Neonatal outcome in new-borns admitted in NICU of tertiary care hospital in central India: a 5-year study

Authors

  • Jyotsna Verma Department of Paediatrics, LN Medical College and Research Centre, Bhopal, Madhya Pradesh, India
  • Shweta Anand Department of Paediatrics, LN Medical College and Research Centre, Bhopal, Madhya Pradesh, India
  • Nawal Kapoor Department of Paediatrics, LN Medical College and Research Centre, Bhopal, Madhya Pradesh, India
  • Sharad Gedam Department of Paediatrics, Vidisha Medical College, Bhopal, Madhya Pradesh, India
  • Umesh Patel Department of Paediatrics, RKDF Medical College, Bhopal, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20182512

Keywords:

Neonatal outcome, New-born, NICU

Abstract

Background: Neonatal mortality rate contributes significantly to under five mortality rates. Data obtained from pattern of admission and outcome may uncover various aspects and may contribute and help in managing resources, infrastructure, skilled hands for better outcome in future.

Methods: This retrospective study was done on 1424 neonates who were admitted at LN Medical College and JK Hospital, Bhopal in neonatal intensive care unit (NICU) in the Department of Paediatrics from January 2013-December 2017.

Results: 1424 newborns admitted within 24 hours of birth were included in the study. About 767 were male neonates, (Male: female1.16:1). The low birth weight babies were 54% in our study. Among the various causes of NICU admission, Respiratory distress was present in 555 (39%) of neonates, Respiratory distress syndrome (Hyaline membrane disease) being the most common cause of respiratory distress. Neonatal sepsis accounted for morbidity in 24% of neonates, with Klebsiella being the most common organism grown in the blood culture. The incidence of congenital anomalies was 2.5%. The neonatal mortality was found to be 11% in our study. Prematurity with Respiratory distress syndrome (Hyaline membrane disease) and perinatal asphyxia were the two most common causes of neonatal mortality in the study. Extremely low birth weight neonates had the highest case fatality rate in the study, which indicates the need to develop an efficient group of professionals in teaching hospitals who will provide highly specialized and focused care to this cohort of vulnerable neonates.

Conclusions: Present study has shown respiratory distress, perinatal asphyxia, and sepsis as the predominant causes of neonatal morbidity. All three are preventable causes, and our health-care programs should be directed toward addressing the risk factors in the community responsible for the development of these three morbidities. The preterm and low birth weight babies had significantly high mortality even with standard intensive care; therefore, a strong and effective antenatal program with extensive coverage of all pregnant females specifically in outreach areas should be developed which will help in decreasing preterm deliveries and also lower the incidence of low birth weight babies.

References

Jehan I, Harris H, Salat S, Zeb A, Mobeen N, Pasha O, McClure EM, Moore J, Wright LL, Goldenberg RL. Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan. Bull World Health Org. 2009;87(2):130-8.

Black RE, Morris SS, Bryce J.Where and why are 10 million children dying every year? Lancet. 2003;361(9376):2226-34.

World Health Organization. Mother–baby package: implementing safe motherhood in countries. Maternal Health and Safe Motherhood Programme. Geneva, WHO 1994. (WHO/FHE/MSM/94.11).

Save the children federation. Saving newborn lives: state of the world's newborns. Washington DC, 2001:pp 1-49.

World Health Organization. Management of Sick Newborn. Report of a technical Working Group, Ankara.

Children: reducing mortality, WHO media centre [internet].2012 June. Available at http: //www.who.int / mediacentre / factsheet / fs178/ en /index.html.

Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol. 1976;33(10):696-705.

Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991;119(3):417-23.

Tochie JN, Choukem SP, Langmia R N, Barla E, Koki-Ndombo P. Neonatal respiratory distress in a reference neonatal unit in Cameroon: an analysis of prevalence, predictors, etiologies and outcomes. Pan African Med J. 2016;24:152.

Kumar MK, Thakur SN, Singh BB. Study of the Morbidity and the mortality patterns in the neonatal intensive care unit at a tertiary care teaching hospital in Rohtas District, Bihar, India. J Clin Diagn Res. 2012;6(2):282-5.

Kumar S, Ahmed M, Anand S. Morbidity and mortality patterns of neonates admitted to neonatal intensive care unit in tertiary care hospital, Bhopal. Pediatr Rev: Int J Pediatr Res. 2016;3(11):776-8.

Baghel B, Sahu A, Vishwanadham K. Pattern and admission and outcome of neonates in NICU of Tribal region Bastar, India. Int J Med Res Prof. 2016;2(6):147-50.

Veena Prasad and Nutan Singh. Causes of morbidity and mortality admitted in Government Medical College Haldwani in Kumoun Region Uttarakhand India. JPBMS. 2011;9(23):1-4.

Ike Elizabeth U, Modupe O, Oyetunde. Pattern of diseases and care outcomes of neonates admitted in special Care Baby Unit of University College Hospital, Ibadan, Nigeria from 2007 To 2011, IOSR J Nurs Health Sci. 2015;4(3):62-71.

Narayan R, Singh S. A study of pattern of admission and outcome in a neonatal intensive care unit at Rural Haryana, India. Int J Pediatr Res. 2017;4(10):611-6.

Tochie JN, Choukem SP, Langmia RN, Barla E, Koki-Ndombo P. Neonatal respiratory distress in a reference neonatal unit in Cameroon: an analysis of prevalence, predictors, etiologies and outcomes. Pan Afr Med J. 2016; 24:152.

Parkash A, Haider N, Khoso ZA, Shaikh AS. Frequency, causes and outcome of neonates with respiratory distress admitted to Neonatal Intensive Care Unit, National Institute of Child Health, Karachi.J Pak Med Assoc. 2015;65(7):771-5

Omoigberale AI, Sadoh WE, Nwaneri DU. A 4 year review of neonatal outcome at the University of Benin Teaching Hospital, Benin City. Niger J Clin Pract. 2010;13:321-5.

Okechukwu AA, Achonwa A. Morbidity and mortality patterns of admissions into the Special Care Baby Unit of University of Abuja Teaching Hospital, Gwagwalada, Nigeria. Niger J Clin Pract. 2009;12:389-94.

Viswanathan R, Singh AK, Mukherjee S, Mukherjee R, Das P, Basu S. Aetiology and antimicrobial resistance of neonatal sepsis at a tertiary care centre in Eastern India: A 3-year study. Indian J Pediatr. 2011;78:409-12.

21 Udo JJ, Anah MU, Ochigbo SO, Etuk IS, Ekanem AD. Neonatal morbidity and mortality in Calabar, Nigeria: A hospital-based study. Niger J Clin Pract. 2008;11:285-9.

Adebami OJ, Joel-Medewase VI, Agelebe E, Ayeni TO, Kayode OV, Odeyemi OA, et al. Determinants of outcome in new-borns with respiratory distress in Osogbo, Nigeria. Int J Res Med Sci. 2017;5:1487-93.

Downloads

Published

2018-06-22

Issue

Section

Original Research Articles