Patterns of neonatal admissions and mortality among neonates admitted to special neonatal care units: a two-year cross-sectional study at selected special neonatal care units in Odisha, India

Authors

  • Smitamayee Sahu Faculty of Nursing, Shri. Venkateshwara University, Gajraula, Uttar Pradesh, India
  • Yayathee Subbarayalu Faculty of Nursing, Shri. Venkateshwara University, Gajraula, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20241039

Keywords:

SNCU, Neonates, Low birth weight, Birth asphyxia

Abstract

Background: Odisha has built 44 special newborn care units to treat severely sick infants at various levels. This study aimed to determine morbidity and mortality profiles among neonates admitted to the SNCUs and extend efforts to improve outcomes by investigating crucial variables.

Methods: We conducted a cross-sectional descriptive study on all neonates admitted to SNCUs of 4 districts (Balangir, Kalahandi, Koraput, and Rayagada) between two calendar years (January 2020 and December 2021). We collected data on epidemiology, clinical presentation, and neonatal and maternal characteristics. We used Microsoft Excel to analyze categorical and continuous variables, with the Chi2 test for proportion comparison.

Results: 17615 neonates were admitted in 2020-2021, 58% below one day and 59% male. ST babies were predominant. Outborn unit had 52% admissions, with 67% full-term and 31% pre-term. 74% of outborns used government vehicles for transportation. Most diagnoses were birth asphyxia, HIE, neonatal jaundice, low birth weight, and neonatal sepsis. The study found that 43% of neonates died from hypoxic ischaemic encephalopathy /perinatal asphyxia, 22% from Sepsis, 12% from extremely low birth weight babies, and 9% from prematurity. The Chi2 test showed a statistically significant difference in survival rates between doctors and dai, with a 91% survival rate and a 71% survival rate.

Conclusions: Birth asphyxia was found to be the most essential cause of morbidity and mortality. Regular training at district levels is crucial for ensuring proper newborn care, including warmth, feeding, cleanliness, and prevention of asphyxia, to reduce preterm birth and low birth weight.

References

Newborn Mortality. Available at: https://www.who. int. Accessed on 20 November 2023.

Newborn Mortality. Available at: https://www.who. int/news-room/fact sheets/detail/levels-and-trends-in-child-mortality-report-2021. Accessed on 20 November 2023.

Strengthening facility-based Paediatric Care. Available at: https://nhm.gov.in/images/pdf/ programmes/childhealth/guidelines/Strenghtening_Facility_Based_Paediatric_Care-Operational_ Guidelines.pdf. Accessed on 20 November 2023.

Soni LK, Rathore P, Rani N. Neonatal morbidity and mortality profile of newborns admitted in sncult. Lam Government Medical College, Raigarh, Chhattisgarh. Int J Recent Sci Res. 2019;10:30584.

PaudelL, KalakhetiB, Sharma K. Prevalence and outcome of preterm neonates admitted to the neonatal unit of a tertiary care center in Western Nepal. J Lumbini Med Coll. 2018;6:1-5.

Desalew A, Sintayehu Y, Teferi N, Amare F, Geda B, Worku T, et al. Cause and predictors of neonatal mortality among neonates admitted to neonatal intensive care units of public hospitals in eastern Ethiopia:A facility-based prospective follow-up study. BMC Pediatr. 2020;20:1-11.

Tette EMA, Nartey ET, Nuertey BD, Azusong EA, Akaateba D, Yirifere J, et al. The pattern of neonatal admissions and mortality at a regional and district hospital in the Upper West Region of Ghana;a cross sectional study. PLoS One. 2020;15:e0232406.

Eze P, Al-Maktari F, Alshehari AH, Lawani LO. Morbidities and outcomes of a neonatal intensive care unit in a complex humanitarian conflict setting, Hajjah Yemen:2017-2018. Confl Health. 2020;14:53.

Nepal D, Agrawal S, Shrestha S, Rayamajhi A. Morbidities and outcomes of a neonatal intensive care unit in a complex humanitarian conflict setting, Hajjah Yemen. JLumbini Med Coll. 2020;6:1-10.

Chintha LP, Bollipo S, Gottumukkala RP, Palepu P. Morbidity and mortality pattern among babies admitted in special newborn care unit, Nellore, Andhra Pradesh, India. Int J Contemp Pediatr. 2019;6: 1898.

Mahajan S, Bajaj M, Vaid A, Thakur A. A one year review of clinical profile and treatment outcomes of neonates admitted to Sick Newborn Care Unit (SNCU) at Regional hospital in Himachal Pradesh draining a rural area. J Med Sci Clin Res. 2019;7:235-41.

Sachan R, Singh A, Kumar D, Yadav R, Singh DK, Shukla KM. Predictors of neonatal mortality referred to a tertiary care teaching institute: A descriptive study. Indian J Child Health. 2016;3154:18-27.

Bassani DG, Kumar R, Awasthi S, Morris SK, Paul VK, Shet A, et al. Causes of neonatal and child mortality in India: a nationally representative mortality survey. Lancet. 2010;376(9755):1853-60.

Ravikumar S, Harikrishnan E, Elayaraja K. Morbidity and mortality profile of neonates in a tertiary care centre in Tamil Nadu: A Study from South India. Int J Contemp Pediatr. 2018;5(2):377-82.

Mmbaga BT, Lie RT, Olomi R, Mahande MJ, Kvåle G, Daltveit AK. Cause-specific neonatal mortality in a neonatal care unit in Northern Tanzania: a registry based cohort study. BMC Pediatr. 2012;12:116.

Siakwa M, Kpikpitse D, Laryea T, Ankobil A, Dare S E. N. A Five-Year Neonatal Mortality Trend in a Ghanaian Teaching Hospital after implementing Strategies to Achieve the Millenium Development Goal (MDG) 4. Int J Paediatr Child Heal. 2014; 2(1):43-9.

Chiabi A, Takou V, Mah E, Nguefack S, Siyou H, Takou V, et al. Risk factors for neonatal mortality at the yaounde gynaeco-obstetric and pediatric hospital, cameroon. Iran J Pediatr. 2014;24(4):393-400.

Ekwochi U, Ndu IK, Nwokoye IC, Ezenwosu OU, Amadi OF, Osuorah D. Pattern of morbidity and mortality of newborns admitted into the sick and special care baby unit of Enugu State University Teaching Hospital, Enugu state. Niger J Clin Pract. 2014;17(3):346-51.

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Published

2024-04-25

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Original Research Articles