Risk factors and trends in neonatal mortality in NICU in a tertiary care hospital in India

Sadashiva B Ukkali, Nagamani Kulkarni, Punitha Badsheshi, Ravindra Naganoor, A. Thobbi
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Abstract

Introduction: The most vulnerable period of human life is neonatal period, which accounts for most of the morbidities and mortalities. Most of them are preventable with adequate health-care facilities. Objectives: The aim of the study was to determine the trends of neonatal mortality and identify the risk factors, most of which are preventable and measure the progress of health-care services. Methods: A retrospective study was conducted in neonatal intensive care unit (NICU) of Al-Ameen Children Hospital (AMCH) Vijayapura, Karnataka, India. Data were extracted from paper medical records at AMCH of a period of 1 year and digitized. Data obtained included age, sex and birth weight, place of delivery, morbidity profile, mortality profile, diagnosis, and period of stay in NICU. Results: A total of 648 neonates were admitted in NICU during the study period of 1-year duration, between January and December 2021. A total of 382 (58.9%) infants were discharged on recovery, 65 (10.3%) were referred due to unavailability of advanced surgical intervention, 39 (6%) were discharged against medical advice, 162 (25%) died due to various reasons. Male neonatal deaths outnumbered female neonates (56.8%). Among the total neonatal deaths, 82 (50.6%) were preterm neonates, 73 (45.1%) were term neonates and 7 (4.3%) were post-term neonates. It was noticed that among neonatal deaths, 87 (54.3%) babies were out-born and 75 (46.2%) babies were inborn. In this study, it was noticed that the mortality percentage of the neonate falling in the category of 1.5–1.9 kg was high compared to other categories. In our study, respiratory distress syndrome was the main cause of mortality accounting for 19.1% (31 cases) of total cases and prematurity was the most common risk factor. Conclusion: Improving the standard of antenatal care and encouraging deliveries in institutions having good NICU facility and early identification of risk factors help to reduce the mortality and its complications.
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印度一家三级医院新生儿重症监护室新生儿死亡率的危险因素和趋势
人类生命中最脆弱的时期是新生儿期,占发病率和死亡率的大部分。其中大多数是可以通过适当的保健设施预防的。目的:研究的目的是确定新生儿死亡率的趋势,确定风险因素,其中大多数是可以预防的,并衡量保健服务的进展。方法:对印度卡纳塔克邦Vijayapura Al-Ameen儿童医院(AMCH)新生儿重症监护病房(NICU)进行回顾性研究。数据从AMCH 1年的纸质病历中提取并数字化。获得的数据包括年龄、性别和出生体重、分娩地点、发病率概况、死亡率概况、诊断和在新生儿重症监护病房的住院时间。结果:在2021年1月至12月为期1年的研究期间,共有648名新生儿入住NICU。382例(58.9%)康复出院,65例(10.3%)因无法获得先进的手术干预而转诊,39例(6%)不遵医嘱出院,162例(25%)因各种原因死亡。男婴新生儿死亡人数超过女婴(56.8%)。在新生儿死亡总数中,早产儿82例(50.6%),足月新生儿73例(45.1%),足月后新生儿7例(4.3%)。值得注意的是,在新生儿死亡中,87名(54.3%)婴儿是外产的,75名(46.2%)婴儿是先天性的。在这项研究中,我们注意到1.5-1.9 kg类别的新生儿死亡率高于其他类别。本研究中,呼吸窘迫综合征是导致死亡的主要原因,占总死亡病例的19.1%(31例),早产是最常见的危险因素。结论:在新生儿重症监护病房条件良好的机构提高产前护理水平,鼓励分娩,及早发现危险因素,有助于降低新生儿死亡率和并发症。
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