Morbidity and Mortality Outcomes of Neonates admitted from other Health Care Facilities in a Resource-Limited Neonatal Intensive Care Unit
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-2.11675Keywords:
Low Birth Weight, Morbidity, Neonatal Intensive Care Unit (NICU), Neonatal Mortality, NeonateAbstract
Objective: To determine the morbidity and mortality outcomes of neonates admitted from other health care facilities in a resource limited neonatal intensive care unit.
Study Design: Prospective longitudinal study
Place and Duration of Study: Department of Paediatrics, Combined Military Hospital, Sialkot Pakistan, from Oct 2022 to Mar 2023.
Methodology: A total of 160 newborns were included. Their chronological and postmenstrual age, weight and gender were recorded. After investigations, they were followed for final diagnosis and outcome.
Results: The mean age of these neonates on admission was 3.11±4.92 days with majority of the neonates (70%) less than 24 hours old. Most were males (63.1)%. With a mean weight of 2.35±0.65 kg.
Low birth weight (LBW), which was seen in 25.63% of cases, respiratory distress syndrome (RDS) with prematurity, seen in 20.63 % neonates, and hypoxic ischemic encephalopathy (HIE), seen in 17.5% neonates, were the major factors associated with morbidity. Whereas mortality was associated predominantly with meconium aspiration syndrome (MAS), seen in 26.27% cases, intrauterine growth retardation (IUGR), seen in 25% and neonatal sepsis, seen in 20% of cases.
The majority of admitted cases experienced a successful discharge (86.25%), with an overall mortality rate of 13.75%.
Conclusion: Morbidity was predominantly due to low birth weight, respiratory distress syndrome with prematurity and hypoxic ischemic encephalopathy. Higher mortality was seen in cases of meconium aspiration syndrome, intrauterine growth retardation and sepsis.
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1. Sharrow D, Hug L, You D, Alkema L, Black R, Cousens S, et al. Global, regional, and national trends in under-5 mortality between 1990 and 2019 with scenario-based projections until 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation. Lancet Glob Health 2022; 10(2): e195-206. https://doi.org/10.1016/S2214-109X(21)00515-5
2. Olusanya BO, Kancherla V, Shaheen A, Ogbo FA, Davis AC. Global and regional prevalence of disabilities among children and adolescents: Analysis of findings from global health databases. Front Public Health 2022; 10: 3276.
https://doi.org/10.3389/fpubh.2022.977453
3. Lawn JE, Ohuma EO, Bradley E, Idueta LS, Hazel E, Okwaraji YB, et al. Small babies, big risks: global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting. Lancet 2023; 401(10389): 1707-1719.
https://doi.org/10.1016/S0140-6736(23)00522-6
4. Agudelo-Pérez S, Cifuentes-Serrano A, Ávila-Celis P, Oliveros H. Effect of the helping babies breathe program on newborn outcomes: systematic review and meta-analysis. Medicina 2022; 58(11): 1567. https://doi.org/10.3390/medicina58111567
5. Gonçalves BP, Procter SR, Paul P, Chandna J, Lewin A, Seedat F, et al. Group B streptococcus infection during pregnancy and infancy: estimates of regional and global burden. Lancet Glob Health 2022; 10(6): e807-819.
https://doi.org/10.1016/S2214-109X(22)00093-6
6. Abdallah Y, Namiiro F, Mugalu J, Nankunda J, Vaucher Y, McMillan D et al. Is facility based neonatal care in low resource setting keeping pace? A glance at Uganda’s National Referral Hospital. Afr Health Sci 2016; 16(2): 347-355.
https://doi.org/10.4314/ahs.v16i2.2
7. Shah S, Zemichael O, Meng HD. Factors associated with mortality and length of stay in hospitalised neonates in Eritrea, Africa: a cross-sectional study. BMJ Open 2019; 2(5): e000792.
https://doi.org/10.1136/bmjopen-2011-000792
8. Majigo M, Makupa J, Mwazyunga Z, Luoga A, Kisinga J, Mwamkoa B, et al. Bacterial Aetiology of Neonatal Sepsis and Antimicrobial Resistance Pattern at the Regional Referral Hospital, Dar es Salam, Tanzania; A Call to Strengthening Antibiotic Stewardship Program. Antibiotics 2023; 12(4): 767.
https://doi.org/10.3390/antibiotics12040767
9. Bajad M, Goyal S, Jain B. Clinical profile of neonates with respiratory distress. Int J Contemp Pediatr 2016; 3(3): 1009-1013. https://doi.org/10.18203/2349-3291.ijcp201623823
10. Mohamed HA, Shiferaw Z, Roble AK, Kure MA. Neonatal mortality and associated factors among neonates admitted to neonatal intensive care unit at public hospitals of Somali Regional State, Eastern Ethiopia: A multicenter retrospective analysis. PLoS One 2022; 17(5): e0268648.
https://doi.org/10.1371/journal.pone.0268648
11. Also U, Gwarzo GD. Patterns of morbidity and mortality among neonates seen in a tertiary hospital. Sahel Med J 2020; 23(1): 47. https://doi.org/10.4103/smj.smj_21_19
12. Rahman K, Begum R. Morbidity and mortality profile of neonates admitted in a special care newborn unit of a tertiary care teaching hospital of Assam, India. New Indian J Obgyn 2020; 7(1): 82-87.
https://doi.org/10.21276/obgyn.2020.7.16
13. Ali SR, Ahmed S, Lohana H. disease pattern and outcomes of neonatal admissions at a secondary care hospital in Pakistan. Sultan Qaboos Univ Med J 2013; 13(3): 424-428.
14. Tette EM, Nartey ET, Nuertey BD, Azusong EA, Akaateba D, Yirifere J, et al. The pattern of neonatal admissions and mortality at a regional and district hospital in the Upper West Region of Ghana; a cross sectional study. PloS One 2020; 15(5): e0232406.
https://doi.org/10.1371/journal.pone.0232406
15. Kanodia P, Yadav SK, Bhatta NK, Singh RR. Disease profile and outcome of newborn admitted to neonatology unit of BPKIHS. J Coll Med Sci 2015; 11(3): 20-24.
http://dx.doi.org/10.3126/jcmsn.v11i3.14059
16. Andegiorgish AK, Andemariam M, Temesghen S, Ogbai L, Ogbe Z, Zeng L et al. Neonatal mortality and associated factors in the specialized neonatal care unit Asmara, Eritrea. BMC Public Health 2020; 20: 1-9.
https://doi.org/10.1186/s12889-019-8118-x
17. Aslam S, Ahmed Z, Zaman S, Mansoor E, Nadeem T, Tabussam S et al. Factors Leading to Morbidity and Mortality in Neonates Presenting to Pak Emirates Military Hospital, Rawalpindi. Pak Armed Forces Med J 2022; 72(5): 1752-1756.
https://doi.org/10.51253/pafmj.v72i5.8842
18. Alisjahbana B, Rivami DS, Octavia L, Susilawati N, Pangaribuan M, Alisjahbana A, et al. Intrauterine growth retardation (IUGR) as determinant and environment as modulator of infant mortality and morbidity: the Tanjungsari Cohort Study in Indonesia. Asia Pac J Clin Nutr 2019; 28(S1): 17-31. https://doi.org/10.6133/apjcn.201901_28(S1).0002
19. Shirazi H, Riaz S, Mahmood RA. Morbidity and mortality pattern of newly born babies in a teaching hospital. J Rawalpindi Med Coll 2015; 19(3).
20. Khemani S, Shamim N, Mirza A, Mohammad N, Kagazwala S, Ahmed S et al. Referral pattern and outcomes of neonates from secondary care setting of aga khan university hospital to tertiary care centers in Pakistan. J Pak Med Assoc 2021; 71(5): 1432. https://doi.org/10.47391/JPMA.1259
21. Tanveer S, Basheer F, Motlaq FM, Khushdil A, Nawaz R, Khan FA et al. Pattern of admission and outcome of neonates admitted to tertiary care neonatal ICU. J Fatima Jinnah Med Univ 2019; 13(3): 116-120.
https://doi.org/10.37018/jfjmu.v13i3.638
22. Al-Momani MM. Admission patterns and risk factors linked with neonatal mortality: A hospital-based retrospective study. Pak J Med Sci 2020; 36(6): 1371.
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