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ORIGINAL ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 3  |  Page : 183-188

Pattern of neonatal morbidity and mortality: A prospective study in a District Hospital in Urban India


1 Department of Pediatrics, Sigma Child and Maternity Hospital, Jalandhar, Punjab, India
2 Department of Obstetrics and Gyanecology, Kamal Child and Maternity Hospital, Jalandhar, Punjab, India

Correspondence Address:
Dr. Navdeep Saini
57, Indira Park, Wadala Road, Jalandhar, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4847.191258

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Objective: To determine the cause and disease pattern of neonatal morbidity and mortality in the secondary care neonatal unit of a district hospital. Study Design: Descriptive prospective study. Setting: Department of Pediatrics, General Hospital, Sec 16, Chandigarh. This hospital is providing optimal neonatal Level 2 care. Participants: All neonates who born in General Hospital Sec 16, Chandigarh, over 1 year were enrolled in the study. Outside born neonates and those who were re-admitted in the neonatal nursery after their discharge from hospital were excluded from the study. Methods: All consecutive live-born babies in the period of 1-year were included in the study. Babies received in labor room or operation theater were assigned Apgar score, and vital parameters were recorded. Sick babies were shifted to neonatal nursery as per admission policy, and rest of the babies were shifted with mother. All the babies were examined within 24 h of birth and daily thereafter till their discharge from the hospital. Main Outcome Measure: Antenatal and postnatal services, maternal education. Results: There were 6509 live births, of which 50 were twin pairs and 6409 were singleton birth. About 4.33% babies were born prematurely (<37 weeks), 21.7% babies were low birth weight (LBW) (<2500 g) including 0.4% very LBW (VLBW) babies (<1500 g), and 0.26% as extra LBW (ELBW) (<1000 g) babies. Five hundred and ninety-two (9.09%) babies were suffered from various morbidities, and 67 (1.03%) died during the hospital stay. Hyperbilirubinemia (7%) was the leading cause of neonatal morbidity followed by sepsis (3.99%) and respiratory distress (3.9%) among the various causes of respiratory distress transient tachypnea of the newborn was the leading cause (33%) followed meconium aspiration syndrome (20.5%) and pneumonia (14.9%). Hyaline membrane disease was seen in 11.8% of cases. Congenital malformations were seen in 1.75% of cases. Limb defects (31.3%) were the most common malformation followed by cardiac 49.9%, neural tube defect (13.9%), and Down syndrome 7.8%. Birth asphyxia (29.85%) and respiratory distress (22.38%) were the leading cause of death followed by extreme prematurity (22.3%) and sepsis (14.9%). Morbidity and mortality among LBW babies (22.3% and 3.53%) and ELBW (100% and 88%) and VLBW (84.6% and 46.2%) were higher as compared to normal birth weights (5.44% and 0.33%). Morbidity and mortality among preterm babies (58.5% and 11.7%) were high as compared to term babies (6.97% and 0.53%). Morbidity was higher among large for date babies (41%) as compared to small for date (SFD) (17.7%) and appropriate for date (AFD) (6.8%) babies higher mortality was seen in SFD babies (1.9%) as compared to 0.8% in AFD babies. Conclusion: Hyperbilirubinemia, sepsis, and respiratory distress were the leading causes of morbidity in our study. Birth asphyxia, prematurity, and neonatal sepsis were the leading causes of neonatal mortality in our study. Interventions to reduce preterm delivery, LBW, and birth asphyxia should be planned and implemented by health-care managers at the community level. Improvements in neonatal care at different levels will definitely reduce the neonatal deaths.


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