Knowledge of danger signs in neonates among postnatal mothers of babies admitted in tertiary care neonatal intensive care unit in a two-tier town in South India


  • Grace G. Esther Department of Neonatology, RICH Hospital, Nellore, Andhra Pradesh, India
  • Ananya T. Sai Lakshmi Department of Neonatology, RICH Hospital, Nellore, Andhra Pradesh, India
  • Ravi T. Kumar Department of Pediatrics and Neonatology, RICH Hospital, Nellore, Andhra Pradesh, India



Neonatal danger signs, Knowledge, Mothers


Background: Neonatal period is the first 28 days of life. Neonatal period is highly vulnerable and has high risk of mortality at an average global rate of 17/1000. Neonatal illnesses present with non-specific symptoms and signs. Neonatal danger signs signify common signs of severe illness. Aim of the study was to assess the awareness of postnatal mothers about danger signs in neonates and the associated factors.

Methods: Facility based cross sectional study conducted at a tertiary care hospital in a two-tier town in South India. Source of population was postnatal mothers of babies who were admitted in NICU. A structured questionnaire was used to collect the data through face-to-face interview. Neonatal danger signs are signs that sick neonates show as stated by WHO, which includes- not able to feed, or stopped feeding well, convulsed or fitted since birth, fast breathing, chest in drawing, fever, cold to touch, yellow palms and soles, umbilical redness, or draining of pus, skin boils, or eyes draining pus, no or minimal movement when stimulated. Mothers who mentioned at least 3 are considered to have good knowledge.

Results: Commonly mentioned danger signs are fever (89%), chest indrawing (59%), poor feeding (51%), and umbilical redness (48%). Mothers who had good knowledge was 32% of which 75.9% had counselling on danger signs during antenatal visits, 78% had antenatal visits more than 4,86.9% had post-natal care or visits,51.56% had education above secondary school.

Conclusions: Mothers need counselling on neonatal danger signs during antenatal and post-natal visits to reduce neonatal mortality.


UNICEF. Newborn Child Health. Available at: Accessed on 2 March 2021.

National Family Health Survey. Data Quality Assurance and Quality Control Mechanisms of NFHS, 2019. Available at: Accessed on 2 March 2021.

Abu SA, Fayyad AI, Riaz M, Nofal A, Matary A, Khan A, et al. Mothers' and Caregivers' Knowledge and Experience of Neonatal Danger Signs: A Cross-Sectional Survey in Saudi Arabia. Biomed Res Int. 2019;1750240.

Young Infants Clinical Signs Study Group. Clinical signs that predict severe illness in children under age 2 months: a multicentre study. Lancet. 2008;371(9607):135-42.

Ekwochi U, Ndu IK, Osuorah CD, Amadi OF, Okeke IB, Obuoha E, et al. Knowledge of danger signs in newborns and health seeking practices of mothers and care givers in Enugu state, South-East Nigeria. Ital J Pediatr. 2015;41:18.

Kabakyenga JK, Ostergren PO, Turyakira E, Pettersson KO. Knowledge of obstetric danger signs and birth preparedness practices among women in rural Uganda. Reprod Health. 2011;8(1):1-0.

Salem A, Lacour O, Scaringella S, Herinianasolo J, Benski AC, Stancanelli G, et al. Cross-sectional survey of knowledge of obstetric danger signs among women in rural Madagascar. BMC Pregnancy Childbirth. 2018;18(1):46.

Abdulrida HN, Hassan RJ, Sabri MM. Knowledge and health-seeking practices of mothers attending primary health-care centers in Baghdad Al-Karkh sector about danger signs in newborns. Mustansiriya Med J. 2018;17(1):29

Feyisso M, Addisu Y. Prabhanja danger signs of neonatal and postnatal illness and health seeking. J Curr Res. 2016;8(1):25466-71.

Hibstu DT, Siyoum YD. Knowledge of obstetric danger signs and associated factors among pregnant women attending antenatal care at health facilities of Yirgacheffe town, Gedeo zone, Southern Ethiopia. Arch Public Health. 2017;75:35.

Alex HBA, Dotimi DA, Opara PI. Mothers’ recognition of newborn danger signs and health seeking behaviour. Nigerian J Paediatr. 2014;41(3):199-203.

Sandberg J, Pettersson KO, Asp G, Kabakyenga J, Agardh A. Inadequate knowledge of neonatal danger signs among recently delivered women in southwestern rural Uganda: a community survey. PLoS One. 2014;9(5):97253.

Kibaru EG, Otara AM. Knowledge of neonatal danger signs among mothers attending well baby clinic in Nakuru Central District, Kenya: cross sectional descriptive study. BMC Res Notes. 2016;9(1):1-8.

Nigatu SG, Worku AG, Dadi AF. Level of mother's knowledge about neonatal danger signs and associated factors in North West of Ethiopia: a community-based study. BMC Res Notes. 2015;8:309.

Callaghan KJA, Seifu A, Tholandi M, Graft JJ, Daniel E, Rawlins B, Worku B, et al. Newborn care practices at home and in health facilities in 4 regions of Ethiopia. BMC Pediatr. 2013;13:198.






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