Morbidity profile and mortality of neonates admitted in Neonatal Intensive Care Unit of a Central India Teaching Institute: A prospective observational study

Abstract

Introduction: Neonatal mortality contributes to 40% of infant mortality rate (IMR). Over the years, the IMR has reduced worldwide, as well as in India, but neonatal mortality rate has not decreased proportionately. We have taken up this study so as to ascertain the causes of morbidity prevalent in the neonates admitted in Neonatal Intensive Care Unit (NICU) of a teaching hospital. The teaching hospitals cater to a large population, being a referral center and having majority of facilities required for the adequate care of sick newborn babies. Materials and Methods: The study is conducted in NICU of a teaching hospital admitted within 24 h of birth in central India over a period of 1-year. Results: One thousand three hundred and eighty-eight newborns admitted within 24 h of birth were included in the study. About 63.4% were male neonates, (Male:female 1.7:1). The low birth weight babies were 63.5% in our study. Respiratory distress was present in 47.2% of neonates, meconium aspiration syndrome being the most common cause of respiratory distress. Neonatal sepsis accounted for morbidity in 45.10% of neonates, with Klebsiella being the most common organism grown in the blood culture. The incidence of congenital anomalies was 5.4% with cardiac anomalies being most common. The neonatal mortality was found to be 26.6% in our study. Neonatal sepsis and birth asphyxia were the two most common causes of neonatal mortality in the study. Extremely low birth weight neonates had the highest case fatality rate in the study, which indicates the need to develop an efficient group of professionals in teaching hospitals who will provide highly specialized and focused care to this cohort of vulnerable neonates. Conclusion: Our study has shown respiratory distress, perinatal asphyxia, and sepsis as the predominant causes of neonatal morbidity. All three are preventable causes, and our health-care programs should be directed toward addressing the risk factors in the community responsible for the development of these three morbidities. The preterm and low birth weight babies had significantly high mortality even with standard intensive care; therefore a strong and effective antenatal program with extensive coverage of all pregnant females specifically in outreach areas should be developed which will help in decreasing preterm deliveries and also lower the incidence of low birth weight babies.