CLINICAL PROFILE AND PREDICTORS OF MORTALITY OF EXTRAMURAL NEONATES ADMITTED IN NICU OF TERTIARY CARE HOSPITAL IN CENTRAL RAJASTHAN : PROSPECTIVE OBSERVATIONAL STUDY

Abstract

OBJECTIVE: This study was undertaken to know the clinical profile and predictors of mortality of outborn neonates admitted in Neonatal Intensive Care Unit (NICU). METHOD:This prospective study was conducted in NICU of department of pediatrics,JLN medical college & hospital, Ajmer from January 2019 to December 2019. RESULTS:Of the 2250 neonates admitted,There was male preponderance (64%),male:female ratio was 1.78:1.Majority of neonates (68.4%) were term while 31.2% were preterm and 0.4% were post term gestation. Majority of neonates (79.8%) were admitted in early neonatal period while 20.1% neonates were admitted in late neonatal period. As per birth weight,44.1% neonates were between 1.5-2.49 kg,42.6% neonates had birth weight more than 2.5 kg while 3.4% neonates were <1 kg.Majority of neonates (88.7%) were delivered vaginally while 11.3% were delivered by caesarean section.Majority of neonates (85.1%) were delivered at govt.hospitals while 11% and 3.9% neonates were delivered at private hospitals and at home respectively. Rural residency (73.7%) was far more as compared to urban residency (26.3%).42.8% mothers had primary education and 47.7% mothers had secondary education while 3.8% mothers were illiterate. Majority of cases (66.1%) belonged to middle socioeconomic class. Major causes of NICU admission were birth asphyxia / HIE of newborn (21.11%),neonatal sepsis (16.36%),neonatal jaundice (12%),RDS of newborn (8.6%), and prematurity (7.7%). Out of 2250 neonates admitted, 70.1% babies were successfully discharged while 29.9% neonates died during treatment.Birth Asphyxia / HIE of Newborn (22.25%),RDS of Newborn (20.47%),Neonatal Sepsis (16.02%), Shock (10.98%), Congenital Malformations (6.82%), and ELBW (6.38%) were found to be major causes of mortality among neonates admitted in NICU. CONCLUSION: The majority of morbidities and subsequently the mortalities can be reduced by improving maternal care and essential newborn care,appropriate primary interventions and timely referral to tertiary care centers for high risk cases,with better transport facilities for sick neonates.