Clinical profile and predictors of mortality among the referred neonates at a tertiary care centre in north India: a prospective observational study

2020 ◽  
Vol 50 (3) ◽  
pp. 221-227
Author(s):  
Jasbir Singh ◽  
Poonam Dalal ◽  
Geeta Gathwala
Keyword(s):  
Tertiary Care ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Family Health ◽  
Favourable Outcome ◽  
Clinical Profile ◽  
North India ◽  
Tertiary Care Centre ◽  
Predictors Of Mortality ◽  
Sick Newborn

The National Family Health Survey (NFHS-4) shows encouraging improvement in infant and under-five mortality rates in India. However, the neonatal mortality rate (NMR) still remains high as India contributes to about one-fifth of global deaths. This prospective study was conducted from 15 January to 30 April 2016 to examine the clinical profile and predictors of mortality among referred neonates at our centre. Among 301 neonates, prematurity (40%) was the most common indication for referral followed by need for ventilation (38%) and birth asphyxia (28%). Approximately 73% neonates were referred within 24 h of birth. Ninety (29.9%) neonates died; of these, 63% died within 24 h of presentation. Prematurity, birth asphyxia, hypothermia, shock at presentation and extreme low birth weight were the most significant predictors of mortality. Adequate training of peripheral health personnel, dedicated teams for neonatal referral and strengthening of peripheral sick newborn care units (SNCUs) seem to be promising interventions for favourable outcome.

scholarly journals Transport characteristics and predictors of mortality among neonates referred to a tertiary care centre in North India: a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e044625
Author(s):  
Jasbir Singh ◽  
Poonam Dalal ◽  
Geeta Gathwala ◽  
Ravi Rohilla
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Predictors Of Mortality ◽  
Transport Services ◽  
Interhospital Transport

ObjectiveThe paucity of specialised care in the peripheral areas of developing countries necessitates the referral of sick neonates to higher centres. Organised interhospital transport services provided by a skilled and well-equipped team can significantly improve the outcome. The present study evaluated the transport characteristics and predictors of mortality among neonates referred to a tertiary care centre in North India.DesignProspective observational study.SettingsTertiary care teaching hospital in North India.Patients1013 neonates referred from peripheral health units.Main outcome measuresMortality among referred neonates on admission to our centre.ResultsOf the 1013 enrolled neonates, 83% were transferred through national ambulance services, 13.7% through private hospital ambulances and 3.3% through personal vehicles. Major transfer indications were prematurity (35%), requirement for ventilation (32%), birth asphyxia (28%) and hyperbilirubinaemia (19%). Hypothermia (32.5%, 330 of 1013), shock (19%, 192 of 1013) and requirement for immediate cardiorespiratory support (ICRS) (10.4%, 106 of 1013) on arrival were the major complications observed during transfer. A total of 305 (30.1%, N=1013) deaths occurred. Of these, 52% (n=160) died within 24 hours of arrival. On multivariate logistic analysis, unsupervised pregnancy (<4 antenatal visits; p=0.037), antenatal complications (p<0.001), prematurity ≤30 weeks (p=0.005), shock (p=0.001), hypothermia (p<0.001), requirement for ICRS on arrival (p<0.001), birth asphyxia (p=0.004), travel time >2 hours (p=0.005) and absence of trained staff during transfer (p<0.001) were found to be significant predictors of mortality.ConclusionThe present study depicts high mortality among infants referred to our centre. Adequate training of peripheral health personnel and availability of pre-referral stabilisation and dedicated interhospital transport teams for sick neonate transfers may prove valuable interventions for improved outcomes.

scholarly journals CLINICAL PROFILE AND PREDICTORS OF MORTALITY OF EXTRAMURAL NEONATES ADMITTED IN NICU OF TERTIARY CARE HOSPITAL IN CENTRAL RAJASTHAN : PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
pp. 119-122
Author(s):  
Abhilasha Sharma ◽  
Pukhraj Garg ◽  
Arjun Singh
Keyword(s):  
Birth Weight ◽  
Neonatal Sepsis ◽  
Neonatal Period ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Clinical Profile ◽  
Care Hospital ◽  
Essential Newborn Care ◽  
Predictors Of Mortality

OBJECTIVE: This study was undertaken to know the clinical profile and predictors of mortality of outborn neonates admitted in Neonatal Intensive Care Unit (NICU). METHOD:This prospective study was conducted in NICU of department of pediatrics,JLN medical college & hospital, Ajmer from January 2019 to December 2019. RESULTS:Of the 2250 neonates admitted,There was male preponderance (64%),male:female ratio was 1.78:1.Majority of neonates (68.4%) were term while 31.2% were preterm and 0.4% were post term gestation. Majority of neonates (79.8%) were admitted in early neonatal period while 20.1% neonates were admitted in late neonatal period. As per birth weight,44.1% neonates were between 1.5-2.49 kg,42.6% neonates had birth weight more than 2.5 kg while 3.4% neonates were <1 kg.Majority of neonates (88.7%) were delivered vaginally while 11.3% were delivered by caesarean section.Majority of neonates (85.1%) were delivered at govt.hospitals while 11% and 3.9% neonates were delivered at private hospitals and at home respectively. Rural residency (73.7%) was far more as compared to urban residency (26.3%).42.8% mothers had primary education and 47.7% mothers had secondary education while 3.8% mothers were illiterate. Majority of cases (66.1%) belonged to middle socioeconomic class. Major causes of NICU admission were birth asphyxia / HIE of newborn (21.11%),neonatal sepsis (16.36%),neonatal jaundice (12%),RDS of newborn (8.6%), and prematurity (7.7%). Out of 2250 neonates admitted, 70.1% babies were successfully discharged while 29.9% neonates died during treatment.Birth Asphyxia / HIE of Newborn (22.25%),RDS of Newborn (20.47%),Neonatal Sepsis (16.02%), Shock (10.98%), Congenital Malformations (6.82%), and ELBW (6.38%) were found to be major causes of mortality among neonates admitted in NICU. CONCLUSION: The majority of morbidities and subsequently the mortalities can be reduced by improving maternal care and essential newborn care,appropriate primary interventions and timely referral to tertiary care centers for high risk cases,with better transport facilities for sick neonates.

scholarly journals Quality Of Referral, Admission Status And Outcome Of Neonates Referred To Pediatric Emergency Of A Tertiary Care Institution In North India

2021 ◽  
Author(s):  
Neeraj Mishra ◽  
Shiv Sajan Saini ◽  
Jayashree Muralidharan ◽  
Praveen Kumar
Keyword(s):  
Tertiary Care ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Pediatric Emergency ◽  
North India ◽  
Main Mode ◽  
Sick Newborn ◽  
Admission Status ◽  
Mode Of Transport

Abstract Background: We evaluated quality of referral, admission status and outcome of neonates.Methods: We enrolled newborns admitted between March 2016 and October 2016, excluding neonates referred from outpatient department. Information was collected from referral slips, interviewing accompanying persons and observation.Results: 61% were referred from government hospitals with “Sick Newborn Care Units” contributing to maximum. Main mode of transport was ambulance in 80% and referral notes were available in the majority but incomplete in majority. Sepsis (39%), jaundice (16%) and birth asphyxia (13%) were most common diagnoses. Half of the newborns were hemodynamically unstable. 27% had poor circulation, 15% were hypoxic, 9% hypoglycemic and 8% hypothermic. 22% either died or “Left Against Medical Advice” with a high probability of death.Conclusion: National ambulance service is utilized for transporting newborns. However, there are quality gaps which need attention to develop it into efficient referral system.

scholarly journals Clinical Profile and Outcome of Neonates Admitted to Neonatal Intensive Care Unit (NICU) at a Tertiary Care Centre in Eastern Nepal

2013 ◽  
Vol 33 (3) ◽  
pp. 177-181 ◽  
Author(s):  
Gauri Shankar Shah ◽  
Satish Yadav ◽  
Anil Thapa ◽  
Lokraj Shah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Clinical Profile ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Development Goals

Introduction: Neonatal period is the most susceptible period of life due to different causes, which in most cases are preventable. Every year millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU) for various indications. One of the Millennium Development Goals is to reduce under five mortality by two thirds by 2015. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to NICU. Materials and Methods: A retrospective study was conducted at level III Neonatal NICU of a tertiary -care teaching hospital from January, 2012 to December, 2012. Results: Total of 361 neonates were admitted in NICU. Eighty six neonates (23.8%) were admitted due to prematurity and 73 (20.2%) with birth asphyxia. Among birth asphyxia, 40(54.8%)were in HIE III, 27.4% and 17.8% in HIE II and HIE I, respectively. One hundred eighteen (32.6%) cases were diagnosed as sepsis. The overall mortality was 20.2% during hospital stay. Conclusions: Sepsis, prematurity and birth asphyxia were major causes for admission in NICU. All these etiologies are preventable up to some extent and, if detected earlier, can be effectively treated in order to reduce morbidity and mortality. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8447   J. Nepal Paediatr. Soc. 2013;33(3):177-181

scholarly journals Experience of managing first fifty COVID-19 positive peripartum women in a tertiary care centre in North India

2021 ◽  
Vol 10 (3) ◽  
pp. 1036
Author(s):  
Vijay Zutshi ◽  
Neha Mohit Bhagwati ◽  
Alka .
Keyword(s):  
Pregnant Women ◽  
Severe Disease ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
North India ◽  
Tertiary Care Centre ◽  
Mild Disease ◽  
Qrt Pcr ◽  
The Mean

Background: SARS-CoV-2 has caused significant morbidity and mortality worldwide. Analysis of the clinical profile of COVID-19 positive pregnant women is important to understand the pathophysiology, transmission and outcome of the disease in Indian population.Methods: It is a retrospective observational study of first fifty pregnant patients tested positive for COVID-19 by qRT PCR admitted for delivery in our hospital.Results: In this audit, first fifty COVID-19 pregnant women were studied and the mean age of the patients in this study was 26 years. 98% of these women were admitted for obstetric indications. Seventy two percent of these women were admitted with spontaneous onset of labour. Based on disease severity, 49 (98%) were either asymptomatic or exhibited mild disease and only 1 (2%) had severe disease who succumbed to her illness. Forty six percent patients delivered vaginally and 54% required cesarean delivery. The most common indication for LSCS was fetal distress (43%). Eighteen percent had preterm delivery. Among the newborn babies, one died due to severe birth asphyxia. Sixteen percent babies required NICU stay. Five babies tested positive for COVID-19 of which one baby was positive on day one of life.Conclusions: As per our results, majority of the COVID-19 positive pregnant women had mild disease. There has been increase in cesarean section rate as compared to the previous hospital figures. Only one baby tested positive within 24 hours of delivery so the possibility vertical transmission can not be commented upon as of today.

scholarly journals Epidemiological study on body mass index distribution and health awareness among women at an urban tertiary care centre of north India

2019 ◽  
Vol 8 (4) ◽  
pp. 1542
Author(s):  
Kamna Datta ◽  
Pooja Gupta ◽  
Pushpa Singh
Keyword(s):  
Body Mass Index ◽  
Health Education ◽  
Body Mass ◽  
Tertiary Care ◽  
Family Health ◽  
Overweight And Obesity ◽  
North India ◽  
Obese Women ◽  
Tertiary Care Centre ◽  
Tertiary Center

Background: Obesity has become a new worldwide health problem and is gradually moving towards an epidemic. overweight and obesity implies an abnormal excessive fat accumulation that poses health risk. According to National Family Health Survey-4, prevalence of obesity has doubled in country over the last decade. Asian Indians stand at higher risk for development of obesity related non-communicable diseases at lower body mass index levels.Methods: It was an observational interpretive study carried on 1000 randomly selected women over 3 months in a tertiary center of urban northern India. BMI was obtained by dividing weight in kilograms and height in meters squares. Patients were enquired about any menstrual complains, known comorbidities, awareness of obesity in terms of its cause and effects, about weight reduction and benefits of exercise and its practice and details noted in a preformed performa. No prior intervention or health education was given to avoid bias.Results: Out of 1000 women, mean BMI was found to be 31.85±8.85kg/m2. BMI classification (Asian standards) stated that 8.1% were overweight and 78% of patients were pre obese and obese (maximum in age of 21-40 years). Menstrual complaints were present among 39% of overweight and obese groups. Among comorbidities, hypothyroidism was found to be maximum being 9.5% in the obese group, followed by hypertension and diabetes mellitus. Only 26.3% of obese women were aware of the factors causing obesity. Knowledge of exercise benefits was grossly limited, with only one fourth of the pre obese and obese population being aware of it.Conclusions: Rising obesity in Indian women needs measures for prevention. Though there is knowledge of the cure among Indian females but there is limited ability to implement the same. Health education of women regarding obesity related comorbidities along with the benefits of weight loss with exercises should be promoted strongly.

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