Clinical profile and outcome of neonates admitted to the Neonatal Care Unit at a teaching hospital in Lalitpur, Nepal

Abstract

Background: Neonatal period is a vulnerable time in which the newborn has to adapt to a totally new environment and is susceptible to many problems, which may even be life threatening. It is found that neonatal mortality rate is decreasing in Nepal but at a slower pace than infant and child mortality. In order to improve neonatal outcome, it is crucial to identify the areas where health care can be improved. Objectives:This study was conducted to analyze the spectrum of diseases and outcomes at a level two NICU at a tertiary care teaching hospital. Methods: A descriptive observational study conducted at the neonatal care unit in the Department of Paediatrics at KIST Medical College, Lalitpur, Nepal over one year from 14th of April 2013 to 13th April 2014. Data on age at admission, gender, gestational age, birth weight, initial presenting symptoms at admission, fi nal diagnosis and outcome were collected from in patient records at the hospital record section and analyzed using SPSS 17.0. Results: A total of 279 neonates were studied. The commonest causes of admission were infection (45.9%), followed by respiratory conditions (14.7%), neonatal jaundice (12.5%), perinatal asphyxia (9.3%) and prematurity/ small for gestational age (SGA) (6.5 %). Most of the admissions (62%) were during the fi rst 24 hours of life. The majorities, 89.2%, were term gestation and 10.8% were preterm. Most of the preterm babies were late preterms with gestational ages between 35-36 weeks (73% of preterms were late preterms). Total of four mortalities (1.4%) occurred, three of which were due to perinatal asphyxia and one was a Down's syndrome with overwhelming sepsis. Conclusion: In this study, infections followed by respiratory conditions were the leading causes of admission. Most of the admissions occurred during the fi rst 24 hours of life. This emphasizes the fact that attentiveness during the fi rst day of life, simple measure to prevent infection and early detection and treatment may go a long way in improving neonatal outcome.

Clinical Profile and Outcomes of Neonates Admitted to SNCU Catering Difficult Area in Sub Himalayan Region

“…Strengthening of antenatal, intra-partum and post partum care is very important to combat these complications. There were 1.9% mortalities and 3.4% referrals during study period collaborating with the findings of Shakya et al [15] Mortality rates were found higher (13.7%-27%) in some studies probably due to more number of preterm babies and sicker neonates. [16] Commonest cause for mortality was birth asphyxia in accordance with literature reports.…”

Clinical profile of neonates admitted to a neonatal intensive care unit at a referral hospital in South India

“…These babies need immediate neonatal care to prevent death and hence focus should be on prevention of LBW babies [14]. The male preponderance in this study is similar to other studies [15][16][17]. This may be because of vulnerability of male neonates and gender preference.…”

Free Newborn Care Services: A New Initiative in Nepal

“…The main causes of admission in this study were neonatal sepsis, birth asphyxia and hyperbilirubinemia which in accordance with other studies conducted in Nepal. [8][9][10] Based on the treatment services offered to the sicknewborn, the health facilities are classified into 3 levels: I, II and III. The health posts and primary health care centers offer Level I care with services of newborn care, district hospitals offer special new born care services (SNCU) and zonal hospitals and other tertiary hospitals offer Neonatal Intensive Care Unit (NICU) services.…”