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| LETTER TO EDITOR |
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| Year : 2021 | Volume
: 10
| Issue : 1 | Page : 56-57 |
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Study determinants of neonatal mortality among newborns admitted to neonatal intensive care unit Adama, Ethiopia: A case–control study
Ghulam Nabi
Department of Pediatrics, Bugshan Hospital, Jeddah, Saudi Arabia
| Date of Submission | 09-Apr-2020 |
| Date of Acceptance | 02-Jul-2020 |
| Date of Web Publication | 08-Feb-2021 |
Correspondence Address:
Dr. Ghulam Nabi
Pediatric Consultant and Neonatologist, Bugshan Hospital, Post Box 5860, Jeddah 21432
Saudi Arabia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jcn.JCN_16_20
How to cite this article:
Nabi G. Study determinants of neonatal mortality among newborns admitted to neonatal intensive care unit Adama, Ethiopia: A case–control study. J Clin Neonatol 2021;10:56-7 |
How to cite this URL:
Nabi G. Study determinants of neonatal mortality among newborns admitted to neonatal intensive care unit Adama, Ethiopia: A case–control study. J Clin Neonatol [serial online] 2021 [cited 2021 Feb 27];10:56-7. Available from: https://www.jcnonweb.com/text.asp?2021/10/1/56/308840 |
I read with interest the publication entitled “Study Determinants of Neonatal Mortality among Newborns admitted to neonatal intensive care unit (NICU) Adama, Ethiopia.” It is a case–control study reported by Kolobo et al.[1] I have some comments and queries, which require clarification from the authors:
- There is no mention about how many babies were abnormal and how many had surgical intervention to correct congenital abnormality
- How many came for follow-up. Neonatal mortality in your study was 33.33% (a total of 300 babies were recruited in this study, from these, 100 cases were recorded as neonatal death and 200 controls were alive, improved, and discharged)[1]
- In this study 48(48%) neonates were preterm, this was major factor for neonatal deaths.
Prematurity and its complications followed by congenital malformations were the leading causes of death.[2] Recent studies reveal that the primary causes of mortality in perinatal and neonatal period are preterm births and malformation.[3]
Khan et al in their study reported of the 159 preterm enrolled children, 65% survived, 16% died, and 19% were lost to follow-up. Those who survived were followed up for neurodevelopment by physicians and developmental psychologists. At a mean age of 31 months, the developmental status of 85 children was followed up for 12 months. Of these, 32% were normal, 45% had mild neurodevelopment impairments, and 23% had serious neurodevelopment impairments.[4] Studies from the various regions of Saudi Arabia have shown variable neonatal mortality in NICU.
Arafa and Alsheri[5] from Abha (southern region of Saudi Arabia) have reported high neonatal mortality (22.4%). Bassuni et al.[6] from the same region reported a neonatal mortality of 17.4%. Nabi and Karim[7] from Khamis Mushait (same region) in a retrospective 7-year study of neonatal mortality reported rates of 17%, 27%, 24%, 12.5%, 11.5%, 9.9%, and 6.6% in the year 1984 up to 1990. From Medina Munawara, western region of Saudi Arabia, Nabi and Karim[6] reported 6% neonatal mortality. The reasons for low neonatal mortality in their study were:
- Majority of the pregnant women attended the antenatal clinic and the deliveries were conducted in the hospitals
- Adequate number of beds available for the admission in the NICU
- Adequate number of trained staff (including doctors and nurses), equipment including assisted ventilation, and drugs including surfactant
- Strict aseptic precautions in collaboration with the infectious control team of the hospital
- Early use of expressed breast milk, breastfeeding, and early maternal involvement for the care of the baby
- Three-tier medical care system in this country, including primary health centers, secondary care hospitals, and tertiary care hospitals
- Rapid transport facilities for the transport of sick patients
- Regular perinatal mortality and morbidity meeting between obstetricians and NICU staff to discuss mortality and morbidity in the hospital
- Support from continuous medical education program
- Regular neonatology club meeting in the region. The problems faced by newborn infants vary significantly in different parts of the globe; even among developing nations, there is much variability in the causes of neonatal morbidity and mortality. While planning and providing health-care services to newborn infants, we have primarily looked at the information originating in specialized neonatal units rather than at the grassroot level.[8]
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Kolobo HA Chaka TE, Kasa RT. Study determinants of neonatal mortality among newborns admitted to neonatal intensive care unit Adama, Ethiopia; A case control study. Clin Neonatal 2019;8:232-7.  |
| 2. | Majeed-Saidan MA, Kashlan FT, Al-Zahrani AA, Ezzedeen FY, Ammari AN. Pattern of neonatal and postneonatal deaths over a decade (1995-2004) at a Military Hospital in Saudi Arabia. Saudi Med J 2008;29:879-83. |
| 3. | Greenberg J. Overview of morbidity and mortality. In: Nelson Text Book of Pediatrics. 21 st ed. Philadelphia: Elsevier 1600 J.F.Kinedy Boul; 2020. p. 863-67. |
| 4. | Khan NZ Muslima H, Parveen M, Bhattacharya M, Begum N, Chowdhry S. Neurodevelopment outcomes of preterm infants in Bangladesh. Pediatrics 2006;118:280-89. |
| 5. | Arafa MA, Alsheri MA. Predictors of neonatal mortality in the intensive care unit in Abha Saudi Arabia. Saudi Med J 1997;17:522-26. |
| 6. | Bassuni W, Abbag F Assindi A, Albarki A, Al Binali AM. Neonatal deaths in the Aseer region of Saudi Arabia. Experience in a referral neonatal intensive care unit. Ann Saudi Med 1997;17:522-26. |
| 7. | Nabi G, Karim MA. Correspondence, predictors of neonatal mortality in the intensive care unit in Abha Saudi Arabia. Saudi Med J 2004;25:1306-7. |
| 8. | Nabi G. Re: Call to establish a national lower limit of viability. Ann Saudi Med 2008;28:226-7. [ PUBMED] [Full text] |
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