Factors affecting the outcome of neonatal transport in a tertiary care hospital in Bangladesh

Mohosina Akhter; Mehdi Pervez; Shahjadi Nasreen Sultana; Mahbuba Haque; M. Abdul Kadir; Mohammad Faisal Hasan Bhuiyan; Uttam Kumar Saha

doi:10.18203/2349-3291.ijcp20250395

Authors

Mohosina Akhter Department of Neonatology, Mugda Medical College, Dhaka, Bangladesh
Mehdi Pervez Department of Pediatrics, 250 Bed General Hospital, Barguna, Bangladesh
Shahjadi Nasreen Sultana Department of Neonatology, Sir Salimullah Medical College, Dhaka, Bangladesh
Mahbuba Haque Department of Gynae and Obst, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
M. Abdul Kadir Department of Pediatrics, Dhaka Medical College, Dhaka, Bangladesh
Mohammad Faisal Hasan Bhuiyan Department of Pediatrics, 50 Bedded Upazilla Health Complex, Nalchity, Jhalokathi, Bangladesh
Uttam Kumar Saha Department of Pediatrics, Sher-E-Bangla Medical College, Barishal, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20250395

Keywords:

Newborn transport, Neonates, Uneventful and complicated transfers

Abstract

Background: Effective neonatal transport is crucial for survival of referred sick newborns and poor transportation is associated with higher mortality. In Bangladesh many births still occur at home, especially in rural areas and newborn transport system is not established contributing to adverse neonatal outcome. This study aimed to document the factors affecting the outcome of transport of sick neonates to a tertiary care hospital.

Methods: This prospective observational study was conducted at Department of Neonatology in Mymensingh Medical College Hospital over a period of 6 month extending from January 2023 to June 2023. Neonates were enrolled if referred within 28 days of life and excluded if they had major congenital anomalies. Data on pre-transport, during-transport and post-transport conditions were recorded using a structured questionnaire. Outcomes were categorized as uneventful or complicated transfers, with survival analyzed as a secondary outcome. Statistical analysis was performed using SPSS, with chi-square tests to assess associations (p<0.05).

Results: Out of 384 referred neonates included in this study, 124 (32.3%) had uneventful transfer and 260 (67.7%) had complicated transfers. Prematurity, low birth weight, home delivery, delivery by untrained dai, self-referral, no prereferral treatment and counselling, lack of accompanying health personnel during transport, higher distance, transport without ambulance, lack of adequate support and monitoring equipment and treatment during transport was significantly associated with complicated transport (p<0.05). Mortality was significantly higher in complicated transport group (38.9%) compared to uneventful transport (26.6%).

Conclusions: In conclusion, this study highlights significant gaps in neonatal transport practices revealing that both pre-transport and transport conditions critically influence outcomes. The findings underscore the urgent need for a specialized neonatal transport service to reduce neonatal mortality and morbidity.

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