Causes of mortality and morbidity among neonates admitted to the neonatal intensive care unit in Ladakh, India

Background: The first month of life is the most important and hazardous as neonates are prone to a number of infections and obstacles. This hospital-based prospective study was conducted for two years from June 1, 2017, to May 31, 2019, in the neonatal intensive care unit (NICU) of District Hospital, Kargil-Ladakh. Aims and Objective: The aim of this study is to analyze the causes of morbidity and mortality among neonates in the tribal population of Ladakh region. The final diagnosis of the patients was made mainly on clinical grounds by pediatricians with the help of available necessary laboratory investigations. Results: During the period of 2 years, a total of 686 neonates were admitted to the NICU of district hospital Kargil. Out of the 686 neonates, 57.1% were male and 42.8% female with a ratio of 1.34:1. Of the admitted neonates, 68.8% were inborn and 31.1% were outborn babies. Of them, 628 (91.5%) neonates were discharged, two left against medical advice, four were referred to a specialty hospital in Kashmir valley, and 52 (7.5%) died. Of the 52 expired neonates, 27 (51.9%) were male and 25 (48%) were female. Thirty-seven were inborn and delivered at a district hospital, while 15 were born outside the district hospital. The major causes of morbidity among neonates in NICU were preterm with low birth weight (36.5%), neonatal sepsis (19.2%), meconium aspiration syndrome (19.2%), birth asphyxia (13.4%), and intrauterine growth restriction (5.7%). Conclusion: We found prematurity, neonatal sepsis, meconium aspiration syndrome, and asphyxia to be the common causes of mortality in neonates. Most of these problems can be prevented by improving the quality of the concerned health units, improved maternal care, timely intervention, and timely referral to tertiary care hospitals in high-risk situations.