A Retrospective Study of Predictors of Mortality in Low Birth Weight Neonates in a District Hospital of Lucknow, India

Abstract

Introduction: Low birth babies account for 10% of neonatal mortality. Survival of these babies depends on gestation, birth weight, presence of associated co-morbidities and quality of neonatal care. Aim: To evaluate predictors of mortality of low birth weight neonates admitted in Special Newborn Care Unit (SNCU) of a district hospital in Lucknow. Materials and Methods: A retrospective analysis of case records were done to assess predictors of mortality of low birth weight babies admitted in SNCU of a district hospital in Lucknow from January 2017 to January 2020 was done. Neonatal variables in the form of gender, place of delivery, birth weight, gestation, mode of delivery, need for resuscitation at birth, respiratory distress, need for oxygen, duration of stay in hospital, neonatal outcome in the form of death, discharge, referral or leave against medical advice was assessed. The association between qualitative variables was assessed using Fisher’s-exact test. Quantitative variables were analysed using unpaired t-test. Results: Out of 2227 babies admitted in SNCU of a district hospital, 47.4% (n=1056) babies were low birth weight. Mean age of admission was 3.32±6.35 hours and mean weight on admission was 1.8±0.46 kg. A 53.41% (n=564) were preterm, 46.31% (n=489) were term and only 3 babies (n=0.28%) were post-term babies. A total of 655 (62%) babies were discharged, 85 (8%) referred and 316 (29%) died. Using univariate Odds Ratio (OR) to calculate the risk for mortality and taking p-value <0.05 statistically significant predictors of mortality were prematurity (p-value=0.001, OR 2.223), extremely low birth weight (<0.001), birth asphyxia (p-value=0.024, OR=1.399), place of delivery p-value=0.036, OR=1.290) and duration of stay in the hospital (p-value <0.001). Conclusion: In the present study, it was seen that gestation less than 28 weeks extremely low birth weight perinatal asphyxia and duration of stay in hospital were the most important predictors of mortality. Timely referral could have saved these babies. Consolidation of the existing infrastructure with better networking among the district and tertiary hospitals is required.