DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20222123
Published: 2022-08-24

Study of variables affecting mortality among extramural very low birth weight neonates in tertiary care centre: a prospective observational study

Ruchi A. Gedam, Mohini Apte, Suraj P. Gondase

Abstract


Background: Over the past few decades, the burden of extramural very low birth weight (VLBW) neonates is increasing due to advances in obstetrics services. Objective of present study was to know variables affecting mortality in these neonates.   

Methods: A prospective observational study was conducted at department of paediatrics, government medical college and hospital, Nagpur, India over a period of 2 years. Out-born neonates admitted in this tertiary care centre with birth weight between 1000-1499 gm were included in the study. Proper antenatal, natal history were taken and data was collected using data collection sheet. All subjects were followed up till discharge or death whichever was earlier. 

Results: Significant demographic factors associated with neonatal mortality were found out to be place of birth, birth attendant, distance travelled and transport time. Neonatal factors which significantly associated with mortality were found out to be hypothermia and SpO2 less than 90%.

Conclusions: Univariate analysis concluded that age at presentation (>24 hours), place of birth, birth attendant, distance travelled, mode of transport, transport time, hypothermia, SpO2<90% were found to be significant factors for predicting risk of mortality in VLBW neonates. However, multivariate analysis concluded only 4 predictors that is age more than 24 hours, transportation time, SpO2 on admission and hypothermia were found to retain their significance. VLBW babies are vulnerable, but with small improvements in infrastructure and personnel training, significance difference in prevention of morbidity and mortality can be seen.


Keywords


VLBW, Outborn, Mortality

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References


Lawn JE, Blencowe H, Oza S, You D, Lee ACC, Waiswa P et al. Every newborn: Progress, priorities, and potential beyond survival. Lancet. 2014;384(9938):189-205.

Behrman RE, Koops BL, Morgan LJ, Battaglia FC. Neonatal mortality risk in relation to birth weight and gestational age: Update. J Pediatr. 1982;101(6):969-77.

Ballot DE, Chirwa TF, Cooper PF. Determinants of survival in very low birth weight neonates in a public sector hospital in Johannesburg. BMC Pediatr. 2010;10:1-11.

Rammohan A, Iqbal K, Awofeso N. Reducing Neonatal Mortality in India: Critical Role of Access to Emergency Obstetric Care. PLoS One. 2013;8(3).

Bahl R, Martines J, Ali N, Bhan MK, Carlo W, Chan KY et al. Research priorities to reduce global mortality from newborn infections by 2015. Pediatr Infect Dis J. 2009;28(1):43-8.

Buch PM, Makwana AM, Chudasama RK, Doshi SK. Status of Newborn Transport in Periphery and Risk Factors of Neonatal Mortality among Referred Newborns. J Pharm Biomed Sci. 2012;16(16):3.

Sachan R, Singh A, Kumar D, Yadav R, Singh DK, Shukla KM. Predictors of Neonatal Mortality Referred To a Tertiary Care Teaching Institute: a Descriptive Study. Indian J Child Health. 2016;03(02):154-8.

Verma A, Gaur A, Ambey R. Predictors in profile of referred newborns for their outcome in a tertiary newborn referral facility. Int J Contemp Pediatr. 2018;6(1):87.

Bokade C, Meshram R. Morbidity and mortality patterns among outborn referral neonates in central India: Prospective observational study. J Clin Neonatol. 2018;7(3):130.