Title: Morbidity and Mortality Profile of Newborns Admitted to the Special Care Newborn Unit (SCNU) of A Teaching Hospital of Upper Assam, India – A Three Year Study
Authors: Manab Narayan Baruah, Pankaj Pradeep Panyang
DOI: http://dx.doi.org/10.18535/jmscr/v4i8.01
Background: Neonatal mortality is the predominant cause of high infant and under five mortality rates. There is lack of data regarding the morbidity and mortality pattern of sick newborns admitted to special care neonatal units of Assam, especially studies done over an extended period of three years. Aim: To study the morbidity and mortality profile of newborns admitted to the Special Care Newborn Unit of Jorhat Medical College & Hospital. Study design: Retrospective study for a period of three years(1ST January 2013-31st December 2015. Material and Methods: All sick newborns admitted to the SCNU during the study period were included in the study. Newborns admitted in the pediatric ward or PICU were excluded. The age, sex, birth weight, gestational age, morbidity, mortality data were collected from the standard monthly reporting format and patient case records. Results: During the study period, a total of 8069 babies were admitted in the SCNU of which 6104(75.6%) were admitted in the inborn unit while 1965(24.4%) were admitted in the outborn unit. 58.4% of babies were males and 42% were low birth weight (<2,500gm).Neonatal sepsis, jaundice and birth asphyxia were the common morbidities seen in the study. Sepsis was more common in the outborn compared to inborn (40% vs 24%). 87% of inborn and 72.6% outborn was successfully discharged from the SCNU. The mortality data shows much higher deaths in the outborn (13.6%) compared to inborn unit (6.6%). 77.5% of deaths were early neonatal deaths (1st week of life). 66.1% of the death cases were low birth weight. Sepsis (42.6%), birth asphyxia (29.3%) and prematurity related complications (17.5%) were the common causes of death. The case fatality rate of all causes of mortality were higher in the outborn versus inborn. Conclusion: The burden of neonatal mortality is largely preventable. Strengthening of facility based care along with improved health care delivery at the peripheral level is essential to decrease neonatal mortality and ensure intact survival of sick newborns. Key words: neonatal, morbidity, mortality, SCNU, inborn, outborn. 1. Lawn JE, Cousens S, Zupan J; Lancet Neonatal Survival Steering Team.4 million deaths: when? Where? Why? Lancet 2005;2005;365: 891-900. 2. Toolkit for setting up of special care newborn units, stabilisation units and newborn corners. NewDelhi: United Nations Children’s Fund,2008.9p (http://www.unicef.org/India/SCNU_book1_April_6 pdf , accessed on 12/05/2016). 3. Zodpey S, Paul VK:Public Health Founda-tion of India, AIIMS, Save the Children: State of India’s Newborns (SOIN) report 2014; Last accessed on 19/06/2016. 4. Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de bernis L ; Lancet Neonatal Survival Steering Team. Evid-ence based, cost effective interventions: how many newborns can we save? Lancet 2005;365:977-88. 5. P V Sridhar, P S Thammanna, M Sandeep; Morbidity pattern and Hospital outcome of Neonates admitted in a Tertiary care Teaching Hospital, Mandya : International Journal of Scientific study; 2015;Vol3 , Issue 6: 126-129. 6. Niru Prabha Saharia, Arati Deka, Vivekananda MS; Mortality and Morbidity Pattern of Neonatal ICU of Gauhati Medical College and Hospital: IOSR Journal of Dental and Medical Sciences; Vol15,issue 6,VerXI(June 2016): 73-75. 7. Indian Council of Medical Research. National Neonatal Perinatal Database Network, New Delhi 2002-2003; ICMR, 2005:2437.(wwwnewbornwhocc.org, accessed 20/06/2016) 8. Sutapa Bandyopadhyay Neogi, Sumit Malhotra, Sanjay Zodpey, Pavitra Mohan; Assessment of Special Care Newborn Units in India: Journal of Health Popula-tion, Nutrition, 2011;Oct 29(5):500-509. 9. Mani Kant Kumar, Sachida Nand Thakur, Brish Bhanu Singh: Study of the morbidity and Mortality patterns in the Neonatal Intensive Care Unit at a Tertiary Care Teaching Hospital in Rohtas district, Bihar, India: Journal of Clinical and Diagnostic Research: 2012, April, Vol6(2): 282-285. 10. Ritu Rakholia, Vineeta Rawat, Mehar Bano, Gurpreet Singh: Neonatal morbidity and mortality of sick newborns admitted in a teaching hospital of Uttarakhand: CHRI-SMED Journal of Health and Research; Vol1,Issue4/Oct-Dec2014: 228-234. 11. Chandrakala R Iyer, Gornale VK, Harsha P, Katwe N et al: Morbidity and Mortality pattern of neonatal care unit in a Medical College Hospital from South India: Pediatric Review, International Journal of Pediatric Research;Vol2,Issue 4,Oct-Dec2015: 105-110. 12. Modi Rohit, Modi bhavesh, Patel Jaimin Kumar, K Margaret Punitha: Study of the Morbidity and Mortality Pattern in the Neonatal Intensive Care Unit at a Tertiary Care Teaching Hospital in Gandhinagar district, Gujarat, India: Journal of Research in Medical and Dental Sciences; Vol 3, Issue 3,July-Sep 2015: 208-212.Abstract
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