Pattern of Disease Admissions and Their Outcome of Neonates Admitted In Neonatal Intensive Care Unit of A Tertiary Care Hospital in Quetta

Hira Javed; Arshad Khushdil; Khursheed Ali Bangash; Rida Tahir; Faisal Javed; Sidra

doi:10.51253/pafmj.v74i2.9520

Authors

Hira Javed Department of Paeds, Combined Military Hospital Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Arshad Khushdil Department of Paeds / Combined Military Hospital Quetta/National University of Medical Sciences (NUMS) Pakistan
Khursheed Ali Bangash Department of Neurosurgery / Combined Military Hospital Quetta/National University of Medical Sciences (NUMS) Pakistan
Rida Tahir Department of Paeds, Combined Military Hospital Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Faisal Javed Department of Medicine / Abbasi Shaheed Hospital Karachi
Sidra Department of Paeds / Combined Military Hospital Quetta/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i2.9520

Keywords:

Caesarean section, Intensive Care Unit, Mortality, Neonates, Pakistan

Abstract

Objective: to determine the admission pattern and outcomes of neonatal admissions to a neonatal intensive care unit (NICU) in a tertiary care hospital of Quetta Pakistan.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Neonatal Intensive Care Unit, Combined Military Hospital (CMH), Quetta Pakistan, from Jan to Dec 2020.

Methodology: All neonates admitted to the NICU Indoor or Outdoor Department during study duration were included. The disease pattern of the admission was noted, along with information regarding gender, gestational age, birth weight, diagnosis, duration of NICU stay, and outcome.

Results: Of 424 neonates, respiratory-related disorders were predominantly higher (185,43.6%) followed by infection/sepsis-related disorders (105,24.8%), care of prematurity (81,19.1%), whereas 53(12.5%) had miscellaneous disorders. The overall mortality rate was observed in 34(8.0%) babies. A significant mean difference in gestational age (p: <0.001), birth weight (p: <0.001), and duration of stay (p: 0.003) was observed for reasons for admissions. Furthermore, a significant association of reasons for admission was observed with gender (p: 0.013), route of admission (p: <0.001), and respiratory support (p: <0.001).

Conclusion: The pattern of the disease admission showed that respiratory-related disorders were predominantly higher, followed by infection/sepsis-related disorders and care of prematurity. Though the mortality rate was low, however, low birth weight, prematurity, and caesarean delivery are common risk factors.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Liang LD, Kotadia N, English L, Kissoon N, Ansermino JM, Kabakyenga J, et al. Predictors of Mortality in Neonates and Infants Hospitalized With Sepsis or Serious Infections in Developing Countries: A Systematic Review. Front Pediatr 2018; 6: 277. https://doi.org/10.3389/fped.2018.00277.

Hug L, Alexander M, You D, Alkema L. UN Inter-Agency Group for Child Mortality Estimation. National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030: a systematic analysis. Lancet Glob Health 2019; 7(6): e710-e720.

https://doi.org/10.1016/S2214-109X(19)30163-9

GBD 2019 Under-5 Mortality Collaborators. Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019. Lancet 2021; 398(10303): 870-905.

https://doi.org/10.1016/S0140-6736(21)01207-1

World Health Organization (WHO). Facts Sheet. Newborn Mortality. 2022. [Internet]. Available at:

https://www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-child-mortality-report-2021 (Accessed on October 27, 2022).

Aziz A, Saleem S, Nolen TL, Pradhan NA, McClure EM, Jessani S, et al. Why are the Pakistani maternal, fetal and newborn outcomes so poor compared to other low and middle-income countries? Reprod Health 2020; 17(Suppl 3): 190.

https://doi.org/10.1186/s12978-020-01023-5

Saleem S, Naqvi F, McClure EM, Nowak KJ, Tikmani SS, Garces AL, et al. Neonatal deaths in infants born weighing ≥ 2500 g in low and middle-income countries. Reprod Health 2020; 17(Suppl 2): 158. https://doi.org/10.1186/s12978-020-01013-7

Khemani S, Shamim N, Mirza A, Muhammad N, Kagazwala S, Ahmed S, et al. Referral pattern and outcomes of neonates from secondary care setting of Aga Khan University Hospital to tertiary care centers in Pakistan. J Pak Med Assoc 2021; 71(5): 1432-1437. https://doi.org/10.47391/JPMA.1259

Gowa M, Habib I, Tahir A, Yaqoob U, Junejo S. Disease Spectrum and Frequency of Illness in Pediatric Emergency: A Retrospective Analysis From Karachi Pakistan,. Ochsner J 2019; 19(4): 340-346. https://doi.org/10.31486/toj.18.0134

Fadul W, Ahmed A, Mohamed AI, Tamomh AG. Pattern of admission and outcome of neonates admitted to neonatal intensive care unit of alobaid pediatrics teaching hospital-North Kordofan state, Sudan. J Pediatr Neonatal Care 2022; 12(2): 117-122. https://doi.org/10.15406/jpnc.2022.12.00467

Demissie BW, Abera BB, Chichiabellu TY, Astawesegn FH. Neonatal hypothermia and associated factors among neonates admitted to neonatal intensive care unit of public hospitals in Addis Ababa, Ethiopia. BMC Pediatr 2018; 18(1): 263.

https://doi.org/10.1186/s12887-018-1238-0

Ali SR, Ahmed S, Lohana H. Disease patterns and outcomes of neonatal admissions at a secondary care hospital in pakistan. Sultan Qaboos Univ Med J 2013; 13(3): 424-428.

Gebremariam A. Factors predisposing to low birth weight in Jimma Hospital south western Ethiopia. East Afr Med J 2005; 82(11): 554-558. https://doi.org/10.4314/eamj.v82i11.9408

Toru T, Anmut W. Assessment of Low Birth Weight and Associated Factors Among Neonates in Butajira General Hospital, South Ethiopia, Cross Sectional Study, 2019. Int J Pediatr 2020; 2020: 5841963.

https://doi.org/10.1155/2020/5841963

Wynn JL, Polin RA. A neonatal sequential organ failure assessment score predicts mortality to late-onset sepsis in preterm very low birth weight infants. Pediatr Res 2020; 88(1): 85-90. https://doi:10.1038/s41390-019-0517-2

Zeigler AC, Ainsworth JE, Fairchild KD, Wynn JL, Sullivan BA. Sepsis and Mortality Prediction in Very Low Birth Weight Infants: Analysis of HeRO and nSOFA. Am J Perinatol 2023; 40(4): 407-414. https://doi.org/10.1055/s-0041-1728829

Ariff S, Habib A, Memon Z, Arshad T, Samejo T, Maznani I, et al. Effect of Community-Based Kangaroo Mother Care Package on Neonatal Mortality Among Preterm and Low Birthweight Infants in Rural Pakistan: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2021; 10(8): e28156.

https://doi.org/10.2196/28156

Abbas F, Kumar R, Mahmood T, Somrongthong R. Impact of children born with low birth weight on stunting and wasting in Sindh province of Pakistan: a propensity score matching approach. Sci Rep 2021; 11(1): 19932.

https://doi.org/10.1038/s41598-021-98924-7

Khan S, Zaheer S, Safdar NF. Determinants of stunting, underweight and wasting among children < 5 years of age: evidence from 2012-2013 Pakistan demographic and health survey. BMC Public Health 2019; 19(1): 358.

https://doi:10.1186/s12889-019-6688-2

Shahani Z, Shaikh AR, Gemnani VK, Abro K, Aizuddin AN, Manaf MR, et al. Neonatal Morbidity Patterns and Admission Outcomes: A Cross Sectional Study at a Tertiary Care Hospital in Pakistan. J Pharm Res Int 2022:72-76.

Rasheed J, Aleem T, Wakeel N, Khalid M, Zafar F. Pattern, causes and outcome of neonatal admissions in a Teaching Hospital, Multan, Pakistan. Rawal Med J 2018; 43(2): 289.

Ali SM, Karamat S, Khawaja AA, Urooj H, Shaikh F, Farooq S, et al. Frequency of maternal and neonatal complications associated with second stage caesarean section in Civil Hospital Karachi, Pakistan. Professional Med J. 2020 Feb 4; 27(03): 535-539.

https://doi:10.29309/TPMJ/2020.27.3.3429