Study of neonatal morbidity and mortality pattern in NICU in LBW neonates over a five-year period at a rural tertiary care teaching hospital in South-West Bihar

Abstract

Introduction: Preterm birth is a major cause of mortality and morbidity for newborns and imposes a considerable burden on limited health care resources. Even though the incidence of preterm birth is rising worldwide due to the continued innovation in neonatal intensive care unit facilities, the survival of preterm neonates has significantly increased. Aim and objectives:  1. To study the morbidity and mortality pattern in low birth weight neonates.

1. To analyze the risk factors of mortality in low birth weight neonates. Methodology: This was a retrospective record-based study conducted in the neonatal intensive care unit of a tertiary care teaching hospital situated in rural South Bihar, India. The medical record of a total of 1222 neonates belonging to the Rohtas district and admitted in the NICU of Narayan Medical College & Hospital, Sasaram between April 2015 and April 2020 were reviewed. The data on admission, sex, gestational age, birth weight, indications for admission, primary diagnosis and associated medical condition, duration of hospitalization, complications encountered, investigations during hospitalization, and outcome over-extracted and analyzed. Results: The data analysis for the morbidity showed that neonatal hyperbilirubinemia (NNH) was the most common cause of admission to NICU, followed by early-onset sepsis (EOS), perinatal hypoxia-ischemia (birth asphyxia), prematurity (admitted for preterm care, no complications on admission), respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS) and late-onset sepsis (LOS), in that order. Conclusion: This study identified neonatal hyperbilirubinemia (NNH), early-onset sepsis (EOS), perinatal hypoxia-ischemia (birth asphyxia), prematurity, respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS), and late-onset sepsis (LOS) as the major causes of neonatal morbidity in the NICU of our institute in rural South Bihar. The major causes of neonatal deaths were perinatal hypoxia-ischemia, prematurity, EOS, RDS, LOS, and MAS. Prematurity, LOS, RDS, birth asphyxia, MAS, and NEC were the most lethal diseases in terms of case fatality rates.

Key Words: NICU, Neonatal Morbidity, Neonatal Mortality, Rohtas, Bihar.