Etiologies of NICU Deaths

Jacob, Jack; Kamitsuka, Michael; Clark, Reese H.; Kelleher, Amy S.; Spitzer, Alan R.

doi:10.1542/peds.2014-2967

Cited by 109 publications

(88 citation statements)

References 8 publications

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“…Similar result was described by Katz et al from Sarlahi district of Nepal. 10 Death rates for an inborn and outborn neonate was similar in our study. Earlier study by Hedstrom et al from Uganda's neonatal center found two times more risk of mortality in outborn neonates.…”

Section: Discussionsupporting

confidence: 83%

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Morbidities and Outcome of a Neonatal Intensive Care in Western Nepal

Adhikari

Rao

Ganesh

et al. 2017

J Nepal Health Res Council

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Background: Neonatal mortality rate of developing countries is declining over decades. In the recent years increasing number of preterm and high risk neonates have facilities for tertiary care treatment. The aim of the study was to assess the morbidities and outcome of neonatal intensive care admissions.Methods: It was a retrospective observational study carried out in neonatal intensive care unit of the Manipal Teaching Hospital, Pokhara, Nepal from January 2014 to December 2015. Neonatal details including place of delivery, birth weight, gestation, diagnosis at admission, hospital course and final outcome were recorded in predesigned proforma. Risk of mortality was calculated using odds ratio and 95% confidence interval. Results: There were total 1708 admission during study period and inborn as well as out born neonates were equally admitted. Neonatal hyperbilirubinemia (37.1%), neonatal sepsis 532 (31.2%), prematurity, 314 (18.4%) perinatal asphyxia 112 (6.6%), meconium aspiration syndrome 79 (4.6%) and intrauterine growth restriction 49 (2.8%) were main indications for hospitalization. A total of 1410 (82.6%) the patients were discharged after treatment, 167 (9.7) left against medical advice, 115 (6.7%) died in hospital and 16 (1%) cases were referred. Preterm neonates had twice the risk of mortality than term neonates (OR =2.1664). Birth weight < 2500 grams had three times more risk of neonatal mortality than normal birth weight (OR =3.0783).Conclusions: Neonatal hyperbilirubinemia, prematurity and neonatal sepsis were common morbidities inneonatal intensive care unit.

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Section: Discussionsupporting

confidence: 83%

“…[5][6][7][8][9] In the developed countries genetic or structural anomalies is major cause of poor outcome. 10 Most of the neonatal deaths occur in the first week of life.…”

Section: Introductionmentioning

confidence: 99%

Morbidities and Outcome of a Neonatal Intensive Care in Western Nepal

Adhikari

Rao

Ganesh

et al. 2017

J Nepal Health Res Council

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“…In contrast, the proportions of deaths due to congenital anomalies (n=4, 4.1%) included tracheal stenosis, multiple dysmorphic feathures without definite diagnosis and cyanotic heart anomalies were relatively lower than those reported in other studies 6,25,31) , likely because infants who required cardiac or abdominal surgery were transferred to other hospitals due to a lack of professional manpower in our unit. There were 99 cases who were transferred to other hospitals over the 13-year period studied, mainly because of abdominal operations for congenital gastrointestinal obstruction or NEC (n=43), and cardiac manage ment for suspected congenital heart defects (n=24).…”

Section: Discussioncontrasting

confidence: 72%

“…Although advanced medical care over recent decades has resulted in significantly improved neonatal outcomes [1][2][3][4] , neonatal mortality still represents a large proportion of overall infant and childhood mortality. Under standing the causes and trends of deaths in neonatal intensive care units (NICUs) is important because the proportion of postneonatal deaths has a major impact on infant mortality 5,6) . Prematurity remains one of the major causes of neonatal death [7][8][9] , but there have been important changes in the specific causes of neonatal mortality [10][11][12][13][14] .…”

Section: Introductionmentioning

confidence: 99%

Deaths in the Neonatal Intensive Care Unit between 2002 and 2014

Park

Kim

2016

Neonatal Med

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Purpose: To report the causes and patterns of death among infants admitted to our neonatal intensive care unit (NICU) over a 13-year period. In addition, we analyzed trends regarding the type of end-of-life care provided. Results: Of the 5,223 admissions to our NICU, 97 neonates died. The overall mortality rate was 1.9%. The most common cause of death was sepsis (15%). At a lower gestational age, infants died of extreme prematurity and complications of prematurity. Among term infants, the principal cause of death shifted to hypoxic ischemic encephalopathy and asphyxia. A total of 63 infants (64.9%) received maximal inten sive care, and 34 infants (35%) had redirection of intensive care. During this period, the proportion of death after redirection of care increased from 30.6% to 39.6%. Infants decided to forgo life-sustaining care before death had significantly lower gestational ages and lower birth weights (30.5 vs. 27.1 weeks, P=0.005; 1,528 vs. 1,063 g, P=0.025). Conclusion: Infection remained an important cause of death for neonate, particularly for preterm infants. The proportion of infants who had redirectoin of care before death was increased, suggesting that quality-of-life should be considered an important factor in the decision-making process for the infant, parents, and medical staff.

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“…NEC becomes a larger proportionate cause of mortality as GA increases, particularly at 26-27wk GA. In addition, data from a prospective study in 46 US neonatal intensive care units (NICU) found NEC to be the second most common cause of death among all infants (term and preterm) born at ≥22wk GA, accounting for 10% of NICU deaths 22 . Only deaths due to extreme prematurity were more common, accounting for 14% of all NICU deaths.…”

Section: Survivalmentioning

confidence: 99%

Short- and Long-Term Outcomes for Extremely Preterm Infants

2016

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Prematurity is the leading cause of infant mortality worldwide. In developed countries, extremely preterm infants contribute disproportionately to both neonatal and infant mortality. Survival of this high-risk population has incrementally improved in recent years. Despite these improvements, approximately 1 in 4 extremely preterm infants dies during the birth hospitalization. Among those who survive, respiratory and other morbidities are common, although their effect on quality of life is variable. In addition, long-term neurodevelopmental impairment is a large concern for patients, clinicians and families. However, the interplay of multiple factors contribute to neurodevelopmental impairment, with measures that change over time and outcomes that can be difficult to define and predict. Understanding outcomes of extremely preterm infants can help better counsel families regarding antenatal and postnatal care and guide strategies to improve survival without morbidity. This review summarizes recent evidence to provide an overview into the short- and long-term outcomes for extremely preterm infants.

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Etiologies of NICU Deaths

Cited by 109 publications

References 8 publications

Morbidities and Outcome of a Neonatal Intensive Care in Western Nepal

Morbidities and Outcome of a Neonatal Intensive Care in Western Nepal

Deaths in the Neonatal Intensive Care Unit between 2002 and 2014

Short- and Long-Term Outcomes for Extremely Preterm Infants

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