Morbidity and mortality pattern of very low birth weight and extremely low birth weight neonates in a tertiary care hospital

Authors

  • Wani Shahid Hussain Department of Pediatrics, Government Medical College, Srinagar, Jammu and Kahmir, India
  • Muzafar Jan Department of Pediatrics, Government Medical College, Srinagar, Jammu and Kahmir, India
  • Rahat Abbas Department of Gynaecology, SKIMS Medical College, Srinagar, Jammu and Kahmir, India
  • Zarkah Nabi Department of Pathology, SKIMS Medical College, Srinagar, Jammu and Kahmir, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20192025

Keywords:

Extremely low birth weight, Perinatal asphyxia, Respiratory distress syndrome, Very low birth weight

Abstract

Background: Although the mortality and morbidity rates for Very Low Birth Weight (VLBW) and Extremely Low Birth Weight (ELBW) neonates have improved over last few decades, they still remain highly vulnerable groups. This study determines the neonatal morbidity and mortality within first four weeks of life in VLBW and ELBW neonates.

Methods: It was a hospital based prospective study conducted in the department of paediatrics at GB Pant hospital, an associated hospital of Government Medical College Srinagar. All included neonates were evaluated in neonatology section and were followed up to 4 weeks of life. Standard protocols were used for management of these neonates.

Results: A total of 116 neonates were included in the study. Among the 116 neonates 82 (70.69%) were VLBW and 34 (29.31%) were ELBW. 28 (34.14%) VLBW and 18 (52.94%) ELBW neonates died. Among the morbidities Respiratory Distress Syndrome was found in 35.37% of VLBW and 70.59% of ELBW neonates, out of which 12.20% VLBW and 20.58% ELBW neonates developed Bronchopulmonary dysplasia. Perinatal asphyxia was found in 20.73% of VLBW and 29.41% of ELBW neonates and Pathological apnea occurred in 28.04% VLBW and 85.29% ELBW neonates. 40.24% VLBW and 73.53% ELBW neonates developed clinically significant jaundice requiring treatment. Clinical sepsis was found in 43.90% VLBW and 67.65% ELBW neonates while as culture proven sepsis was found in 26.83% VLBW and 41.18% ELBW neonates. Intra ventricular haemorrhage was found in 15.85% VLBW and 52.94% ELBW neonates. Necrotizing enterocolitis developed in 18.29% VLBW and 35.29% ELBW neonates. Retinopathy of prematurity was found in 21.95% VLBW and 26.47% ELBW neonates. Patent ductus arteriosus was found in 14.63% VLBW and 32.35% ELBW neonates.

Conclusions: Present study has shown Respiratory distress syndrome, perinatal asphyxia and sepsis as the predominant causes of neonatal morbidity and mortality and these are preventable with a proper health care system and policy directed to the primary prevention.

References

Jane E. Stewart & Marsha R. Joselow. Manual of Neonatal Care by John P. Cloherty. 7th ed. 2011:185.

Arefin MS, Matin MA, Chowdhury MA, Ali ML, Ahmad SS, Bhuyan AH, et al. A comparative study between the outcome of very low birth weight and low birth weight hospitalized babies. ORION. 2008 Sep;31.

Lopez E, Gascoin G, Flamant C, Merhi M, Tourneux P, Baud O. Exogenous surfactant therapy in 2013: what is next? who, when and how should we treat newborn infants in the future?. BMC Pediatr. 2013;13(1):165.

Engle WA. Surfactant-replacement therapy for respiratory distress in the preterm and term neonate. Pediatrics. 2008;121(2):419-32.

Bahadue FL, Soll R. Early versus delayed selective surfactant treatment for neonatal respiratory distress syndrome. Cochrane Database Syst Rev. 2012;11:CD001456.

Kandraju H, Murki S, Subramanian S, Gaddam P, Deorari A, Kumar P. Early routine versus late selective surfactant in preterm neonates with respiratory distress syndrome on nasal continuous positive airway pressure: a randomized controlled trial. Neonatol. 2013;103(2):148-54.

Dilmen U, Özdemir R, Tatar Aksoy H, Uras N, Demirel N, Kırimi E, et al. Early versus late selective treatment in preterm infants born between 25 and 30 gestational weeks: a prospective randomized multicenter study. J Maternal Fetal Neonatal Med. 2014;27(4):411-5.

Rojas-Reyes MX, Morley CJ, Soll R. Prophylactic versus selective use of surfactant in preventing morbidity and mortality in preterm infants. Cochrane Database Syst Rev. 2012;3:CD000510.

Sandri F, Plavka R, Ancora G, Simeoni U, Stranak Z, Martinelli S, et al. Prophylactic or early selective surfactant combined with nCPAP in very preterm infants. Pediatr. 2010;125(6):e1402-9.

Ann R. Stark. Manual of Neonatal Care by John P. Cloherty. 7th ed .2011:397.

Neu J, Walker WA. Necrotizing enterocolitis. N Eng J Med. 2011;364(3):255-64.

Merhar SL, Tabangin ME, Meinzen‐Derr J, Schibler KR. Grade and laterality of intraventricular haemorrhage to predict 18-22 month neurodevelopmental outcomes in extremely low birthweight infants. Acta Paediatr. 2012;101(4):414-8.

Clyman RI. Patent ductusarteriosus in the premature infant. In: Taeusch HW, Ballard RA,Gleason CA, editors. Avery’s diseases of the newborn. 8th ed. Philadelphia: Elsevier Saunders; 2005:816-26.

Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall RI, Barton LE, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg. 1978;187(1):1.

Prematurity IC. for the C of R of. The International Classification of Retinopathy of Prematurity Revisited. Arch Ophthalmol. 2005;123(7):991-9.

Papile LA, Burstein J, Burstein R. Incidence and evolution of subependymal and intra ventricular hemorrhage: a study of infants with birth weight less than 1,500 gm. J Pediatr. 1978;92:529-34.

Richard B. Parad. Manual of Neonatal Care by John P. Cloherty 7th ed. 2011:417.

Mukhopadhyay K, Louis D, Murki S, Mahajan R, Dogra MR, Kumar P. Survival and morbidity among two cohorts of extremely low birth weight neonates from a tertiary hospital in northern India. Ind Pediatr. 2013;50(11):1047-50.

Fanaroff AA, Stoll BJ, Wright LL, Carlo WA, Ehrenkranz RA, Stark AR, et al. Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol. 2007;196:147.e1-8.

Downloads

Published

2019-04-30

Issue

Section

Original Research Articles