The pattern of admission and their related outcomes in NICU of a tertiary care teaching hospital, Udaipur, Rajasthan, India

Introduction: To achieve MDG4 (Millennium Developmental Goals-4), a substantial reduction inearly neonatal deaths will be required. The first steps in improving early neonatal survival are todocument the number and rate of deaths and identify their common causes. As per the NationalFamily Health Survey-3 report, the current neonatal mortality rate (NMR) in India is 39 per 1000 livebirths, neonatal deaths account for nearly 77% of all infant deaths (57/1000) and nearly half ofunder-five child deaths (74/1000). This study was undertaken to study the disease pattern andoutcome of neonates admitted to the neonatal intensive care unit (NICU) of a tertiary care teachinghospital located in Udaipur, Rajasthan. Material and methods: The age, sex, gestational age, andmorbidity and mortality profile of all NICU admissions in 5 years was determined and the differencebetween Inborn (those born in the Teaching Hospital) and Out born was calculated. Morbidity riskfactors to reduce NMR in Udaipur were determined. Results: A total of 2648 neonates wereadmitted to NICU during the study period, out of which none were excluded from the study. Theratio of Male to Female admitted was 1.30:1. The major causes of morbidity were MeconiumAspiration Syndrome (16.16%), Respiratory Distress Syndrome(10.12%), Cong. HeartDefects(8.76%), Neonatal Sepsis(4.83%) and Hypoxic-Ischemic Encephalopathy(5.66%). In thisstudy, the overall mortality rate was 9.96%. Most of the Deaths were due to MAS(25.75%),RDS(15.90%), Neonatal Sepsis(10.22%), and HIE(12.87%). Neonates with birth weight <1000ghad poor outcomes compared to neonates with birth weight >2500g. Conclusion: This studyidentified Prematurity, Extremely low birth weight, MAS, and Neonatal Sepsis as major causes ofMorbidity and MAS, RDS as the major contributors to neonatal mortality. Improving antenatal care,maternal health, and timely referral of high-risk cases to tertiary care hospitals will help to improveneonatal outcomes.

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Morbidities and Outcome of a Neonatal Intensive Care in Western Nepal

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v15i2.18203 ◽

2017 ◽

Vol 15 (2) ◽

pp. 141-145 ◽

Cited By ~ 3

Author(s):

Sudhir Adhikari ◽

Kalipatanam Seshagiri Rao ◽

Ganesh B.K. ◽

Namraj Bahadur

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Neonatal Mortality ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Tertiary Care ◽

Neonatal Hyperbilirubinemia ◽

Preterm Neonates ◽

Risk Of Mortality

Background: Neonatal mortality rate of developing countries is declining over decades. In the recent years increasing number of preterm and high risk neonates have facilities for tertiary care treatment. The aim of the study was to assess the morbidities and outcome of neonatal intensive care admissions.Methods: It was a retrospective observational study carried out in neonatal intensive care unit of the Manipal Teaching Hospital, Pokhara, Nepal from January 2014 to December 2015. Neonatal details including place of delivery, birth weight, gestation, diagnosis at admission, hospital course and final outcome were recorded in predesigned proforma. Risk of mortality was calculated using odds ratio and 95% confidence interval. Results: There were total 1708 admission during study period and inborn as well as out born neonates were equally admitted. Neonatal hyperbilirubinemia (37.1%), neonatal sepsis 532 (31.2%), prematurity, 314 (18.4%) perinatal asphyxia 112 (6.6%), meconium aspiration syndrome 79 (4.6%) and intrauterine growth restriction 49 (2.8%) were main indications for hospitalization. A total of 1410 (82.6%) the patients were discharged after treatment, 167 (9.7) left against medical advice, 115 (6.7%) died in hospital and 16 (1%) cases were referred. Preterm neonates had twice the risk of mortality than term neonates (OR =2.1664). Birth weight < 2500 grams had three times more risk of neonatal mortality than normal birth weight (OR =3.0783).Conclusions: Neonatal hyperbilirubinemia, prematurity and neonatal sepsis were common morbidities inneonatal intensive care unit.

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Neonatal Mortality in the Neonatal Intensive Care Unit at Benghazi Pediatric Hospital– Libya.

AL-MUKHTAR JOURNAL OF SCIENCES ◽

10.54172/mjsc.v35i4.331 ◽

2020 ◽

Vol 35 (4) ◽

pp. 284-293

Author(s):

Zahra Mansour Alharam ◽

Isaada Elsaeti ◽

Mohamed Alferjani

Keyword(s):

Birth Weight ◽

Neonatal Mortality ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Case Series ◽

Future Research ◽

Pediatric Hospital ◽

Neonatal Deaths ◽

Case Series Study ◽

Term Newborns

This research aims to study mortality rates and identify the direct causes of neonatal deaths among newborns at Benghazi Pediatric Hospital. A descriptive case series study was conducted during 2015. Data included; birth weight, gender, residency, duration of hospital stay, age of neonates at death, and causes of death. Out of 1610 neonatal admissions reviewed, the total number of deaths was 122 during 2015. The data focused on death certificates of neonates and showed that the male gender was predominant (62.3 %). Most of them had a birth weight ranged between 2-2.9 Kg. Approximately 52 % of neonatal deaths in one day were of newborns <1 week old, and 54% were full-term newborns. The most frequent direct single cause of death in neonates was prematurity, then neonatal sepsis and congenital heart disease respectively. The study concluded that the most frequent causes of infant mortality related deaths were prematurity then neonatal sepsis. Furthermore, future research is recommended, and the calculation of early and late neonatal mortality rate with the availability of total live births.

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IMPACT OF NEONATAL INTENSIVE CARE

PEDIATRICS ◽

10.1542/peds.97.2.215 ◽

1996 ◽

Vol 97 (2) ◽

pp. 215-215

Author(s):

Student

Keyword(s):

Intensive Care ◽

Birth Weight ◽

Mortality Rate ◽

Neonatal Mortality ◽

Neonatal Intensive Care ◽

Neonatal Mortality Rate ◽

Total Reduction ◽

Weight Groups

Neonates who weighed > 1.5 kg at birth were the major contributors to the overall reduction in the neonatal mortality rate (NMR); approximately two thirds of total reduction in the NMR between 1960 and 1980 and 52.6% of the total reduction between 1980 and 1986 occurred in the > 1.5-kg birth weight groups.

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A profile on the spectrum of neonatal mortality and morbidity pattern of extramural neonates in the Specialised Neonatal Care Unit (SNCU) in a tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180529 ◽

2018 ◽

Vol 5 (2) ◽

pp. 427 ◽

Cited By ~ 1

Author(s):

Anuradha D. ◽

Rajesh Kumar S. ◽

Aravind M. A. ◽

Jayakumar M. ◽

J. Ganesh J.

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress ◽

Neonatal Mortality ◽

Low Birthweight ◽

Tertiary Care ◽

Birth Asphyxia ◽

Newborn Care ◽

Care Hospital ◽

Neonatal Deaths

Background: Every year, nearly four million newborn babies die in the first month of life. India carries the single largest share (around 25-30%) of neonatal deaths in the world. Neonatal deaths constitute two thirds of infant deaths in India. 45% of the deaths occur within the first two days of life. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively at the appropriate time. It was further estimated that health facility-based interventions can reduce neonatal mortality by 23-50% in different settings. Facility-based newborn care, thus, has a significant potential for improving the survival of newborns in India. This research has been planned with an aim to study the profile of pattern of admissions in a SNCU and their outcomes following admission and management in the unit.Methods: All babies referred for neonatal problems (less than 28 days) and admitted in NICU will be included. Both term and preterm babies will be considered. The criteria for admission includes various causes like low birth weight, preterm, birth asphyxia, respiratory distress, hyperbilirubinemia, congenital anomalies, risk factors (maternal, neonatal, prenatal), infections and outcome will be analysed.Results: Among the 2927 admissions term babies and boys outnumbered. The common causes for admission were birth asphyxia, respiratory distress, low birthweight and preterm. Most babies had an uncomplicated stay. The mortality in the extramural neonates was due to neonatal sepsis, extreme preterm and congenital malformations.Conclusions: Intensive and interventional management, along with good neonatal monitoring and care can reduce the mortality and improve the survival of low birth weight babies and other treatable problems. Thus, a combined effort of management by pediatricians, nursing care, neonatal intensive care unit can improve the survival rates of neonates.

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Choice of Antibiotics in Late Neonatal Sepsis in the Extremely Low Birth Weight Infant

Canadian Journal of Infectious Diseases ◽

10.1155/2003/510265 ◽

2003 ◽

Vol 14 (1) ◽

pp. 28-31 ◽

Cited By ~ 1

Author(s):

Tara R Allen ◽

Orlando P da Silva

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Neonatal Intensive Care Unit ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Bacterial Resistance ◽

Neonatal Infection ◽

Extremely Low Birth Weight ◽

Suspected Sepsis

OBJECTIVE: To review the choice of antibiotics in treating suspected late neonatal sepsis in infants weighing 1000 g or less in a neonatal intensive care unit.METHODS: Retrospective review of medical records.RESULTS: Ninety-six infants weighing 1000 g or less were admitted to the neonatal intensive care unit during the study period. Sixty-two infants survived beyond four days of life and had at least one sepsis workup done to exclude late neonatal infection. Of the 62 study patients, 42 (68%) were started on ampicillin and netilmicin (A/N) and 20 (32%) were started on vancomycin and ceftizoxime (V/C) as the antibiotics of choice, pending culture results. Of the patients started on A/N, 17 of 42 had a positive blood culture compared with 11 of 20 on V/C (40% versus 55%, P=0.40). The mean (±SD) birth weight of infants started on A/N was 793±133 g compared with a mean of 728±153 g in the group that received V/C (P=0.09). Seven patients died in the A/N group compared with three in the V/C group (16.7% versus 15%, P=0.84). In addition to the sepsis episode studied, before they were discharged from hospital, 21 of 42 (50%) infants in the A/N group had further workups for suspected sepsis, compared with 16 of 20 (80%) (P=0.048) infants initially given V/C.CONCLUSIONS: Ampicillin and netilmicin is a safe antibiotic combination for neonates suspected of late sepsis. This, in turn, may be important in reducing vancomycin overuse and the potential for bacterial resistance to this antimicrobial agent.

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Mean platelet volume (MPV) as a diagnostic marker in neonatal sepsis

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20191008 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1036

Author(s):

Prathyusha . ◽

Shreekrishna G. N. ◽

Sinchana Bhat ◽

Sahana P.

Keyword(s):

Neonatal Sepsis ◽

Predictive Value ◽

Neonatal Intensive Care ◽

Diagnostic Marker ◽

Tertiary Care ◽

Study Groups ◽

Care Hospital ◽

Neonatal Deaths ◽

Significant Difference ◽

Group B

Background: Neonatal sepsis is a frequent and important cause of morbidity and mortality which accounts for one quarter of neonatal deaths. There are very few studies done in India to evaluate the role of MPV as diagnostic marker of neonatal sepsis.Methods: Prospective case control study in a tertiary care hospital. Neonates > 30 weeks gestation admitted to neonatal intensive care unit during the study period of 1 year with clinically suspected were included in the study. Neonates with Septic screen positive and culture positive sepsis were included in group A and normal neonates were included in Group B. MPV was done for all the subjects and values more than 10.2fl was considered positive. Newborns with congenital anomalies and who were already on antibiotics prior to admission were excluded from the study. Statistical analysis was done using Statistical Package of Social Sciences (SPSS) version 17.0.Results: 106 neonates were included in the study. MPV showed statistically significant difference between the study groups (mean 12.8±1.52, 10.82±1.20 respectively) at a cut of value of 10.2fl and a sensitivity of 93%, specificity of 84 % with a positive predictive value of 83% and negative predictive value of 94%.Conclusions: MPV can be used as an adjuvant marker along with established septic screen to ensure early diagnosis and treatment of neonatal sepsis with no additional expense.

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Trends and Determinants of Perinatal Mortality in a Tertiary Care Hospital of Nepal

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v20i1.29133 ◽

2021 ◽

Vol 20 (1) ◽

pp. 77-82

Author(s):

Yuba Nidhi Basaula ◽

Radha Kumari Paudel ◽

Ram Hari Chapagain

Keyword(s):

Mortality Rate ◽

Perinatal Mortality ◽

Neonatal Sepsis ◽

Perinatal Asphyxia ◽

Tertiary Care ◽

Care Hospital ◽

Perinatal Deaths ◽

Neonatal Deaths ◽

Perinatal Mortality Rate ◽

Increasing Trend

Introduction: Perinatal mortality rate (PMR) in Nepal is still very high. In major hospitals of Nepal, it is still ranging from 20 to 30 per thousand births. This study was carried out to review the different aspects of PMR and classifying them and identify the causes of perinatal and neonatal deaths and assessing the need for improvement in quality of pregnancy and newborn care. Methods: It was a retrospective study carried out in Bharatpur Hospital, Chitawan, Nepal. Data of all stillbirths from 22 weeks of pregnancy and neonatal deaths up to seven days of life was taken from monthly perinatal audit and annual mortality review. The data was taken from July 2017 to Jun 2019. All the perinatal deaths were then classified. Results: Over a two year period, there were total 25,977 births and total death was 369. Thus perinatal mortality rate was 12.3 per thousand births. Still births (fresh and macerated) contributed almost 82.4% of the perinatal deaths and neonatal death contributed 17.6% of total deaths. Deaths related to unexplained intrauterine fetal death (IUFD) showed an increasing trend and have increased by more than 20% in past two years from 39.1% to 60.8%. Deaths due to perinatal asphyxia, neonatal sepsis, respiratory distress syndrome and extreme prematurity were increased. Conclusions: PMR over the two years has shown increasing trend at our institute. There is need to improve antenatal, obstetric as well as intra-partum services to further reduce the still birth as well as deaths due to prematurity, RDS, neonatal sepsis and perinatal asphyxia.

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Neonatal Mortality Rate in Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital in Missan Province From 2011 to 2014

European Scientific Journal ESJ ◽

10.19044/esj.2016.v12n27p55 ◽

2016 ◽

Vol 12 (27) ◽

pp. 55

Author(s):

Esraa Abd Al-Muhsen Ali

Keyword(s):

Mortality Rate ◽

Neonatal Mortality ◽

Teaching Hospital ◽

Causes Of Death ◽

Neonatal Period ◽

Birth Asphyxia ◽

Neonatal Care ◽

Neonatal Mortality Rate ◽

Neonatal Deaths ◽

Neonatal Care Unit

Background: The neonatal mortality rate is a key outcome indicator for newborn care and directly reflects prenatal, natal, and postnatal care. Early neonatal deaths are more closely associated with pregnancy-related factors and maternal health, whereas late neonatal deaths are associated more with factors in the newborn‘s environment. Objectives: To estimate the neonatal mortality rate in Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital in Missan Province during period (2011-2014). To determine the most common causes of death in the neonatal period. Patients and methods: A hospital-based study was done depending on data collected from records of the Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital in Missan Province to calculate the number of deaths within the neonatal period (0-28 days) that was conducted from 2011 to 2014. The other line of data was collected from Obstetrical Ward by calculating number of live births for the same period. Then Neonatal Mortality Rate is calculated and conducted for each year according to the method recommended by WHO. Results: The neonatal mortality rates were 12.15, 13.51, 16.37 and16.11 in 2011 to 2014 respectively in which there was an increment in mortality rate. The main causes of death were respiratory distress syndrome, birth asphyxia and congenital anomalies. Conclusion: Neonatal mortality rate was high in the Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital, but it was less than the previous period in Iraq since 1990. These results suggest, that to decrease neonatal mortality, improved health service quality is crucial.

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Predictors of mortality in neonatal sepsis in a resource-limited setting

Journal of Advanced Pediatrics and Child Health ◽

10.29328/journal.japch.1001034 ◽

2021 ◽

Vol 4 (1) ◽

pp. 057-061

Author(s):

Nyenga Adonis Muganza ◽

Mukuku Olivier ◽

Mutombo André Kabamba ◽

Mpoy Charles Wembonyama ◽

Luboya Oscar Numbi ◽

...

Keyword(s):

Birth Weight ◽

Mortality Rate ◽

Low Birth Weight ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Democratic Republic Of Congo ◽

University Hospitals ◽

Predictors Of Mortality ◽

Resource Limited

Introduction: Sepsis remains a major cause of death in neonatal period. Although significant advances in diagnosis, therapeutic and prevention strategies have been noted, sepsis remains a common concern in clinical practice especially in low-resource countries. The aim of this study was to determine the predictors of mortality in neonatal sepsis in Lubumbashi city (Democratic Republic of Congo). Methods: The records of newborns with sepsis managed in Neonatal Intensive Care Units in two University Hospitals between November 2019 and October 2020 were studied. Binary and multiple logistic regressions have been used to observe the association between independent variables and dependent variable. Results: A total of 162 cases of neonatal sepsis were reviewed. The mortality rate of neonatal sepsis was 21% of babies admitted. Very low birth weight (< 1500 grams) and primiparity were significantly associated with mortality in neonatal sepsis (AOR = 12.66; 95% CI 2.40 to 66.86; p = 0.003 and AOR = 3.35; 95% Cl 1.31 to 8.59; p = 0.012, respectively). Conclusion: The mortality rate of neonatal sepsis was 21%. Very low birth weight and primiparity were significantly associated with mortality in neonatal sepsis.

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