DISEASE PATTERN AND OUTCOME OF NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNIT IN SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE

Abstract

Abstract Background: Neonatal morbidity along with the mortality is a major health issues in the developing countries accounting majority of under 5 year mortality(1,10). Majority of which are preventable. Regular assessment of the illness patterns in hospital NICU settings is an indicator to show the availability, utilization and effectiveness of mother and child health services( 15). Objective: The aim of this study was to assess the disease pattern and outcome of neonates who were admitted to NICU at SPHMMC. Methods and Subjects An institutional based cross sectional retrospective study was conducted on 226 neonates who were admitted to the neonatal care unit of St Paul’s Hospital Millennium Medical College from May to July 2020, were included in this study. Data collected from patient’s chart by pre-structured and pre tested check lists. The independent variables were demographic, obstetric, and clinical characteristics, while the dependent variable was neonatal mortality. Data were analyzed using simple frequencies, odds ratio, and finally binary logistic regression analysis for mortality outcome. Odds Ratio with 95% Confidence Interval (CI) was used to determine the effect of the independent variables on the outcome variable. P-value less than 0.05 is considered statistically significant. Result: Out of 226 study population male to female ratio was 1.23:1. The mean age at admission was 13.79 hours. The most common reason for admission to NICU RDS 45(19.9%), followed by TTN 26(11.5%), MAS 24(10.6%) ,Neonatal hyperbilirubinemia 20(8.8%) and early onset neonatal sepsis 18(8%). 74.3% of the patients discharged from NICU, while 8(3.5%) of the patients were referred to other health facility and 49(21.7%) were died in the Hospital. From total neonates died RDS account 31(63.2%) followed by EONS 8(16.3%) and PNA4(8.1%). The rest gastroschisis and TEF 2(4%) each. Lastly MAS resulted in death in 1(2%). Most of the deaths occurred 24 to 72 hours 16(32.7%),while 14 (28.5%) and 13(26.5%) of the patients died 3 to 7 days and within the first day of admission respectively. Gestational age, admission oxygen saturation and 1st minute APGAR score were significantly associated with the outcome of neonates. Conclusion: Prematurity with RDS followed by early onset neonatal sepsis, MAS and Neonatal hyperbilirubinemia are common reasons for admission. Of total 226 admissions 49(21.7%) neonates died. Most common cause of death are prematurity with RDS followed by EONS and PNA. Gestational age, low admission oxygen saturation and 1st minute APGAR score were significantly associated with increased neonatal death. Key words: Neonatal admission, Neonatal mortality, neonate, NICU, outcome