DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20192036

Predictors of mortality among neonates transported to tertiary care centre

Preeti Malhotra, Karuna Thapar, Gurpreet Kaur

Abstract


Background: The neonatal transport in India has taken a giant leap in last years. For reducing the death among transported newborns, transport in well-equipped ambulance could play a vital role. As there is not much data available in Punjab on neonates being transported to tertiary care center so the present study was conducted to know the predictors of mortality in newborns transported to tertiary care center.

Methods: The present study was an observational study conducted in neonatal intensive care unit of department of Pediatrics at SGRD institute of medical science and research, Amritsar, Punjab, India over a period of 18 months from 1st January 2017 to 30th June 2018. Total 121 neonates were enrolled in the study. History and clinical examination were done at the time of admission and the various study variables were statistically analysed.

Results: Out of total 121 neonates, 76 were discharged, 12 expired and 33 left against medical advice. Mortality rate was 9.9%. Mortality was higher in neonates who had hypothermia, hypoglycemia, poor perfusion and bradycardia at the time of admission. Neonates with extremely low birth weight (<1 kg) and those admitted after 6 hours of age also had higher mortality.

Conclusions: Predictors of mortality were hypothermia, hypoglycaemia, poor perfusion and bradycardia at the time of admission. New-borns require special care for stabilization before and during transport, which can be achieved by using specially equipped neonatal ambulances. So, these neonatal ambulances should be started in all states to decrease the neonatal mortality rate.

Keywords


Extremely low birth weight, Neonatal ambulances, Transported neonates

Full Text:

PDF

References


Lawn JE, Cousens S, Zupan J. Lancet neonatal survival steering team. 4 million neonatal deaths: when? Where? Why?. Lancet. 2005;365(9462):891-900.

Sehgal A, Roy MS, Dubey NK, Jyothi MC. Factors contributing to outcome in newborns delivered out of hospital and referred to a teaching institution. Indian Pediatr. 2001;38:1289-4.

NNF clinical practice guidelines. Available at: http://www.nnfi.org/images/pdf/nnf. Accessed 13 February 2011.

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 Org. 2006;84:706-13.

Raju TNK, Vidyasagar D. Neonatal transportation: Taking intensive care to the infant. In: Aladjem S, Vidyasagar D, eds. Atlas of Perinatology, London, W.B. Saunders. 1982:313-16.

Ramji S. Transport in community J Neonat. 2005;19(1):328-1.

Aggarwal KC, Gupta R, Sharma S, Sehgal R, Roy MP. Mortality in newborns referred to tertiary hospital: An introspection. J Family Med Primary Care. 2015;4(3):435.

Narang M, Kaushik JS, Sharma AK, Faridi MM. Predictors of mortality among the neonates transported to referral centre in Delhi, India. Indian J Public Health. 2013;57(2):100.

Punitha P, Kumaravel KS. Study on the current status of neonatal transport to a special newborn care unit. Stanley Med J. 2016;3(3):55-8.