thirds of the newborn deaths usually occur in the first week of life. Newborn survival has become an important issue to improve the overall health care goals. This study is carried out to identify primary causes of early neonatal deaths and to ascertain the factors affecting early neonatal mortality.

Methods: This is a prospective study of all the early neonatal deaths in tertiary hospital of Maharashtra over two years. Details of each early neonatal death were filled in the standard perinatal death proforma.

Results: Out of the 2073 total births, there were 75 early neonatal deaths (END) which is nearly 36.18 per 1000 live births. The important causes of END were severe birth asphyxia, respiratory distress syndrome and septicemia. About 50% of deaths were observed in mothers with age < 20 years, 25% deaths observed in mothers of age group 20-29 years, and similar percentage is with age >30 years. Most of the early neonatal deaths were due to Birth asphyxia and RDS was the second most important cause of early neonatal deaths. 70% of ENDs were among LBW babies. Prevention of premature delivery, proper management of very low birth weight babies and early detection and appropriate management of perinatal hypoxia have become important interventional strategies in reducing early neonatal deaths.

Conclusions: Early Neonatal Mortality (ENM) at Tertiary Hospital is fairly high. In present study, early neonatal death rate of 36.18 per 1000 live births is observed which significantly higher than reported in literature.


Keywords


Birth asphyxia, END, NMR, RDS

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References


National Institution for Transforming India. SRS statistical report 2013. Available at http://niti.gov.in/content/neo-natal-mortality-ratenmr-1000-live-births. Accessed 10 December 2017.

Singh M. Care of the newborn. 6th edition. Sagar Publications; 2004:3,63.

Fanaroff AA, Martin RJ. Neonatal-perinatal medicine. Disease of the fetus and infant. 4th edition. Mosby; 1986.

Ravikumara M, Bhat BV. Early neonatal mortality in an intramural birth cohort at a tertiary care hospital. Indian J Pediatr. 1996;63:785-9.

Kameswaran C, Bhatia BD. Perinatal mortality: a hospital based study. Indian Pediatr. 1993;30:997-1002.

Manorama V, Jugesh C, Singh D. Perinatal mortality in Ludhiana, Punjab: a seven-year hospital study. Indian J Pediatr. 1992;59:561-5.

Ramesh P. Perinatal mortality. Incidence and effect of various maternal factors. Indian J Pediatr. 1981;49:297-304.

Kapoor RK, Shrivastava AK. Perinatal mortality in urban slums in Lucknow. Indian Pediatr. 1996;33:19-23.

Gupta PK, Gupta AP. Perinatal mortality. Indian Pediatr. 1985;22:201-5.

Pradeep M, Rajam L, Sudevan P. Perinatal mortality: a hospital-based study. Indian Pediatr. 1995;32:1091-4.

Usha S. Symposium: perinatal mortality in India. can it be reduced through primary health care? Indian J Pediatr. 1986;53:327-34.

Santhanakrishnan BR, Gopal S. Perinatal mortality in referral teaching hospital in Madaras City. Indian J Pediatr. 1986;53:359-63.

Sane SY, Patel BM. Neonatal respiratory distress syndrome. An autopsy study of 190 cases. Indian J Pediatr. 1985;52:43-6.

Swain S, Ojha KN, Prakash A, Bhatia BD. Maternal and perinatal mortality due to eclampsia. Indian Pediatr. 1993;30:771-3.

Tallur SS, Kasturi AV, Nadgir SD, Krishna BV. Clinico-bacteriological study of neonatal septicemia in Hubli. Indian J Pediatr. 2000;67(3):169-74.

Ahmed NU, Azad C. Clinical and bacteriological profile of neonatal septicemia in a tertiary level pediatric hospital in Bangladesh. Indian Pediatr. 2002;39:17.

Jaswal RS, Kaushal RK, Goel A, Pathania K. Role of C-reactive protein in deciding duration of antibiotic therapy in neonatal septicemia. Indian pediatrics. 2003;40(9):880-3.