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LETTER TO EDITOR
Year : 2021  |  Volume : 10  |  Issue : 1  |  Page : 56-57

Study determinants of neonatal mortality among newborns admitted to neonatal intensive care unit Adama, Ethiopia: A case–control study


Department of Pediatrics, Bugshan Hospital, Jeddah, Saudi Arabia

Date of Submission09-Apr-2020
Date of Acceptance02-Jul-2020
Date of Web Publication08-Feb-2021

Correspondence Address:
Dr. Ghulam Nabi
Pediatric Consultant and Neonatologist, Bugshan Hospital, Post Box 5860, Jeddah 21432
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcn.JCN_16_20

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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 Mar 8];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:

  1. There is no mention about how many babies were abnormal and how many had surgical intervention to correct congenital abnormality
  2. 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]
  3. 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:

  1. Majority of the pregnant women attended the antenatal clinic and the deliveries were conducted in the hospitals
  2. Adequate number of beds available for the admission in the NICU
  3. Adequate number of trained staff (including doctors and nurses), equipment including assisted ventilation, and drugs including surfactant
  4. Strict aseptic precautions in collaboration with the infectious control team of the hospital
  5. Early use of expressed breast milk, breastfeeding, and early maternal involvement for the care of the baby
  6. Three-tier medical care system in this country, including primary health centers, secondary care hospitals, and tertiary care hospitals
  7. Rapid transport facilities for the transport of sick patients
  8. Regular perinatal mortality and morbidity meeting between obstetricians and NICU staff to discuss mortality and morbidity in the hospital
  9. Support from continuous medical education program
  10. 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 Top

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.  Back to cited text no. 1
    
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.  Back to cited text no. 2
    
3.
Greenberg J. Overview of morbidity and mortality. In: Nelson Text Book of Pediatrics. 21st ed. Philadelphia: Elsevier 1600 J.F.Kinedy Boul; 2020. p. 863-67.  Back to cited text no. 3
    
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.  Back to cited text no. 4
    
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.  Back to cited text no. 5
    
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.  Back to cited text no. 6
    
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.  Back to cited text no. 7
    
8.
Nabi G. Re: Call to establish a national lower limit of viability. Ann Saudi Med 2008;28:226-7.  Back to cited text no. 8
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