Morbidity and mortality patterns among outborn referral neonates in central India: Prospective observational study

Background: Accurate assessment of morbidity and mortality patterns of neonates are reported of inborn babies treated in neonatal intensive care unit, but data on outborn neonates treated suboptimally in general pediatric ward is lacking. Objective: The objective of the study is to document the morbidity and mortality pattern of outborn referral neonates. Materials and Methods: This was a prospective observational study undertaken at a tertiary care teaching government hospital, for 1 year. All outborn referral neonates admitted were included in the study. Relevant maternal and neonatal data were included and analyzed. Results: A total of 1077 outborn referral neonate were admitted during the study, out of which 39 were excluded from the study. As a result, 1038 neonates were included for analysis with 58.96% male and 41.04% female giving a male to female ratio 1.4:1. Most of them were from rural area and lower socioeconomic class. About 96.92% mothers were registered either at primary, secondary, or tertiary health-care facilities. The average distance traveled by neonate was 84.81 km. The leading cause of admission was sepsis (37.37%), prematurity with respiratory distress syndrome (14.55%), perinatal asphyxia (17.53%), jaundice (9.73%), and others such as malformations, meconium aspiration syndrome, genetic syndrome, and metabolic complication. Neonatal mortality rate was 31.98% and more than two-thirds deaths were within 1st week of life, with no sex predilection. The most common cause of mortality was sepsis (34.94%), followed by perinatal asphyxia (22.29%) and prematurity with respiratory distress. Conclusion: Neonatal mortality was 31.98% in our study. Systemic infection, prematurity with respiratory distress and perinatal asphyxia were the leading causes of admission in our study. These preventable causes should be urgently addressed if we hope to achieve the millennium developmental goal.