Morbidities and survival outcome of admitted low birth weight neonates in non-teaching district hospital SNCU

Abstract

Background: 0.8% of India’s health care spending is for universalization of SNCU. The working status of a non-medical college SNCU is still far from satisfaction in relation to manpower, availability, maintenance and utilization of equipment’s. There are very few studies on outcome of morbities in non-teaching hospital SNCU and no studies analysing on morbities of LBW neonates in such SNCU with multiple deficiencies. LBW comprises 30% of SNCU admissions, half of perinatal and 1/3 rd of neonatal deaths. Methods: A retrospective study analyzing morbities and survival outcome of admitted LBW neonates in SNCU of district hospital Madikeri, Kodagu District, Karnataka, India from October 2014 to October 2015. 224 LBW neonates were grouped as per birth weight (<1 kg, 1-1.499 kg, 1.5-1.99 kg, 2-2.499 kg and maturity at birth (<28 weeks, 28-34 weeks, 34-37 weeks, Term). Intrauterine growth charts used to note birth weight for period of gestation and further classified into preterm, and term IUGR. Morbidities and survival outcomes followed until discharge were analyzed by descriptive and analytic statistics with respect to maturity, birth weight and IUGR . Results: 28.61% of SNCU admissions were LBW. 79.46% of LBW babies were preterm. 8.93%, 37.1%, 33.48% and 20.54% babies were <28 weeks, 28-34 weeks, 34-37 weeks and term neonates. 1.7%, 24.6%, 43.75%, and 29.99% weighed <1 kg, 1-1.499 kg, 1.5-1.99 kg and 2-2.499 kg. Incidence of RDS was 20.09%, Meconium aspiration syndrome was 4.46%, Neonatal sepsis 16.1%, Birth asphyxia 11.61%, Neonatal jaundice 7.59%, Apnoea 2.71%, hypoglyceamia 1.34%, hypothermia 1.79%, Refusal to feed 2.71%, congenital anomalies 1.34%. Discharge, deaths, referrals and LAMA for <1 kg (25%, 25%, 25%, 25%), for 1-1.499 kg (47.27%, 25.45%, 14.54%, 12.73%), for 1.5-1.99 kg (80.61%, 5.1%, 11.22%, 3.06%), for 2-2.499 kg (76.12%, 1.49%, 13.43%, 8.9%). Prevalence of IUGR in admitted LBW neonates was 43.75%. Early preterm <34 weeks were LBW AGA babies and late preterm 34-37 weeks were LBW SGA babies (P value-<0.001). Correlation between ELBW, VLBW and LBW neonates and its relation to deaths and discharge were highly significant (P value -<0.001), LAMA was significant (P value -<0.05). 70.08% cases were successfully discharged, 12.59% referred to tertiary care, 7.59% LAMA. 9.38% babies died. LBW constituted 47.72% of total SNCU deaths. Conclusions: Morbidity and survival outcome of LBW neonates is directly proportional to birth weight and gestational age. Though a low resource non-teaching hospital unit with deficiencies in manpower and functioning equipment’s 70.08% of LBW babies were successfully discharged. FBNC units are contributing enormously to bring down neonatal death rates.