Morbidity and mortality pattern among babies admitted in special newborn care unit, Nellore, Andhra Pradesh, India

Lakshmi Prasanna Chintha, Suneetha Bollipo, Ravi Prabhu Gottumukkala, Sathya Prakash Palepu


Background: India contributes to 25% of neonatal mortality around the world. In developing countries neonatal mortality is quite high despite of advances in perinatal and neonatal care. The establishment of Special Newborn Care Units (SNCU) has been quite essential in reducing the neonatal morbidity and mortality. This study was conducted to assess the outcome of SNCU at a newly commissioned tertiary care teaching hospital at Nellore District, Andhra Pradesh. Aim of this study the morbidity and mortality patterns in an SNCU at tertiary care teaching hospital.

Methods: It was a Retrospective, Hospital based, Descriptive study which was done among neonates admitted to SNCU, Nellore District, Andhra Pradesh for a period of 1 year (January 2015-December 2015). All the neonates admitted to SNCU, Nellore District, Andhra Pradesh during the study period were included in the study. Data was recorded in a predesigned semi-structured proforma. the data was entered into excel-sheet and analyzed using SPSS software version 21.

Results: A total of 1015 babies were included in the study. Almost half 592(58.32%) were born in this hospital(inborn) and 423(41.67%) babies were referred from peripheral hospitals and nursing homes (out born). about 3/4th 767(75.5%) of babies were admitted in the first 24 hours of life. Almost half (53.4%) of the study group were male and 46.6% were female. The chief causes of admission in SNCU were Respiratory Distress Syndrome (40.2%) followed by birth asphyxia (19.1%), sepsis (13.3%), Neonatal Jaundice (9.9%) and prematurity (6.6%). In our study 63.0% patients were discharged, 19.3% had left hospital against medical advice, 10.1% died and 7.6% were referred to other institutions for specialized treatment.

Conclusion: Respiratory Distress Syndrome, neonatal sepsis, neonatal hyperbilirubinemia, and HIE as the major causes of morbidity. Low Birth Weight and prematurity were the commonest contributors of death, therefore, attempts to prolong the pregnancy each week might improve the neonatal outcome considerably.


Neonate, Neonatal period, Neonatal morbidity, Neonatal mortality, Neonatal care, Perinatal care, Special newborn care unit

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Rohit M, Bhavesh M, Punitha KM. Study of the Morbidity and the Mortality Pattern in the Neonatal Intensive Care Unit at a Tertiary Care teaching Hospital in Gandhinagar District, Gujarat, India. J Res Med Den Sci. (2015);3(3):208-12.

Behl L, Grover N, Kaushik SL. Perinatal and Neonatal Mortality-A Hospital Based Study. Indian Pediatr. 1998;35(7):683-4.

Zupan J, Aahman E. Perinatal mortality for the year 2000: estimates developed by WHO. Geneva: World Health Organization, 2005.

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

Bryce J, Bishi-pinto C, Shibuya K, Balck RE. WHO estimates of the causes of death in children. Lancet 2005; 365:1147-52.

Registrar general and census commissioner, India. Sample Registration System Bulletin 2013. Ministry of Home affairs, Government of India, 2013. Available at:

International Institute for Population Sciences (IIPS) and Macro International. 2007. National Family Health Survey (NFHS-3), 2005–06: India: Volume. Mumbai: IIPS. Available at

Setting up a special care newborn unit in a district hospital. Toolkit for setting up of special care newborn units, stabilization units and newborn corners. New Delhi: United Nations Children's Fund; 2008;26.

Ministry of Health & Family Welfare, Government of India, September 2014,India newborn action plan 1-84. Available at:

Roy RN, Nandy S, Shrivastava P, Chakraborty A, Dasgupta M, Kundu TK. The mortality pattern of the hospitalised children in a tertiary care hospital of Kolkata. Indian J Community Medicine. 2008;33(3):187-9.

Rakholia R, Rawat V, Bano M, Singh G. Neonatal morbidityand mortality of sick newborns admitted in a teaching hospital of Uttarakhand. CHRISMED J Health Res. 2014;1(4):228-34.

Bhatia BD, Mathur NB, Chaturvedi P, Dubey AP. Neonatal mortality pattern in rural based Medical college hospital. Indian J Pediatr.1984;51(3):309-12.

Orimadegun AE, Akinbami FO, Tongo OO, Okereke JO. Comparison of neonates born outside and inside hospitals in a children emergencyunit, Southwest of Nigeria. Pediatr Emerg Care. 2008;24(6):354-8.

Owa JA, Osinaike AI. Neonatal morbidity and mortality in Nigeria.Indian J Pediatr. 1998;65:441-9.

Sridhar PV, Thammanna PS, Sandeep M. Morbidity Pattern and Hospital Outcome of Neonates Admitted in a Tertiary Care Teaching Hospital, Mandya. Int J Sci Stud 2015;3(6):126-9.

Gauchan E, Basnet S, Koirala DP, Rao KS. Clinical profi le and outcomeof babies admitted to Neonatal Intensive Care Unit (NICU). J Inst Med. 2011;33:1-5.

Simiyu DE. Morbidity and mortality of neonates admitted in general paediatric ward at Kenyatta National Hospital. East Afr Med J 2003;80:611-6.

Simpson CD, Ye XY, Hellmann J, Tomlinson C. Trends in cause-specific mortality at a Canadian outborn NICU. Pediatr. 2010;126:e1538-44.

Das PK, Basu K, Chakraborty S, Basak M, Bhowmik PK. Early neonatal morbidity and mortality in a city based medical college nursery. Indian J Public Health. 1998;42(1):9-14.

Mallick AK, Sarkar UK. One year experience of neonatal mortality and morbidity in a state level neonatal intensive care unit and its comparison with national neonatal-perinatal database. J Indian Med Assoc. 2010;108(11):738-9.

Morbidity and mortality among out born neonates at 10 tertiary care institutions in India during the year 2000. J Trop Pediatr. 2004;50(3):170-4.

Shrestha S, Karki U. Indications of admission and outcome in anewly established neonatal intensive care unit in a developing country (Nepal). Nepal Med Coll J. 2012;14(1):64-7.

Khan MR, Maheshwari PK, Shamim H, Ahmed S, Ali SR. Morbiditypattern of sick hospitalized preterm infants in Karachi, Pakistan. J Pak Med Assoc. 2012;62(4):386-8.

Chowdhury ME, Akhter HH, Chongsuvivatwong V, Geater AF. Neonatal mortality in rural Bangladesh: An exploratory study. J Health Popul Nutr. 2005;23:16-24.