Pattern of Neonatal Admissions and Care Outcomes in Special Care Newborn Unit of Cox’s Bazar District Hospital, Bangladesh
Asian Journal of Pediatric Research,
Background: Neonatal morbidity and mortality contribute significantly to under‑five morbidity and mortality. A substantial reduction in neonatal mortality is therefore necessary to achieve the Sustainable Development Goals targets.
Aims: Assessed the pattern of neonatal admission and care outcomes.
Place and Duration of Study: Special Care Newborn Unit of Cox’s Bazar District hospital, Bangladesh conducted in September 2022.
Methodology: Hospital-based retrospective study. Data extracted from the admission register and the records of 3982 newborns admitted between August 2021 and July 2022. Bivariate analysis using the Chi-square test, was performed to determine factors associated with neonatal mortality and p value was set at significant level of 5%.
Results: 3982 neonates were admitted, 2426 (61%) were male and 1556 (39%) were female with1071 (27%) from the hospital and 2911(73%) from outside the hospital. Birth asphyxia was the commonest morbidity,49% followed by Low Birth Weight/prematurity (18%) and neonatal sepsis 17%. 3,225 (81.4%) of the neonates admitted survived while 538 (13.5%) died and 203(5.1%) were discharged against medical advice. There was significant association between birth weight, morbidity pattern and mortality p<0.05) with most deaths associated with prematurity/LBW. There was significant association between neonatal mortality and the place of delivery, death among outborn was 16% compared with 7% among inborn (p<0.05) but no significant association between neonatal mortality and gender.
Conclusion: There was a high burden of neonatal care at the hospital and majority of causes of neonatal morbidity and mortality were preventable. There is need for holistic approach to pregnancy, delivery and newborn care to reduce neonatal morbidity and mortality in the district.
- Special care newborn unit
How to Cite
National Institute of Population Research and Training (NIPORT), and ICF. Bangladesh Demographic and Health Survey 2017-18. Dhaka, Bangladesh, and Rockville, Maryland, USA: NIPORT and ICF; 2020.
Government of the People’s Republic of Bangladesh. Ministry of Health and Family Welfare. Newborn Signal Functions In Bangladesh; 2022.
UNICEF and WHO Every Newborn Action Plan. Country Progress Tracking Report; 2015.
Kabir Ehtesham. National Newborn Health Standard Operating Procedure, Bangladesh: 2021-2030; 2021.
Bangladesh MOH & FW.Standard Operating Procedure (SOP) for Newborn Care services at primary and secondary level hospitals; 2019.
Anwar Islam, Tuhin Biswas. Health system in Bangladesh: Challenges and opportunities. American Journal of Health Research. 2014;2(6):366-374.
World Health Organization Bangladesh Health System Review. Health Systems in Transition.2015;5:3. Available:https://apps.who.int/iris/bitstream/handle/10665/208214/9789290617051_eng.pdf?sequence=1&isAllowed=y
Narayan R. A study of the pattern of admissions and outcome in a neonatal intensive care unit at high altitude. Sri Lank J Child Health. 2012;41(2):79-81.
Monika Mazumder, Md Naznin Sultana, Akter Banu, Ayasha Sultana, Md. Eunus Ali. The pattern of neonatal admission and outcome in special care newborn unit of a medical college hospital in northern Bangladesh. Int J Med Res Prof. 2019; 5(5):214-17. DOI:10.21276/ijmrp.2019.5.5.047
Roy RN, Nandy S, Shrivastava P, Chakraborty A, Dasgupta M, Kundu TK. Mortality pattern of hospitalized children in a tertiary care hospital of kolkata. Indian J Community Med. 2008;33(3):187-9. PMID: 19876482; PMCID: PMC2763676.
Doctor HV, Bairagi R, Findley SE, Helleringer S, Dahiru T. Northern Nigeria maternal, newborn and child heath programme: Selected analyses from population-based baseline survey. The Open Demography Journal. 2021;4:11-21.
Narayan R, Singh S. A study of pattern of admission and outcome in a neonatal intensive care unit at Rural Haryana, India. International Journal of Pediatric Research. 2017;4:10.
Toma BO, Ige OO, Abok I. Pattern of neonatal admissions and outcome in a tertiary institution in north central Nigeria. J Med Trop. 2013;15:121.
Becklake MR, Kauffmann F. Gender differences in airway behaviour over the human life span. Thorax. 1999;54:1119–1138.
Libert C, Dejager L, Pinheiro I. The X chromosome in immune functions: When a chromosome makes the difference. Nat Rev Immunol. 2010;10:594-604.
Aijaz N, Huda N, Kauzar S. Disease Burden of NICU at a Tertiary Care Hospital, Karachi. Journal of the Dow University of Health Sciences Karachi. 2012;(6)1:32-35.
Naeem Akram Butt, Ammerulah Malik, Muhammad Yaqub Kazi. Pattern of neonatal admissions in a Tertiary Care Hospital. P J M H S. 2010;4(4):436.
Sadia Yasmeen, Khawaja Ahmad, Irfan Waheed, Rafia Gu. Spectrum of neonatal admissions and their outcome in a Tertiary Care Hospital. Pak Armed Forces Med J. 2017;67(6):1044-49.
Osuorah D, Ekwochi U, Ndu I, Nwokoye I, Ezenwosu O, Amadi O. Pattern of morbidity and mortality of newborns admitted into the sick and special care baby unit of enugu state university teaching hospital, Enugu State. Nigerian Journal of Clinical Practice. 2014; 17(3):346. PMID: 24714015
Ravikumar S, Harikrishnan E, Elayaraja K. KASK. Morbidity and mortality profile of neonates in a tertiary care centre in Tamil Nadu: A study from south India. International Journal of Contemporary Pediatrics. 2018;5(2):377–382.
Mmbaga BT, Lie RT, Olomi R, Mahande MJ, Kvåle G, Daltveit AK. Cause-Specific neonatal mortality in a neonatal care unit in Northern Tanzania: A registry based cohort study. BMC Pediatrics. 2012; 12(1):116.
Baghel B, Sahu A, Vishwanadham K. Pattern and admission and outcome of neonates in nicu of tribal region Bastar, India. Int J Med Res Prof. 2016;2(6):147-50.
Parkash J, Das N. Pattern of admissions to neonatal unit. J Coll Physicians Surg Pak. 2005;15(6):341-4.
Ike Elizabeth U, Modupe O, Oyetunde. Pattern of diseases and care outcomes of neonates admitted in special care baby unit of university college hospital, Ibadan, Nigeria from 2007 to 2011. IOSR J Nursing Health Science. 2015;4(3):62-71.
Hussain S. Neonatal morbidity and mortality pattern in a tertiary care neonatal unit of a teaching hospital. Ann Pak Inst Med Sci. 2014;10(1):7-11.
Sridhar PV, Thammanna PS, Sandeep M. Morbidity pattern and hospital outcome of neonates admitted in a tertiary care teaching hospital, Mandya. Int J Sci Stud. 2015;3(6):126-129
Seid SS, Ibro SA, Ahmed AA, Olani Akuma A, Reta EY, Haso TK. Causes and factors associated with neonatal mortality in Neonatal Intensive Care Unit (NICU) of Jimma University Medical Center, Jimma, South West Ethiopia. Pediatr Health Med Ther. 2019;10:39-48.
Kumar MK, Th akur SN, Singh BB. Study of morbidity and the mortality patterns in NICU at tertiary care teaching hospital in Rohtas district, Bihar, India. JCDR. 2012;6:282-5.
Shahidulla M, Hassan Z, Jahan I. Perinatal characteristics and outcome of neonates at nicu of a tertiary level hospital in Bangladesh. Bangladesh J Child Health. 2017;41(1):34-39.
Walana W, Acquash EKS, Abdul MA, NaafuB, Aruk E, Vicar KE. (2016) Pattern, causes and treatment outcomes of neonatal admission in the Tamale Teaching Hospital. Clinics Mother Child Health. 2016;13(4).
DOI: 10. 4172/2090- 7214. 1000252
Mohamed Omar Osman, Abdikani Mawlid Nur, Tahir Yousuf Nour, Mahamed Hussen Hashi, Abdilahi Abdiselam Osman. (2020). Prevalence and causes of neonatal mortality among neonates admitted in neonatal intensive care unit at sultan hassan yabare referral hospital, East Ethiopia. Science Journal of Clinical Medicine. 2020;9(1):11-17.
Onwuanaku CA, Okolo SN, Ige KO, Okpe SE, Toma BO. The effects of birth weight and gender on neonatal mortality in North Central Nigeria. BMC Research Notes. 2011;4:562. Available:http://dx.doi.org/10.1186/1756-0500-4-562
Manzar N, Manzar B, Yaqoob A, Ahmed M, Kumar J. The study of etiological and demographic characteristics of neonatal mortality and morbidity – A consecutive case series study from Pakistan. BMC Pediatr. 2012;12:131.
Muhammad Sallem, Raghib Iqbal, Shahzad Bokhari. Pattern of Neonatal Admissions and its outcome in a tertiary care hospital of Southern Punjab (a 5 years study). PJMHS. 2014;8(4).
Saini N, Chhabra S, Chhabra S, Garg L, Garg N. Pattern of neonatal morbidity and mortality: A prospective study in a District Hospital in Urban India. J Clin Neonatol. 2016;5:183-8.
Agarwal R, Agarwal K, Acharya U, Christina P, Sreenivas V, Seetaraman S. Impact of simple interventions on neonatal mortality in a low‑resource teaching hospital in India. J Perinatol. 2007;27:44‑9.
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;13:424-8.
Tajkia G, Amin SK, Rahman ME, Setu M, Roy K, Haldar S. Pattern of admission and outcome in a neonatal intensive care unit (nicu) of a tertiary care hospital in Dhaka, Bangladesh. AKMMC J. 2019;10(2):150-158.
Hoque M, Alam S, Ahmed A. Pattern of neonatal admissions and outcome in an intensive care unit (icu) of a tertiary care paediatric hospital in Bangladesh – A one-year analysis. Journal of Bangladesh College of Physicians and Surgeons. 2014;31(3):134–139. Available:https://doi.org/10.3329/jbcps.v31i3.20979
Save the Children. Surviving the first day. State of the worlds mothers; 2013.
Alhassan Abdul-Mumin, Sheila Agyeiwaa Owusu, Abdulai Abubakari. Factors associated with treatment outcome of preterm babies at discharge from the Neonatal Intensive Care Unit (NICU) of the tamale teaching hospital, Ghana. Hindawi International Journal of Pediatrics; 2020. Article ID 5696427.
Felicitas Okwako, Winstone Nyahiko, Eren Oyungu. Short term survival of premature infants admitted into the newborn unit at moi teaching and referral hospital Kenya. East African Medical Journal. 2017;94:10.
Bayana E, Gela D, Gebreyohannis T. Disease outcome and associated factors among neonates admitted to neonatal intensive care unit at JIMMA university medical center, JIMMA, southwest Ethiopia. Iranian Journal of Neonatology. 2020; 11(3).
Koum D, Essomba N, Odile N, Ngwe I, Ndanga M, Ndombo PK. Factors associated with early neonatal morbidity and mortality in an urban district hospital. Int J Latest Res Sci Technol. 2015;5(3): 9-43.
Titaley CR, Dibley MJ, Agho K, Roberts CL, Hall J. Determinants of neonatal mortality in Indonesia. BMC Public Health. 2008;8:232.
Javaria Rasheed, Tooba Aleem, Nabila Wakeel, Muhammad Khalid, Fauzia Zafar. Pattern, causes and outcome of neonatal admissions in a Teaching Hospital, Multan, Pakistan. Rawal Medical Journal. 2018; 43(2).
Siva Saranappa SB, Madhu GN, Singh RA.Study of disease pattern and outcome of newborns admitted to NICU in a tertiary care hospital. J Evolut Med Dent Sci. 2014;3(5):1113-9.
Anna Williams, Sabbir Ahmed, Marufa Khan, Sanjida Alam, Joseph Johnson. Introducing kangaroo mother care in public-sector health facilities in Bangladesh Project Brief MaMoni HSS Project MCHIP USAID SEPT; 2018.
Md Mozammel Haque, Farzana Hoque Parna, Mirza Farzana Holy, Nazma Parvin Shammy. Implementation and outcome of intermittent KMC - experience at a secondary level hospital in Bangladesh Archiv Euromedical. 2020;3.
Queen Dube, Tanya Guenther, Bina Valsangkar, Gedesi Banda. Save the children kangaroo mother care follow up study: Early outcomes among newborns discharged from facility based KMC in Malawi; 2019.
Nguah SB, Wobil PN, Obeng R. et al. Perception and practice of kangaroo mother care after discharge from hospital in Kumasi, Ghana: A longitudinal study. BMC Pregnancy Childbirth. 2011;11: 99.
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