Study of variables affecting mortality among extramural very low birth weight neonates in tertiary care centre: a prospective observational study

Abstract

Background: Over the past few decades, the burden of extramural very low birth weight (VLBW) neonates is increasing due to advances in obstetrics services. Objective of present study was to know variables affecting mortality in these neonates. Methods: A prospective observational study was conducted at department of paediatrics, government medical college and hospital, Nagpur, India over a period of 2 years. Out-born neonates admitted in this tertiary care centre with birth weight between 1000-1499 gm were included in the study. Proper antenatal, natal history were taken and data was collected using data collection sheet. All subjects were followed up till discharge or death whichever was earlier. Results: Significant demographic factors associated with neonatal mortality were found out to be place of birth, birth attendant, distance travelled and transport time. Neonatal factors which significantly associated with mortality were found out to be hypothermia and SpO2 less than 90%.Conclusions: Univariate analysis concluded that age at presentation (>24 hours), place of birth, birth attendant, distance travelled, mode of transport, transport time, hypothermia, SpO2<90% were found to be significant factors for predicting risk of mortality in VLBW neonates. However, multivariate analysis concluded only 4 predictors that is age more than 24 hours, transportation time, SpO2 on admission and hypothermia were found to retain their significance. VLBW babies are vulnerable, but with small improvements in infrastructure and personnel training, significance difference in prevention of morbidity and mortality can be seen.