Study of a spectrum of neonatal mortality of neonates admitted in NICU of tertiary care hospital

Abstract

The neonatal phase of an infant’s life is vulnerable period. Low birth weight and premature babies were universally accepted as high-risk factors of morbidity and neonatal deaths. Hence to study mortality pattern of neonates in NICU of tertiary care hospital in metropolitan city, a cross sectional study of 420 neonates admitted in NICU during 06 months periods was studied.

About93% of the admitted neonates were in the early neonatal period and 7% presented in late neonatal period. There were 58.33% males out number their 41.67% female counterparts. About 267 (63.57%) neonates were of preterm gestation and 36.33% were full-term. The weight parameter of neonates showed that 63.1% were low birth weight and 36.9% were of normal weight. 75% of the admitted neonates were delivered in our Institute and 25% referred from outside for neonatal intervention study identified a greater number of LBW, pre-termed babies. 12.62% neonatal mortality was found among admitted neonates. It was observed that bleeding PV or PROM was the highest risk factor (21.05%) followed by multiple pregnancy (20.18%) and PIH 1(15.79%). 30.2% neonates showed cause of death as severe perinatal asphyxia followed by respiratory distress syndrome (26.4%). Birth Asphyxia 16(30.2%), prematurity with respiratory distress syndrome 14(26.4%), septicemia 13(24.5%) Meconium Aspiration Syndrome 7(13.2%) followed by Congenital Anomalies 2(3.77%) were the top five major contributors to the mortality in our study. The most common cause of neonatal mortality was birth asphyxia in our study. No significant association was found between gender, gestational age and birth weight of neonates with mortality rate of the neonates (p>0.05). A significant association was observed between hospital stay and mortality rate of neonates ((X²=32.75, p<0.00001). Neonates stayed for three or more days at NICU were 84% less likely to die to neonates who stayed for less than three days (OR = 0.16, with 95% CI 0.08 to 0.32)

By proper health education and strengthening of antenatal services along with awareness of neonatal problems in low-birth-weight babies, the incidence of very low birth weight and their complications can be reduced.