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

Anurekha V, Kumaravel K.S, Kumar P, Satheesh kumar D

Abstract


Introduction: A country’s health is measured in terms of infant mortality. The neonatal care was revolutionized after the inception of NHM. The reduction in mortality can be achieved by systematic approach to common diseases prevailing in the area and by applying the uniform treatment protocol to bring down the mortality. So, this study aims at identifying the morbidity and mortality pattern in a tertiary care referral center. Methodology: Hospital data based retrospective study from Jan’ 2016 to Dec’ 2017. Results: Total of 7108 neonates was analyzed. Male: female ratio was 1.25:1. Low birth weight babies accounted 48.91% and pre-term babies around 54.63%. Of this predominant were late preterm babies. Jaundice requiring photo therapy (21.97%) topped the list of morbidities followed by sepsis (19.27%) and respiratory distress (7.86%). Sepsis (24.93%), RDS (19.95%) and birth asphyxia (18.95%) were the leading causes of mortality. Overall mortality in this study was 11.28%. Conclusion: Hyper bilirubinemia, Sepsis and respiratory distress syndrome were the leading causes of morbidity. Neonatal sepsis can be prevented by enforcing strict hand hygiene and aseptic protocols. Low birth weight and prematurity were the significant contributors to morbidity and mortality. Hence antenatal programs to prevent prematurity and low birth weight babies should be strengthened.

Full Text:

PDF HTML

References


Sankar MJ, Neogi SB, Sharma J, Chauhan M, Srivastava R, Prabhakar PK, Khera A, Kumar R, Zodpey S, Paul VK. State of newborn health in India. J Perinatol. 2016 Dec; 36(s3): S3-S8. doi: 10.1038/jp. 2016.183.

Gonzalez RM, Gilleskie D. Infant Mortality Rate as a Measure of a Country's Health: A Robust Method to Improve Reliability and Comparability. Demography. 2017 Apr; 54 (2):701-720. doi: 10.1007/s13524-017-0553-7.

Registrar general and census commissioner, India. SRS sample registration system bulletin volume 51 No1, 2017.

Bryce J, Boschi-Pinto C, Shibuya K, Black RE; WHO Child Health Epidemiology Reference Group. WHO estimates of the causes of death in children. Lancet. 2005 Mar 26-Apr 1; 365 (9465):1147-52.

Grady SC, Frate SN et al. Neonatal mortality in East Africa, And west Africa–a geographic analysis of district level demographic and heath survey. Geospat Health, 2017 May 26; 12 (1): 501. doi: 10.4081/gh. 2017.501.

Lawn JE, Cousens S, Zupan J. Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? Where? Why? Lancet 2005; 365: 891–900. DOI: https: //doi.org/ 10. 1016/ S0140-6736 (05)71 048-5.

Million Death Study Collaborators, Bassani DG, Kumar R, Awasthi S, Morris SK, Paul VK, Shet A, Ram U, Gaffey MF, Black RE, Jha P. Causes of neonatal and child mortality in India: a nationally representative mortality survey. Lancet. 2010 Nov 27;376(9755):1853-60. doi: 10.1016/S0140-6736 (10) 61461-4. Epub 2010 Nov 12.

Kumaravel KS, Ganesh J, Balaji J, Pugalendhiraja KV, Ramesh Babu B. A study on impact of NRHM on Neonatal care and clinical profile Neonates admitted in a SNCU of a rural medical college. Journal of evolution of medical and dental sciences.2015; 82(13); 14335.

Kalter HD, HossainM, BurnhamG, Khan NZ, Saha SK et al. Validation of caregiver interviews to diagnose common causes of severe neonatal illness. Indian perinate epidemiol1999;13; 99-113.

BangdiwalaSI, NiswadiA, UghadeS, Zodpey S, Integrating results from formative phase studies for informing the design of intervention studies on neonatal health in India. world health popul; 2006 1:1-10.

Okechukwu AA, Achonwa A. Morbidity and mortality patterns of admissions into the Special Care Baby Unit of University of AbujaTeaching Hospital, Gwagwalada, Nigeria. Niger J ClinPract. 2009 Dec;12 (4): 389-94.

Mukhtar-Yola M, Iliyasu Z. A review of neonatal morbidity and mortality in Aminu Kano Teaching Hospital, Northern Nigeria. Trop Doct 2007; 37:130-2.

Shreshtha S, Sharma A, Upadhyay S, Rijal P. Perinatal mortality audit. Nepal Med Coll J 2010;87: 130-8.

Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, Cousens S, et al. Neonatal mortality levels for 193 countries in 2009 with trends since 1990: A systematic analysis of Progress, projections, and priorities. PLoS Med 2011; 8:e1001080.

Shakya A, Shrestha D, Shakya H, Shah SC, Dhakal AK. Clinical profile and outcome of neonates admitted to the Neonatal Care Unit at a teaching hospital in Lalitpur, Nepal. Journal of Kathmandu Medical College 2014; 3(4) Issue 10:144-148.

Shrestha SP, Shah AK, Prajapati R, YR Sharma YR. Profile of Neonatal Admission At Chitwan Medical College. Journal of Chitwan Medical College 2013; 3 (6): 13-16.

Jan AZ, Ahmad S, Zahid SB. Clinical Audit of admission pattern and its outcome in a neonatal ICU.Gomal J Med Sci 2013;11:31-6.

Gauchan E, Basnet S, Koirala DP, Rao KS. Clinical profile and outcome of babies admitted to Neonatal Intensive Care Unit (NICU). J Inst Med 2011; 33:1-5.

Morbidity and mortality among outbornneonatesat 10tertiary careinstitutions in India during the year2000.J Trop Pediatr. 2004 Jun;50(3):170-4.

Mallick AK, Sarkar UK. One year experience of neonatal mortality and morbidity in a state level neonatal intensive care unit and its comparison with national neonatal-perinatal database. J Indian Med Assoc 2010; 108:738-9, 742.

Islam MN, Siddika M, Hossain MA, Bhuiyan MK, Ali MA. Morbidity pattern and mortality of neonates admitted in a tertiary level teaching hospital in Bangladesh.Mymensingh MedJ.2010 Apr;19(2):159-62.

Simiyu DE. Morbidity and mortality of neonates admitted in general paediatric wards at Kenyatta National Hospital. East Afr Med J. 2003 Dec;80(12): 611-6.

Patil Ravindra B, KoppadRaghavendraswamy, BenakanalShreeshail.Clinical Profile and Outcome of Babies Admitted to Neonatal Intensive Care Unit (NICU), Mc Gann Teaching Hospital Shivamogga, Karnataka: A Longitudinal Study. Sch. J. App. Med. Sci., 2014; 2 (6G): 3357-3360.

Sridhar PV, Thammanna PS, Sandeep M. Morbidity Pattern and Hospital Outcome of Neonates Admitted in a Tertiary Care Teaching Hospital, Mandya. Intl J Sci Study 2015;3(6): 126-129.

Rakholia R, Rawat V, Bano M, Singh G. Neonatal morbidity and mortality of sick newborns admitted in a teaching hospital of Uttarakhand. CHRISMED J Health Res 2014; 1:228-34.

Malik S, Gohiya P, Khan IA. Morbidity profile and mortality of neonates admitted in Neonatal Intensive Care Unit of a Central India Teaching Institute: A prospective observational study. J ClinNeonatol 2016; 5: 168-73.

Modi R, Modi B, Patel JK, Punitha KM. Study of the Morbidity and the Mortality Pattern in the Neonatal Intensive Care Unit at a TertiaryCare teaching Hospital in Gandhinagar District, Gujarat, India. J Res Med Den Sci 2015;3(3):208-12.

Taksande A, Vilhekar K, Chaturvedi P, Jain M. Congenital malformations at birth in Central India: A rural medical college hospital based data. Indian J Hum Genet 2010; 16:159-63.

National Neonatal Perinatal Database. Report for Year 2000. National NeonataologyFoum India; 2000.

Neonatal – Perinatal database and birth defects surveillance. Report of regional review meeting. New Delhi, India: World Health House SEARO;2014.p. 3-6.

Carlo WA, Goudar SS, Jehan I, Chomba E, Tshefu A, Garces A, Parida S, Althabe F, McClure EM, Derman RJ, Goldenberg RL, Bose C, Krebs NF, Panigrahi P, Buekens P, Chakraborty H, Hartwell TD, Wright LL; First Breath Study Group. Newborn-care training and perinatal mortality in developing countries. N Engl J Med. 2010 Feb 18;362(7):614-23. doi: 10. 1056 /NEJMsa0806033.


Refbacks

  • There are currently no refbacks.