A Study on The Disease Pattern and Outcome in Neonatal Intensive Care Unit, Tertiary Care Hospital of Andhra Pradesh

Murali Krishnaiah, S. Basha, Abdul Khaleef, Z. Rahman
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Abstract

Background: There was very scanty data available regarding the neonatal morbidity and mortality patterns in NICU. Hence, the current study aimed to document and analyze the disease pattern, and outcome in neonates admitted in NICU of tertiary care center. Subjects and Method: A prospective observational study was conducted at neonatal intensive care unit (NICU) of SVRRGGH, Tirupati from September 2014 to August 2015. A total of 2287 newborns were admitted who met selection criteria. All neonate’s demographics, clinica l profile, and outcome were analyzed. Results: From a total of 2287 newborns, 71.7% were delivered vaginally, 56.05% were male, 38.0% were <2500 g, and 48.02% were preterm babies. The neonatal deaths consisted of 448 (19.58%) newborns; 71.98% of whom pre-term babies, 80.8% of whom birth weight >2.5kg, 23.2% of whom out born, and majority died before 7 days of age. Neonatal sepsis (30.65%) is the most common cause of death followed by birth asphyxia hypoxic ischemic encephalopathy in 29.04%, hyaline membrane disease (11.03%), neonatal jaundice (9.68%), meconium aspiration syndrome (7.69%), hemorrhagic disease of newborn (1.68%), and congenital malformations (2.79%). There was a statistical association observed between neonatal death and gender (p= 0.023); neonatal death and mode of admission; neonatal death and gestational age (p <0.001); neonatal death and birth Weight (p< 0.001). Conclusion: current study identified preterm, low birth weight, neonatal sepsis, birth asphyxia, Hyaline membrane disease as major causes of morbidity and Neonatal sepsis, Hyaline Membrane Disease, and HIE as the major contributors to the neonatal mortality. Improving antenatal care, maternal health checkup and timely referral of high risk cases to tertiary care centers may help to improve neonatal outcome.
安得拉邦三级医院新生儿重症监护病房疾病模式及结局研究
背景:关于新生儿重症监护室新生儿发病率和死亡率模式的数据非常少。因此,本研究旨在记录和分析三级护理中心NICU收治的新生儿的疾病模式和预后。对象与方法:于2014年9月至2015年8月在蒂鲁帕蒂市SVRRGGH新生儿重症监护病房(NICU)进行前瞻性观察研究。符合入选标准的新生儿共2287名。分析所有新生儿的人口统计学、临床概况和结果。结果:2287例新生儿中,顺产新生儿占71.7%,男婴占56.05%,体重2.5kg占38.0%,早产占23.2%,7日龄前死亡占多数。新生儿败血症(30.65%)是最常见的死亡原因,其次是出生窒息缺氧缺血性脑病(29.04%)、透明膜病(11.03%)、新生儿黄疸(9.68%)、胎粪吸入综合征(7.69%)、新生儿出血性疾病(1.68%)和先天性畸形(2.79%)。新生儿死亡与性别有统计学关联(p= 0.023);新生儿死亡和入院方式;新生儿死亡与胎龄(p <0.001);新生儿死亡率和出生体重(p< 0.001)。结论:本研究确定早产、低出生体重、新生儿脓毒症、出生窒息、新生儿透明膜病是新生儿发病的主要原因,新生儿脓毒症、透明膜病和HIE是新生儿死亡的主要原因。改善产前保健、产妇健康检查和及时将高危病例转诊到三级保健中心,可能有助于改善新生儿结局。
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