The pattern of admission and their related outcomes in NICU of a tertiary care teaching hospital, Udaipur, Rajasthan, India

Abstract

Introduction: To achieve MDG4 (Millennium Developmental Goals-4), a substantial reduction inearly neonatal deaths will be required. The first steps in improving early neonatal survival are todocument the number and rate of deaths and identify their common causes. As per the NationalFamily Health Survey-3 report, the current neonatal mortality rate (NMR) in India is 39 per 1000 livebirths, neonatal deaths account for nearly 77% of all infant deaths (57/1000) and nearly half ofunder-five child deaths (74/1000). This study was undertaken to study the disease pattern andoutcome of neonates admitted to the neonatal intensive care unit (NICU) of a tertiary care teachinghospital located in Udaipur, Rajasthan. Material and methods: The age, sex, gestational age, andmorbidity and mortality profile of all NICU admissions in 5 years was determined and the differencebetween Inborn (those born in the Teaching Hospital) and Out born was calculated. Morbidity riskfactors to reduce NMR in Udaipur were determined. Results: A total of 2648 neonates wereadmitted to NICU during the study period, out of which none were excluded from the study. Theratio of Male to Female admitted was 1.30:1. The major causes of morbidity were MeconiumAspiration Syndrome (16.16%), Respiratory Distress Syndrome(10.12%), Cong. HeartDefects(8.76%), Neonatal Sepsis(4.83%) and Hypoxic-Ischemic Encephalopathy(5.66%). In thisstudy, the overall mortality rate was 9.96%. Most of the Deaths were due to MAS(25.75%),RDS(15.90%), Neonatal Sepsis(10.22%), and HIE(12.87%). Neonates with birth weight <1000ghad poor outcomes compared to neonates with birth weight >2500g. Conclusion: This studyidentified Prematurity, Extremely low birth weight, MAS, and Neonatal Sepsis as major causes ofMorbidity and MAS, RDS as the major contributors to neonatal mortality. Improving antenatal care,maternal health, and timely referral of high-risk cases to tertiary care hospitals will help to improveneonatal outcomes.