Morbidity pattern based on clinico-biochemical profile of neonates admitted in NICU of a tertiary care hospital in the mid north bank region of Assam

Chinmayee Barthakur, Julie Sarmah, N. Saharia
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Abstract

The neonatal period carries the highest risk of death per day compared to any other period during childhood. Of all newborn deaths three fourths result from three preventable and treatable conditions– complications due to prematurity, intrapartum related deaths (including birth asphyxia) and neonatal infections. The study was to describe the morbidity pattern with outcome, based on clinical diagnosis and relevant biochemical parameters amongst neonates admitted in NICU in the tertiary care hospital. A retrospective case record analysis of all the NICU admissions between January 2021 to March 2021 was done based on both electronic and hard data. The neonates with complete records of clinical presentation, relevant biochemical investigations were included in the study. Out of 624 neonates admitted in NICU during the study period, 622 were included in the final analysis. The proportion of fullterm and preterm among inborns (77.6% &18.8%) and outborns (76.2% & 21.8%) were similar, but the proportion of low-birth-weight babies in outborns was higher than in the inborns. The overall discharge rate was 85.5%. It was higher for inborn neonates as compared to outborn neonates (88.7% vs 79%). The death rate was higher in outborns than in inborns. The highest no of NICU admission was due to asphyxia related conditions followed by neonatal jaundice in both genders and in all inborn and outborn neonates. Out of total admissions in NICU, 72(11.6%) was due to infections causing neonatal sepsis, meningitis and acquired pneumonia. While neonatal jaundice has a lower mortality rate, preventable conditions like birth asphyxia and infections remain major concerns for neonatal morbidity and mortality in this region. The study emphasizes the need for strengthened antenatal care, improved infection control, and increased access to trained neonatologists to ensure better outcomes for newborns.
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基于阿萨姆邦中北岸地区一家三级医院新生儿重症监护室收治的新生儿临床生化特征的发病模式
与儿童期的任何其他时期相比,新生儿期每天的死亡风险最高。在所有新生儿死亡病例中,有四分之三是由三种可预防和可治疗的病症造成的--早产并发症、产期相关死亡(包括出生窒息)和新生儿感染。本研究旨在根据三级医院新生儿重症监护室收治的新生儿的临床诊断和相关生化指标,描述其发病模式和结局。研究人员根据电子数据和硬数据,对 2021 年 1 月至 2021 年 3 月期间新生儿重症监护室的所有入院病例进行了回顾性病例记录分析。具有完整临床表现和相关生化检查记录的新生儿被纳入研究范围。在研究期间,新生儿重症监护室共收治了 624 名新生儿,其中 622 名被纳入最终分析。新生儿中足月儿和早产儿的比例(77.6% 和 18.8%)与新生儿中足月儿和早产儿的比例(76.2% 和 21.8%)相似,但新生儿中低出生体重儿的比例高于新生儿。总体出院率为 85.5%。出生新生儿的出院率高于非出生新生儿(88.7% 对 79%)。非新生儿的死亡率高于新生儿。在新生儿重症监护室入院的新生儿中,因窒息相关病症入院的比例最高,其次是新生儿黄疸,男女均是如此,所有新生儿中的新生儿黄疸均与出生时的窒息有关。在新生儿重症监护室的所有入院病例中,有 72 例(11.6%)是因为感染而导致新生儿败血症、脑膜炎和获得性肺炎。虽然新生儿黄疸的死亡率较低,但出生窒息和感染等可预防的疾病仍是该地区新生儿发病率和死亡率的主要问题。这项研究强调,有必要加强产前护理、改善感染控制和增加获得训练有素的新生儿科医生服务的机会,以确保新生儿获得更好的治疗效果。
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