Patterns of neonatal admissions and mortality among neonates admitted to special neonatal care units: a two-year cross-sectional study at selected special neonatal care units in Odisha, India

Abstract

Background: Odisha has built 44 special newborn care units to treat severely sick infants at various levels. This study aimed to determine morbidity and mortality profiles among neonates admitted to the SNCUs and extend efforts to improve outcomes by investigating crucial variables. Methods: We conducted a cross-sectional descriptive study on all neonates admitted to SNCUs of 4 districts (Balangir, Kalahandi, Koraput, and Rayagada) between two calendar years (January 2020 and December 2021). We collected data on epidemiology, clinical presentation, and neonatal and maternal characteristics. We used Microsoft Excel to analyze categorical and continuous variables, with the Chi2 test for proportion comparison. Results: 17615 neonates were admitted in 2020-2021, 58% below one day and 59% male. ST babies were predominant. Outborn unit had 52% admissions, with 67% full-term and 31% pre-term. 74% of outborns used government vehicles for transportation. Most diagnoses were birth asphyxia, HIE, neonatal jaundice, low birth weight, and neonatal sepsis. The study found that 43% of neonates died from hypoxic ischaemic encephalopathy /perinatal asphyxia, 22% from Sepsis, 12% from extremely low birth weight babies, and 9% from prematurity. The Chi2 test showed a statistically significant difference in survival rates between doctors and dai, with a 91% survival rate and a 71% survival rate. Conclusions: Birth asphyxia was found to be the most essential cause of morbidity and mortality. Regular training at district levels is crucial for ensuring proper newborn care, including warmth, feeding, cleanliness, and prevention of asphyxia, to reduce preterm birth and low birth weight.