Outcome analysis of Neonates admitted to Neonatal Intensive Care Unit of a Border District of Uttar Pradesh

Abstract

Background: As per the Child Mortality Report 2018 by UNICEF the current neonatal mortality rate in India stands at 24 per 1000 live births with it being more than the national average for Uttar Pradesh. The neonatal morbidity and outcome pattern in terms of discharge or otherwise shows considerable national, state, district and sub- district variations due to a multitude of diverse factors contributing to it at various levels. Aim & Objective: The aim of the study was to explore the mortality rate and outcome in NICU setting, and factors influencing the outcomes. Methods and Material: This government NICU based follow-up study comprised of data analysed from 450 neonates through a semi-structured questionnaire using face to face interview technique. Data was evaluated in SPSS and; independent t test and chi square test were applied. Statistical analysis used: Data was evaluated in SPSS and; independent t test and chi square test were applied. Results: For morbidity low birth weight (LBW) (14.4%) and for mortality LBW/prematurity (56%) were the most common causes. The discharge rate was 64.4%. Good outcome in the form of successful discharge was statistically significant with birth weight (p=0.000), gestational age (0.001), length of stay at NICU (p=0.003) male sex (p=0.003) and feeding of newborn (p=0.002) Conclusions: The study enunciates a high discharge rate in tertiary care government NICU with a mixed morbidity and mortality profile. The causes are mainly preventable and hence can be largely mitigated through dedicated ante natal, intra natal and post-natal care.

Morbidity and Mortality Profile of Neonates Admitted in Neonatal Intensive Care Unit in a Tertiary Care Hospital, South-Eastern Rajasthan, Jhalawar Medical College, Jhalawar: A Retrospective Study

“…Outborn babies died significantly more compared to inborn babies due to sepsis (25.87% vs. 14.37%) These mortality data showed similar patterns in other studies [5][6][7][8][9][10][11][12]. In NICU, mortality can be reduced substantially if a good disinfection and hygiene practices are established as part of essential newborn care in peripheral hospital and referral center.…”

“…Among sick neonates, the most common causes for morbidity were sepsis (18.1%), birth asphyxia (15.6%), and RDS (11.5%). Incidence of sepsis was at par with other NICU in Pakistan and South Africa[6][7][8][9][10][11][12]. The incidence of RDS can be attributed to increased preterm admissions.…”

Evaluation of Morbidity and Mortality of the Newborn Admitted to Special Newborn Care Unit

“…Data regarding admissions and deaths concerning sex, place of birth, birth weight, gestational age, duration of stay, specific morbidities, and the overall outcome were collected and analyzed. The study's diagnosis of neonatal illness and cause of death was made using clinical information based on working definitions of the South-east Asia regional Neonatal-Perinatal Database WHO [5,6]. To prevent overlapping of cases in different categories of morbidities, the primary disease was considered the final diagnosis even when the baby developed complications of primary infection or had more than one disease.…”

“…No autopsy was done to confirm the cause of death. The definitions of the following terminologies are used in the study from the source mentioned above [6].…”

“…• Intramural/inborn-birth of a baby in the same facility, • Extramural/outborn-the birth of a baby outside the facility and referred here. • Low birth-weight (LBW) < 2.5 kgs, very LBW < 1.5 kg), extreme LBW < 1 kg) • Respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS), birth asphyxia (BA), septicemia, pneumonia, meningitis (Sepsis), major congenital malformations (MCM) [6].…”