Morbidity and mortality profile of neonates admitted in special newborn care unit of a teaching hospital in Uttarakhand, India

Abstract

Background: India accounts for 24% of global neonatal mortality. It is important to study the mortality and morbidity pattern as it helps to implement new treatment protocols, interventions, planning and policy making which helps in better survival and improvement in the quality of life among survivors. The aim of the project study was to determine the causes of morbidity and mortality in neonates admitted in our hospital.Methods: This study was conducted at Special Newborn Care Unit (SNCU) of Veer Chandra Singh Garhwali Government Institute of Medical Science and Research providing level II neonatal care. This is a retrospective hospital based observational study. Data from admission and discharge registers were extracted, compiled and analyzed from March 2016 to February 2018. Neonates taken against medical advice and those referred to tertiary care centers were excluded in calculation of survival outcome. Statistical analysis was done in form of percentage, proportions and chi square test was used to find statistical significance.Results: 1582 neonates were admitted during the study period. 60.80% were inborn and 39.20% were outborn. 59.54% were male and 40.46% were female. Major causes of admission were jaundice (24.72%), sepsis (20.48%), birth asphyxia (18.52%), meconium aspiration syndrome (10.11%). Birth asphyxia was the major cause of mortality, followed by sepsis and prematurity. Mortality was more in outborn babies 14.67% compared to inborn babies 9.80%.Conclusions: Neonatal jaundice, birth asphyxia and sepsis were the commonest causes of morbidity. Common causes of mortality were birth asphyxia and sepsis and prematurity. More deliveries at institutions with SNCU facility, early identification of danger signs and timely referral to tertiary care centers can prevent neonatal deaths.

Pattern of Neonatal Morbidity and Mortality: A Retrospective Study in a Special Newborn Care Unit, Mumbai

“…NNH was found to be the most common indication for SNCU admission in the current study (25.99% of neonates). This finding is in line with the other studies by Adikane et al, Kumar et al,and Saharia et al [14,15,17]. However, in the study published by Verma et al, respiratory distress was reported as the most common indication for admission, whereas Panigrahy et al reported prematurity (39.2%) as the most common cause of admission [13,16].…”

“…Jindal et al reported similar finding with 1.9% mortality, whereas majority of studies published from India reported higher mortality rate [21]. The previous studies have reported mortality rates ranging from 10.45% to 26% [9,13,15,16,18].…”

“…In this study, most of the neonates (85%) admitted to SNCU were early neonates. Kumar et al and Panigrahy et al also observed majority of admissions within the first 7 days of life [15,16], which indicate that this period of life is the most vulnerable and critical period.…”

“…In this study, birth asphyxia was the major cause of mortality (50%), followed by MAS, prematurity, and congenital anomaly. Many previous have also observed perinatal asphyxia as the leading cause of death [15,16,22,23]. Pandya et al found sepsis as the common cause of death [24].…”

<p>Prevalence and Factors Associated with Neonatal Mortality at Ayder Comprehensive Specialized Hospital, Northern Ethiopia. A Cross-Sectional Study</p>

“…25 It is lower than the study done in MizanTepi, Ethiopia where mortality was (22.8%) 26 But it was higher than studies done in Ethiopia, at University of Gonder14.3%, Felege Hiwot referral hospital 13.29% and India 11.41%. 15,27,28 This high degree of variation in mortality rate could be due to the difference in the health facility setups because some of the setups could be well-equipped, the presence of skilled manpower, also the difference in methodology use and the study participants' economic status.…”