Unveiling referral's impact on asphyxiated newborns: a cross-sectional study
DOI:
https://doi.org/10.18203/2349-3291.ijcp20242335Keywords:
Asphyxia, Special newborn care unit, Referral, Out-bornAbstract
Background: Birth asphyxia also known as perinatal asphyxia, refers to the lack of oxygen during the childbirth. The asphyxiated newborns require a comprehensive care and many special newborns care units have established in Gujarat for the sick newborns. This study mainly focuses on understanding the reasons for referral, the average travel time to tertiary care institutions, and identifying gaps to minimize unnecessary referrals among patients.
Methods: The cross-sectional study was conducted over a period of one year, and out-born asphyxiated newborns were selected based on the inclusion criteria. A pretested, semi-structured questionnaire was used to collect the data, which was later analyzed using Microsoft excel and statistical package for the social sciences (SPSS) 26.
Results: Out of the 131 newborns, 31% had moderate-severe asphyxia. Approximately 9% of the patients had to travel for more than 2hours to reach the final health facility. Among the patients, risk of mortality was significantly higher among the those who were referred from the private health facility. Lack of availability of bed, ventilator and economic burden were among the common reason for referral.
Conclusions: There is a necessity to prevent unnecessary multiple and delayed referrals, and to provide essential care during transport to improve the outcomes.
References
Agarwal R, Jain A, Deorari AK, Paul VK. Post-resuscitation management of asphyxiated neonates. Indian J Pediatr. 2008;75(2):175-80.
Ministry of Health and Family Welfare, Government of India and Save the Children. Two year progress of Special Newborn Care Units in India- A brief report. 2013. Available at: https://nhm.gov.in/images/ pdf/programmes/child-health/annual-report/Two_ Year_Progress_of_SNCUs-A_Brief_Report_(2011-12_&_2012-13).pdf. Accessed on 12 June 2024.
Navjaaat Shishu Suraksha Karyakaram (NSSK). Resuscitation and Essential Newborn Care- Resource Manual-Ministry of Health and Family Welfare. 2020. Available at: https://nhm.gov.in/images/ pdf/programmes/child-health/guidelines/NSSK/ NSSK-Resource-Manual.pdf. Accessed on 12 June 2024.
World Health Organization. Standards for improving the quality of care for small and sick newborns in health facilities. 2020. Available at: https://www.who.int/publications/i/item/9789240010765. Accessed on 12 June 2024.
Gohiya P, Ubriani N, Dwivedi R. Impact of early referral on immediate outcome of asphyxiated newborns. J Clin Neonatol. 2021;10:1.
Bokade C, Meshram R. Morbidity and mortality patterns among outborn referral neonates in central India: Prospective observational study. J Clin Neonatol. 2018;7:130.
Baidya M, Shirin M, Saha LC. Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital. 2017;41.
Kiputa M, Salim N, Kunambi PP, Massawe A. Referral challenges and outcomes of neonates received at Muhimbili National Hospital, Dar es Salaam, Tanzania. PLoS One. 2022;17.
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;57:100-4.
Memon S, Shaikh S, Bibi S. To compare the outcome (early) of neonates with birth asphyxia in-relation to place of delivery and age at time of admission. J Pak Med Assoc. 2012;62:1277-81.
Mohan K, Mishra PC, Singh DK. Clinical Profile of Birth Asphyxia in Newborn. Int J Sci Technol. 2013;3:10-9.
Paul VK, Singh M, Sundaram KR, Deorari AK. Correlates of mortality among hospital-born neonates with birth asphyxia. Natl Med J India. 1997;10(2):54-7.
Aggarwal K, Gupta R, Sharma S, Sehgal R, Roy M. Mortality in newborns referred to tertiary hospital: An introspection. J Family Med Prim Care. 2015;4:435.
