Neonatal outcome in new-borns admitted in NICU of tertiary care hospital in central India: a 5-year study

Background: Neonatal mortality rate contributes significantly to under five mortality rates. Data obtained from pattern of admission and outcome may uncover various aspects and may contribute and help in managing resources, infrastructure, skilled hands for better outcome in future.Methods: This retrospective study was done on 1424 neonates who were admitted at LN Medical College and JK Hospital, Bhopal in neonatal intensive care unit (NICU) in the Department of Paediatrics from January 2013-December 2017.Results: 1424 newborns admitted within 24 hours of birth were included in the study. About 767 were male neonates, (Male: female1.16:1). The low birth weight babies were 54% in our study. Among the various causes of NICU admission, Respiratory distress was present in 555 (39%) of neonates, Respiratory distress syndrome (Hyaline membrane disease) being the most common cause of respiratory distress. Neonatal sepsis accounted for morbidity in 24% of neonates, with Klebsiella being the most common organism grown in the blood culture. The incidence of congenital anomalies was 2.5%. The neonatal mortality was found to be 11% in our study. Prematurity with Respiratory distress syndrome (Hyaline membrane disease) and perinatal asphyxia were the two most common causes of neonatal mortality in the study. Extremely low birth weight neonates had the highest case fatality rate in the study, which indicates the need to develop an efficient group of professionals in teaching hospitals who will provide highly specialized and focused care to this cohort of vulnerable neonates.Conclusions: Present study has shown respiratory distress, perinatal asphyxia, and sepsis as the predominant causes of neonatal morbidity. All three are preventable causes, and our health-care programs should be directed toward addressing the risk factors in the community responsible for the development of these three morbidities. The preterm and low birth weight babies had significantly high mortality even with standard intensive care; therefore, a strong and effective antenatal program with extensive coverage of all pregnant females specifically in outreach areas should be developed which will help in decreasing preterm deliveries and also lower the incidence of low birth weight babies.

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Trends in Neonatal Mortality at a Tertiary Level Teaching Hospital

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v33i3.8957 ◽

2013 ◽

Vol 33 (3) ◽

pp. 213-217

Author(s):

Srijana Basnet ◽

Laxman Shrestha

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Neonatal Mortality ◽

Teaching Hospital ◽

Distress Syndrome ◽

Linear Trend ◽

Perinatal Asphyxia ◽

Live Births

Introduction: Neonatal services at Tribhuvan University Teaching hospital (TUTH) was essentially up to level II till year 2008 and upgraded to level III care in later years. A 4 years retrospective study was carried out at TUTH, Kathmandu, Nepal to determine any change in the trend of neonatal mortality after the improvement in its services. Materials and Methods: Labor room record book, neonatal record book, perinatal audit data and neonatal record charts were used to collect the data. Results: During the study period, there were total of 15063 live births. The neonatal mortality ranges from 9.46 to 14.88 per 1000 live births per year. There was no significant fall in trend of neonatal mortality (x2 for linear trend=1.40, p=0.23). There was also no significant fall in trend in perinatal mortality rates over this period (x2 for linear trend=1.92, p=0.16).The number of neonates referred to other hospitals has been significantly reduced by 61%.(x2 for linear trend=33.18, p<0.001). Majority of the neonatal deaths (72%) occurred within first 7 days of life and more than a third (39%) died within the first 24 hours of life. Respiratory distress syndrome, perinatal asphyxia and neonatal sepsis were three major causes of death. Deaths due to respiratory distress and perinatal asphyxia has not changed significantly over the years (p=0.4 and 0.25 respectively). Incidence of low birth weight ranges from 10.8 – 16.1% of total live births. 63% of neonatal mortality occurred in low birth weight babies. This trend has not changed in over the years (x2=1.03, p=0.31). Conclusion: With the improvement in the services, though neonatal mortality remained unchanged, referral rates and mortality due to respiratory distress syndrome of prematurity has decreased. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8957 J. Nepal Paediatr. Soc. 2013;33(3):213-217

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The Magnitude and Risk Factors of Acute Respiratory Distress Syndrome among Newborn Admitted To Neonatal Intensive Care Unit at Benghazi Medical Center

Asian Journal of Medicine and Health ◽

10.9734/ajmah/2021/v19i1230416 ◽

2021 ◽

pp. 41-61

Author(s):

Munera Awad Radwan ◽

Najia Abdelati El-Mansori ◽

Mufeda Ali Elfergani ◽

Mohanad Abdulhadi Lawgali

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Medical Center ◽

Female Gender ◽

Hyaline Membrane Disease ◽

Hyaline Membrane

Background: Hyaline Membrane Disease (HMD)/Respiratory Distress Syndrome (RDS) is the most common lung condition affecting premature babies. The inadequate amount of surfactant causes alveoli to collapse when the baby breathes out. It is hard for your baby to re-inflate the collapsed alveoli when he breathes. The lack of surfactant and resulting inflammation is called. Hyaline Membrane Disease (HMD)/Respiratory Distress Syndrome (RDS). Aim of the Study: To determine the magnitude of Hyaline membrane disease or respiratory distress syndrome and identify the risk factors and complication among newborn babies in neonatal intensive care unit at Benghazi medical center (BMC). Materials and Methods: Case series study. The study was conducted during the period between March 2017 to March 2018 of HMD cases at Benghazi medical center. A convenient sample of 120 cases diagnosed as HMD. Studied variables include the following; gestational age, birth weight, gender, type of pregnancy and type of delivery also the data for mothers such as (diabetes mellitus, preeclampsia hypothyroidism, receiving of Dexamethasone injection and premature rupture of membrane). Also investigation and treatment and finally the outcomes of babies. Statistical Methods: Data were analyzed with SPSS version 17, analysis of associations was made with application Chi - square test for categorical variables comparison, was applied for test of association P <0.25. P was considered statistically significant if ≤ 0.05. Results: Female gender was predominant (52%). Most of cases of HMD were between 1000 -2000 kg. Among the 120 cases we have (15%) sever HMD and the majority of cases have moderate –to sever Hyaline membrane disease 39 (32.5%) whereas very sever HMD were observed in nearly 27% of cases. The risk factors were history of maternal preeclampsia, maternal diabetes mellitus, prematurity and low birth weight babies and neonatal sepsis, all these were found to be very common risk factors of HMD. Pearson chi-square test p value highly significant of female gender with complications of HMD. Our results observed more than half of babies were died. Conclusion: The risk factors were history of maternal preeclampsia, maternal diabetes mellitus, prematurity and low birth weight babies and neonatal sepsis all these were found to be very common risk factors of HMD. Also we concluded that the cases had premature rupture of membrane, which identified as risk factors of hyaline membrane disease. Furthermore, we concluded that highly significant of female gender with complications of HMD, such as Pneumothorax, bronco pulmonary, dysplasia, intra ventricular hemorrhage and congenital heart diseases were common co- morbidities with respiratory distress syndrome, all these could be have an association with the development of hyaline membrane disease, finally we observed more than half of babies were died this is a warning sign for health services.

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Radiological Incidence and Course of Bronchopulmonary Dysplasia in 100 Consecutive Low Birth Weight Neonates

Acta Radiologica ◽

10.1177/028418519503600405 ◽

1995 ◽

Vol 36 (4-6) ◽

pp. 353-357 ◽

Cited By ~ 2

Author(s):

P. Lanning ◽

O. Tammela ◽

M. Koivisto

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress ◽

Bronchopulmonary Dysplasia ◽

Chest Radiography ◽

Hyaline Membrane Disease ◽

Low Birth Weight Infants ◽

Underlying Condition ◽

Hyaline Membrane

Bronchopulmonary dysplasia (BPD) is an important cause of chronic respiratory distress in low birth infants. The radiological incidence and course of BPD were assessed in 100 consecutive low birth weight infants. Chest radiographs were examined on admission, at the ages of 3 days, 7 days, 2 weeks and 4 weeks and at later follow-up until the examinations were normal. Twelve of the children died. The severity and typical radiological abnormalities of BPD were assessed. Among the children alive, there were 26 with BPD (29.5%). The BPD incidence was highest between the age of 2 weeks and 3 months (18–21%) declining to 3.4% at the age of 12 months. Radiological evidence of BPD was already seen at the age of 2 weeks in 16 of the children. Most cases (73%) had their maximum BPD score at the age of 1 to 3 months. The normalisation of the chest radiography occurred predominantly in the age between 3 and 6 months. The most frequent underlying condition in BPD was hyaline membrane disease in 81%.

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Survival and mortality of preterm neonates in a neonatal intensive care unit in Northern Ethiopia: a retrospective cohort study

Scientific Reports ◽

10.1038/s41598-021-04521-z ◽

2022 ◽

Vol 12 (1) ◽

Author(s):

Gdiom Gebreheat ◽

Hirut Teame

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Birth Weight ◽

Neonatal Mortality ◽

Neonatal Intensive Care ◽

Distress Syndrome ◽

Perinatal Asphyxia ◽

Preterm Neonates ◽

Mean Survival Time

AbstractThe purpose of this study was to assess the predictors of preterm neonatal survival in a neonatal intensive care unit (NICU). A cohort study was conducted retrospectively on 1017 preterm neonates using medical records from January 2014 through December 2018. The Kaplan–Meier model was used to estimate mean survival time and cumulative survival probability. Furthermore, Multivariable Cox regression analysis was run to identify predictors of preterm neonatal mortality using an adjusted hazard ratio (AHR) at P < 0.05 and 95% confidence interval (CI). During the follow-up period in the NICU, the mean survival time of the preterm neonates was 47 (95% CI (43.19–48.95)) days. Compound presentation (AHR = 2.29, 95% CI (1.23–4.24)), perinatal asphyxia (AHR = 2.83, 95% CI (1.75–4.58)), respiratory distress syndrome (AHR = 3.01, 95% CI (1.80–5.01)), 1-min APGAR score (AHR = 0.78, 95% CI (0.62–0.98)), and birth weight (AHR = 0.32, 95% CI (0.17–0.58)) were found to be significant predictors of time to preterm neonatal mortality. In conclusion, the survival probability of preterm neonates showed a considerable decrement in the first week of life. Fetal presentation, gestational age, birth weight, 1-min APGAR score, perinatal asphyxia and respiratory distress syndrome found as independent predictors of preterm neonatal mortality.

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Causes of Preterm and Low Birth Weight Neonatal Mortality in a Rural Community in Kenya: Evidence From Verbal and Social Autopsy

10.21203/rs.3.rs-76613/v1 ◽

2020 ◽

Author(s):

Beatrice Olack ◽

Nicole Santos ◽

Mary Inziani ◽

Vincent Moshi ◽

Polycarp Oyoo ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Neonatal Mortality ◽

Distress Syndrome ◽

Neonatal Period ◽

Preterm Neonates ◽

Neonatal Deaths ◽

Social Autopsy

Abstract BackgroundUnder-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. We aimed to establish causes of neonatal LBW and preterm mortality in Migori County, among participants of the PTBI-K (Preterm Birth Initiative-Kenya) study.MethodsThis was a cross sectional study whereby Verbal and social autopsy (VASA) interviews were conducted with caregivers of deceased LBW and preterm neonates delivered within selected 17 health facilities in Migori County, Kenya. The probable cause of death was assigned using the WHO International Classification of Diseases (ICD-10). ResultsBetween January 2017 to December 2018, 3175 babies were born preterm or LBW, and 162 (5.1%) died in the first 28 days of life in 17 participating health facilities in the PTBI-K project. VASA was conducted among 88 (53.7%) neonatal deaths. Almost half (38, 43.2%) of the deaths occurred within the first 24 hours of life. Birth asphyxia (45.5%), neonatal sepsis (26.1%), respiratory distress syndrome (12.5%) and hypothermia (11.0%) were the leading causes of death. In the early neonatal period, majority (54.3%) of the neonates succumbed to asphyxia while in the late neonatal period majority (66.7%) succumbed to sepsis. Delay in seeking medical care was reported for 4 (5.8%) of the neonatal deaths. ConclusionDeaths among LBW and preterm neonates occur early in life due to preventable causes. This calls for enhanced intrapartum and immediate postpartum care interventions targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia.

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Causes of preterm and low birth weight neonatal mortality in a rural community in Kenya: evidence from verbal and social autopsy

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04012-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Beatrice Olack ◽

Nicole Santos ◽

Mary Inziani ◽

Vincent Moshi ◽

Polycarp Oyoo ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Neonatal Mortality ◽

Distress Syndrome ◽

Neonatal Period ◽

Preterm Neonates ◽

Neonatal Deaths ◽

Social Autopsy

Abstract Background Under-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. We aimed to establish causes of neonatal LBW and preterm mortality in Migori County, among participants of the PTBI-K (Preterm Birth Initiative-Kenya) study. Methods Verbal and social autopsy (VASA) interviews were conducted with caregivers of deceased LBW and preterm neonates delivered within selected 17 health facilities in Migori County, Kenya. The probable cause of death was assigned using the WHO International Classification of Diseases (ICD-10). Results Between January 2017 to December 2018, 3175 babies were born preterm or LBW, and 164 (5.1%) died in the first 28 days of life. VASA was conducted among 88 (53.7%) of the neonatal deaths. Almost half (38, 43.2%) of the deaths occurred within the first 24 h of life. Birth asphyxia (45.5%), neonatal sepsis (26.1%), respiratory distress syndrome (12.5%) and hypothermia (11.0%) were the leading causes of death. In the early neonatal period, majority (54.3%) of the neonates succumbed to asphyxia while in the late neonatal period majority (66.7%) succumbed to sepsis. Delay in seeking medical care was reported for 4 (5.8%) of the neonatal deaths. Conclusion Deaths among LBW and preterm neonates occur early in life due to preventable causes. This calls for enhanced implementation of existing facility-based intrapartum and immediate postpartum care interventions, targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia.

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Neonatal Mortality and Morbidity in a Tertiary Care Hospital of Coastal South India

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v37i3.18734 ◽

2018 ◽

Vol 37 (3) ◽

pp. 232-237

Author(s):

Raja Kannan ◽

Suchetha Rao ◽

Prasanna Mithra ◽

SM Rajesh ◽

Bhaskaran Unnikrishnan ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Neonatal Mortality ◽

Congenital Malformations ◽

Distress Syndrome ◽

Care Hospital ◽

Mortality And Morbidity ◽

New Born

Correction: On 13th June, Prasanna Mithra was added as an author of this paper.Introduction: Progress in new-born survival has been slow. There is a variation in neonatal death rates across states and geographical region of a country. Understanding the pattern of mortality is essential in improving new-born survival. This study was conducted to study the mortality and morbidity profile in Neonatal Intensive Care Unit (NICU) of a university teaching hospital.Material and Methods: This was a retrospective descriptive study including records of all neonates admitted in NICU from January 2015 to December 2016.Results 3623 neonates were admitted during the study period. Majority were preterm and low birth weight babies. Neonatal jaundice (41.4%) was the leading cause of admission. Major cause of morbidity was sepsis (26.2%). Average duration of stay were higher in out borns (8.4 days) compared to inborn (6.5 days) neonates. Among mortality a higher male predominance was seen. Neonatal sepsis (36.3%) was the single most common cause of mortality followed by respiratory distress syndrome (27.4%) and congenital malformations (18.6%). Out born neonates which were self-transported had higher mortality rate than transported by ambulance.Conclusion This study identifies sepsis, prematurity and low birth weight as the major causes of morbidity. Sepsis, respiratory distress syndrome and congenital malformations were the leading causes of mortality Understanding causes of neonatal mortality may help to implement interventions to promote new-born survival.

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Analysis of Pathology in Premature Infants in Obstetrics and Gynecology Clinic at St George University Hospital, Plovdiv between 2013 and 2015

Folia Medica ◽

10.3897/folmed.63.e52203 ◽

2021 ◽

Vol 63 (1) ◽

pp. 88-96

Author(s):

Milena Sandeva ◽

Petar Uchikov

Keyword(s):

Intensive Care ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Gestational Age ◽

Premature Birth ◽

Distress Syndrome ◽

Neonatal Period ◽

Hyaline Membrane Disease ◽

Significant Difference ◽

Hyaline Membrane

Introduction: Premature birth is now one of the most profound prenatal problems worldwide because of the high morbidity and mor-tality it is associated with at the beginning of life. Advances in prenatal medicine over the past decades have led to a significant improve-ment of neonatal survival in risk groups of newborns. Infants of gestational age of 22-25 weeks represent the greatest medical, social, and ethical dilemma in neonatology. Most of these newborns need intensive care to survive, and most infants born between 28 and 32 weeks of gestation require special care. Those born 34 to 36 weeks’ gestation also have higher rates of short-term morbid premature birth-related conditions such as respiratory distress syndrome (RDS) and intraventricular hemorrhage (IVH) than their peers born at term. Aim: To carry out an analysis of morbidity during the neonatal period in premature babies. Materials and methods: A retrospective triennial study was conducted on 598 premature newborns. Results: The results of the study show that morbidity rate in premature born infants is high. The most frequent reasons for admission to the neonatal intensive care unit are the other forms of respiratory distress syndrome (45%). Respiratory distress syndrome (RDS) was observed in 23.41% of the prematurity, 10.7% of them were suspected of having other pathology, and 20.9% of premature neonates  manifested no complications in the neonatal period. There was a significant difference in the diagnosis of newborns after birth (p=0.0001, r=0.58), with the newborns with RDS demonstrating the most complications in the neonatal period. Conclusions: The conclusions to be drawn from the analysis of the data are as follows: there is wide comorbidity in the prematurity of RDS. Lower gestational age strongly correlates with the development of RDS. If no corticosteroid therapy is administered the risk of developing hyaline membrane disease increases. There is extremely high probability of neonatal mortality in children with hyaline membrane disease. There is significant difference between the primary diagnosis and the condition of the child at discharge from the medical establishment. Adequate and specialized prenatal care is essential when trying to reduce the incidence of preterm birth.

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