Neonatal Outcomes at a Subdistrict Hospital in North India

Abstract

Subdistrict hospitals form the first referral level facilities for essential newborn care services. However, there is a paucity of information on the pattern of neonatal admission and outcomes at this level. The objective of this study was to describe the spectrum of neonatal mortality at a subdistrict hospital. The study was conducted at a 50-bed hospital at Ballabgarh in northern India. The data of the neonates born in this hospital (inborns) and those admitted with sickness after being delivered at home (outborns) were separately analysed for the period 1994-1999. The main outcomes of interests were incidence, distribution, and primary causes of neonatal mortality. Of 6746 inborns and 385 outborns admitted (total 7,137) there were 56 deaths (0.8 per cent) and 38 (0.6 per cent) referrals among inborn and 70 deaths (18.2 per cent) and 37 (9.6 per cent) referrals among outborns. The deaths or referral rates among inborn for different weight groups were 27.7 per cent for < 1,500 g, 7.2 per cent for 1500-1999 g, 1.2 per cent for 2,000-2,499 g, and 0.6 per cent for weight > or = 2,500 g. Most deaths under 7 days of age were related to prematurity [41 per cent (28/69)] and birth asphyxia [38 per cent (26/68)], while those aged between 7 and 27 days were mostly due to sepsis [91 per cent (42/46)]. The results of this study indicate that babies with a birthweight above 1,500 g have a good outcome at this level. Deaths under 7 days of age were mostly due to birth asphyxia and prematurity, while those after 7 days were almost entirely due to sepsis. Referral is an important outcome at this level of service.

Morbidity and mortality profile of neonates in a tertiary care centre in Tamil Nadu: a study from South India

“…Low birth weights accounted for 60% of the total deaths which is similar to study conducted by Kumar M et al 16 Present study shows that babies with VLBW and Gestational less than 32 weeks were strongly attached with high mortality which is similar to study conducted by Yasmin S et al 17 Neonates who are referred from other centres have a higher mortality when compared to inborn babies and in that Perinatal asphyxia stands first. The outcome of this study reveals the need for the hour regarding the timely perinatal interventions in primary and secondary care.…”

Incidence of Nicu Admissions of Neonates Born to Teenage Mothers in East Godavar I District

“…In a study from a sub-district level hospital from India, Kumar et al reported a similar mortality rate. 25 Our study also showed that preterm babies with a birth weight which was less than 1500g were strongly associated with high mortality. Yasmin et al from Bangladesh also reported that VLBW and lower gestational age (<32weeks) carried a high mortality risk.…”

Impact of simple interventions on neonatal mortality in a low-resource teaching hospital in India

“…19 Excellent survival of small and sick neonates by involving mothers in resource-poor subdistrict hospital was reported from India. 20 Involvement of mothers in care of sick and small neonates can therefore help addressing the crunch of manpower in resource-poor settings.…”