Outcome analysis of Neonates admitted to Neonatal Intensive Care Unit of a Border District of Uttar Pradesh
DOI:
https://doi.org/10.47203/IJCH.2019.v31i03.014Keywords:
Neonate, Outcome, Morbidity, MortalityAbstract
Background: As per the Child Mortality Report 2018 by UNICEF the current neonatal mortality rate in India stands at 24 per 1000 live births with it being more than the national average for Uttar Pradesh. The neonatal morbidity and outcome pattern in terms of discharge or otherwise shows considerable national, state, district and sub- district variations due to a multitude of diverse factors contributing to it at various levels. Aim & Objective: The aim of the study was to explore the mortality rate and outcome in NICU setting, and factors influencing the outcomes. Methods and Material: This government NICU based follow-up study comprised of data analysed from 450 neonates through a semi-structured questionnaire using face to face interview technique. Data was evaluated in SPSS and; independent t test and chi square test were applied. Statistical analysis used: Data was evaluated in SPSS and; independent t test and chi square test were applied. Results: For morbidity low birth weight (LBW) (14.4%) and for mortality LBW/prematurity (56%) were the most common causes. The discharge rate was 64.4%. Good outcome in the form of successful discharge was statistically significant with birth weight (p=0.000), gestational age (0.001), length of stay at NICU (p=0.003) male sex (p=0.003) and feeding of newborn (p=0.002) Conclusions: The study enunciates a high discharge rate in tertiary care government NICU with a mixed morbidity and mortality profile. The causes are mainly preventable and hence can be largely mitigated through dedicated ante natal, intra natal and post-natal care.
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References
India Newborn Action Plan. (2018). Available at: https://www.newbornwhocc.org/INAP_Final.pdf [Accessed 13 Aug. 2018].
Neo Natal Mortality Rate (NMR) (per 1000 live births) | NITI Aayog, (National Institution for Transforming India), Government of India [Internet]. [cited 2018 Sep 29]. Available from: http://niti.gov.in/content/neo-natal-mortality-rate-nmr-1000-live-births [Accessed 18 Sep. 2018].
UNICEF, WHO, World Bank Group and United Nations. Levels and Trends in Child Mortality Report 2018 . Available from: https://data.unicef.org/wp-content/uploads/2018/09/UN-IGME-Child-Mortality-Report-2018.pdf [Accessed 18 Sept. 2018].
A Joint Report of the Registrar General of India and the Centre for Global Health Research [Internet]. Available from: http://www.cghr.org/wordpress/wp-content/uploads/COD-India-Report-2010-2013-Dec-19-2015.pdf [Accessed 25 Sept. 2018].
Punitha P, Kumaravel KS, Pugalendhiraja KV S. A study on the current status of neonatal transport to a special newborn care unit. Stanley Med J. 2016;(October):55–9.
Raikwar P, Parihar D, Batra APS, KaurJ,Juneja P, Kak I. A study of neonatal admission pattern and outcome from rural Haryana.Glob J Res Anal. 2018;7(February):73–5.
Verma J, Anand S, Kapoor N, Gedam S, Patel U. Neonatal outcome in new-borns admitted in NICU of tertiary care hospital in central India: a 5-year study. Int J Contemp Pediatr 2018;5: 1364-7.
Kotwal YS, Jan FA, Yatoo GH, Kotwal S. Neonatal profile and outcome of the neonates admitted in NICU: A hospital based prospective study. Int J Sci Res. 2018;7(5):98–101.
Shah HD, Shah B, Dave PV, Katariya JB, Vats KP. A step toward healthy newborn: An assessment of 2 years' admission pattern and treatment outcomes of neonates admitted in special newborn care units of Gujarat. Indian J Community Med 2018;43:14-8.
Narayan R, Singh S. A study of pattern of admission and outcome in a neonatal intensive care unit at Rural Haryana, India.Int J Pediatr Res. 2017;4(10):611-616.
Mishra AK, Panda SC. Status of neonatal death in sick newborn care unit of a tertiary care hospital. Int J ContempPediatr 2017;4:1638-43.
Prasad RK, Prasad R, Vaghela V, Chovatiya CB. Review of Infant and Child Death in a Tertiary Care Teaching Institute in Surat. 2017;8(11):698–701.
UgwuGiMG. Pattern of morbidity and mortality in the newborn special care unit in a tertiary institution in the Niger Delta region of Nigeria: A two year prospective study. Global Advanced Research Journal of Medicine and Medical Sciences 2012; 1(6);133-8
WHO | SDG 3: Ensure healthy lives and promote wellbeing for all at all ages [Internet]. WHO. World Health Organization; 2017 Available from: http://www.who.int/sdg/targets/en/ [Accessed 5 Sept. 2018].
WHO | Infant, Newborn. WHO [Internet]. 2018; Available from: http://www.who.int/infant-newborn/en/ [Accessed 5 Sept. 2018].
Paul V K, Bagga A, editor. Ghai Essential Pediatrics. 8th ed. New Delhi: CBS Publishers and Distributers Pvt Ltd; 2013. 124-125 p.
South East Asia Regional NEONATAL-PERINATAL DATABASE World Health Organization (South-East Asia Region) [Internet]. Available from: https://www.newbornwhocc.org/pdf/database.pdf [Accessed 1 Oct. 2018].
MoHFW GOI. Facility Based NewbornCare : Operational Guidelines For Planning and Implementation [Internet]. 2011. p. 70. Available from: http://www.nihfw.org/pdf/Facility Based Newborn Care (FBNC) Operational Guide Guidelines for Planning and Implementation.pdf [Accessed 1 Sept. 2018].
Thenmozhi M, Sathya J. Impact of mode of transport on the outcome of extramural newborns in a tertiary care centre. Int J ContempPediatr 2017;4:1817-9
Kawale S, Kotnis SD. Study of Epidemiological Factors Affecting Neonatal Morbidity and Mortality in the Neonates Admitted to Nicu of Tertiary Care Center. Indian J Appl Res. 2016;6(2):198–201.
Kumar MK, Thakur SN, Singh BB Study of the morbidity and the mortality patterns in the neonatal intensive care unit at a tertiary care teaching Hospital in Rohtas District, Bihar, India. J Clin Diagnostic Res . 2012;6(2):282–5.
Prasad V, Singh N. Causes of morbidity and mortality in neonates admitted in Government Medical College, Haldwani in Kumaun Region (Uttarakhand) India. J Pharm Biomed Sci.2011;8(8):1-4
Baghel B, Sahu A, Vishwanadham K. Pattern of Admission and Outcome of Neonates in a NICU of Tribal Region Bastar, India. Int J Med Res Prof. 2016; 2(6):147-50.
Sridhar PV, Thammanna PS, Sandeep M. Morbidity Pattern and Hospital Outcome of Neonates Admitted in a Tertiary Care Teaching Hospital, Mandya. Int J Sci Stud 2015;3(6):126-129.
Rakholia R, Rawat V, Bano M, Singh G. Neonatal morbidity and mortality of sick newborns admitted in a teaching hospital of Uttarakhand. CHRISMED J Health Res 2014;1:228-34.
Kumaravel K. S, Ganesh J, Balaji J, Pugalendhiraja K. V, Ramesh Babu B. “A Study on Impact of NRHM on Neonatal Care and Clinical Profile of Neonates Admitted in a SNCU of a Rural Medical College”. Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 82, October 12; Page: 14335-14347.
Dwivedi K, Prakash S, Parveen K, Shaikh S. Survival outcome of neonates admitted at government and private neonatal intensive care units of Allahabad, India. Int J Community Med Public Health 2017;4:2389-94.
Jeganathan S, Kumar R. Transport from the community and preterm survival: study from a rural based sick newborn care unit of South India. Int J Health Sci Res. 2016; 6(2):69-77.
Garg P, Krishak R, Shukla DK. NICU in a community level hospital. Indian J Pediatr. 2005 Jan;72(1):27-30. doi: 10.1007/bf02760575. PubMed PMID: 15684444.[PubMed].
Ministry of Health and Family Welfare.Annual Report 2017-18 [Internet].National Health Mission. 2018 [Accessed 2018 Sep 24]. Available from: https://mohfw.gov.in/sites/default/files/04Chapter.pdf
Patil R B, Koppad R, Benakanal S. Clinical profile and outcome of babies admitted to Neonatal Intensive Care Unit (NICU)Mc Gann Teaching Hospital Shivamogga, Karnataka: A Longitudinal Study. Sch J Appl Med Sci. 2014;2(6G):3357–60.
Buch PM, MakwanaAM, Chudasama RK, Doshi SK. Status of Newborn Transport in Periphery and Risk Factors of Neonatal Mortality among Referred Newborns. J Pharm Biomed Sci. 2012;16(16):3
Rao SK, Bajaj N, Rawat A. Pre Transport Factors and Transport Quality affecting the Neonatal Outcome. J Evol Med Dent Sci .2015;4(12):1991–5
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. 2012;2(5):1–9.
Jeganathan S, Ravikmar SA, Tamilmani A, Parameshwari P, Chinnarajalu AV, Kolkar YB. Neonatal mortality of sick newborns admitted in a tertiary care teaching hospital in Tamil Nadu, South India. Int J ContempPediatr 2017;4:399-402.
Shalini B, Nikhila C V, Alimelu M. Pre-Admission Factors Influencing Neonatal Mortality. J Dent Med Sci. 2017;16(11):13–9
Narang M, Kaushik JS, Sharma AK, Faridi M. Predictors of mortality among the neonates transported to referral centre in Delhi, India. Indian J Public Health 2013;57:100-4.
Elizabeth U I, Oyetunde MO. Pattern of Diseases and Care Outcomes of Neonates Admitted in. IOSR J Nurs Heal SciVer I .2015;4(3):2320–1940.
Samms-Vaughan ME, Ashley DC, McCaw-Binns AM. Factors determining admission to neonatal units in Jamaica.PaediatrPerinatEpidemiol. 2001;15(2):100–5.
Rathod D, Adhisivam B, Bhat BV. Transport of sick neonates to a tertiary care hospital, South India: condition at arrival and outcome. Trop Doct. 2015 Apr;45(2):96-9. doi: 10.1177/0049475514564270. Epub 2014 Dec 22. PubMed PMID: 25537296.[PubMed]
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