Admission profile and treatment outcome of neonates admitted in special newborn care unit in Maharashtra: A 7-year study

Abstract

Introduction: Facility-Based Newborn Care program is one of the key initiatives launched by the Government of India under the National Rural Health Mission and RMNCH + A strategic program to improve the status of newborn health in the country. Under the program, efforts are being made to provide different levels of newborn care at the health facilities. Special newborn care unit (SNCU) is a neonatal unit in the vicinity of labor room which is to provide special care (all care except assisted ventilation and major surgery) for sick newborns. Aims and Objectives: We aimed to study the admission profile and treatment outcome of neonates admitted in SNCU. Materials and Methods: The present descriptive observational study with longitudinal design was conducted in the government-supported SNCU of District Hospital of Jalgaon district of Maharashtra which included all the neonates admitted in SNCUs from January 2013 to December 2019. The SNCU monthly report which is in a predefined format from the Ministry of Health and Family Welfare, Government of India, which includes data on admission information, reasons of admission, course of admission, and mortality reasons (if any) with treatment outcomes was used for data collection. The outcomes were classified into four groups, namely expired (died during the management), discharged (discharged after successful treatment), Left against medical advice (LAMA), and referred (referred to higher center for further management). Results: In the present study period (i.e., from January 2013 to December 2019), total 16,489 neonates were admitted to the SNCU. Out of them, 9895 (60.01%) were inborn. Majority (93.22%) of the deliveries were institutional deliveries. Meconium aspiration syndrome (MAS) (16.50%) was the most common indication for admission, followed by prematurity (12.68%), other low birth weight (LBW) (1000–2499 g) (11.96%), respiratory distress syndrome (RDS) (11.29%), and birth asphyxia (10.21%), respectively. 78.63% were discharged after successful management while 10.45% died during treatment. 3.97% were referred to higher center for further specialized management and 6.94% left the hospital against medical advice. Prematurity (25.70%) and RDS (25.48%) were the common causes of mortality. Birth asphyxia (15.12%), sepsis (7.73%), MAS (7.67%), and extremely LBW (7.62%) were other important conditions leading to the death of newborns. Conclusion: Thus, we conclude that the admission rate for inborn was higher as compared to outborn. MAS was observed to be the most common indication for admission, followed by prematurity, other LBW (1000–2499 g), RDS, and birth asphyxia, respectively. The discharge rate was 78.63% after successful management while the mortality rate was 10.45%. Prematurity, RDS, and birth asphyxia were the common causes of mortality.