The study of etiological and demographic characteristics of neonatal mortality and morbidity - a consecutive case series study from Pakistan

BMC Pediatrics

Jai Kumar²  Muneer Ahmed²  Anum Yaqoob²  Bushra Manzar²  Nabeel Manzar¹ 

[1] B-3, Paradise Apartments, Sarwar Shaheed Road, Karachi, Pakistan;Department of Pediatrics, Dow University of Health Sciences, Karachi, Pakistan

关键词: Bacteriological spectrum;    Demographic factors;    Causes;    Morbidity;    Mortality;    Neonatal;   

Others  :  1170684
DOI  :  10.1186/1471-2431-12-131

 received in 2012-04-06, accepted in 2012-08-21,  发布年份 2012

【 摘 要 】

Background

To determine the etiology, management, bacteriological spectrum and outcome of neonatal patients admitted in Civil Hospital Karachi (CHK) and to examine the factors associated with it.

Methods

This hospital based descriptive study of 1463 patients from both sexes who were admitted to Paediatric department, CHK from 1st January 2008 till 31st December 2010 with an established cause according to modified Wigglesworth classification and fulfilling other inclusion criteria were included in the study. Data regarding their demographic profile and potential risk factors was collected on a well structured proforma. Cases were followed until discharge or expiry. Data was analyzed using descriptive statistics.

Results

The male to female ratio in our study was 1.12:1. Seven hundred and thirty-four patients were delivered at home (50.2%) and 1010 were less than 7 days old (69%). Out of the total cohort of expired subjects, 89 participants (74.8%) were < 7 days of life. Mortality was more in neonates born at home in rural areas to illiterate mother; 74 patients (62.2%). Most of the deaths; 57 were in neonates suffering from specific infections (47.9%) followed by 38 deaths in immaturity group (31.9%) and 19 related to asphyxial conditions (15.9%). The most common isolates were Staphylococcus aureus (28.7%) followed by Klebsiella (24.8%) and Pseudomonas aeruginosa (16.6 ). One hundred and nineteen (8.13%) of the neonates died in our study group.

Conclusions

These results suggest that neonates with illiterate mothers with high parity and below average socioeconomic level were more susceptible to mortality in the early neonatal period. Most of the cases of mortality were due to specific infections.

【 授权许可】

   
2012 Manzar et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Zupan J: Perinatal mortality in developing countries. N Engl J Med 2005, 352:2047-2048.
• [2]Ngoc NT, Merialdi M, Abdel-Aleem H, Carroli G, Purwar M, Zavaleta N, et al.: Causes of stillbirths and early neonatal deaths: Data from 7933 pregnancies in six developing countries. Bull World Health Organ 2006, 84:699-705.
• [3]Lander T: Neonatal and perinatal mortality: country, regional and global estimates. Geneva: WHO; 2006.
• [4]Lawn JE, Cousens S, Zupan J: 4 million neonatal deaths: when? Where? Why? Lancet 2005, 365:891-900.
• [5]Darmstadt GL, Walker N, Lawn JE, Bhutta ZA, Haws RA, et al.: Saving newborn lives in Asia and Africa: cost and impact of phased scale-up of interventions within the continuum of care. Health Policy Plan 2008, 23:101-117.
• [6]Bhutta ZA, Darmstadt GL, Hasan BS, Haws RA: Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence. Pediatrics 2005, 115:519-617.
• [7]Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, et al.: Evidence-based, costeffective interventions: how many newborn babies can we save? Lancet 2005, 365:977-988.
• [8]Abhimanyu N, Sanjay PZ, Suresh U, Shrikant IB: Neonatal Morbidity and Mortality in Tribal and Rural Communities in Central India. Indian J Community Med 2011, 36(2):150-158.
• [9]Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, et al.: Neonatal Mortality Levels for 193 Countries in 2009 with Trends since 1990: A Systematic Analysis of Progress, Projections, and Priorities. PLoS Med 2011, 8(8):e1001080.
• [10]Baqui AH, Darmstadt GL, Williams EK, Kumar V, Kiran TU, et al.: Rates, timings and causes of neonatal deaths in rural India: implications for neonatal health programmes. Bull World Health Organ 2006, 84:706-713.
• [11]Mirzrah EM: Neonatal seizures and neonatal epileptic syndrome. Neural Clin 2001, 19:427-463.
• [12]Jamal H: Estimation of multidimensional poverty in Pakistan. Social policy and development centre 2009, 79:1-14.
• [13]Wigglesworth JS: Classification of perinatal deaths. Soz Praventivmed 1994, 39:11-14.
• [14]Winbo IG, Serenius FH, Dahlquist GG, Kallen BANICE: A new cause of death classification for still births and neonatal deaths. Neonatal and Intrauterine death classification according to etiology. Int J Epidemiol 1998, 27:499-504.
• [15]Chang JY, Lee KS, Hahn WH, Chung SH, Choi YS, Shim KS, et al.: Decreasing trends of neonatal and infant mortality in Korea: compared with Japan, USA and OECD nations. J Korean Med Sci 2011, 26(9):1115-1123.
• [16]Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al.: Global, regional and national causes of child mortality in 2008: a systematic analysis. Lancet 2010, 375(9730):1969-1987.
• [17]Shams R, Khan N, Hussain S: Bacteriology & Anti-Microbial Susceptibility of Neonetal Septicemia in NICU, PIMS, Islamabad-A Tertiary Care Hospital of Pakistan. Ann Pak Inst Med Sci 2010, 6(4):191-195.
• [18]Ayaz A, Saleem S: Neonatal Mortality and Prevalence of Practices for Newborn Care in a Squatter Settlement of Karachi, Pakistan: A Cross-Sectional Study. PLoS One 2010, 5(11):e13783.
• [19]Kouéta F, Yé D, Dao L, Néboua D, Sawadogo A: Neonatal morbidity and mortality in 2002–2006 at the Charles de gulle pediatric hospital (France). Child Care Health Dev 2004, 30(6):699-709.
• [20]Owa JA, Osinaike AI: Neonatal morbidity and mortality in Nigeria. Indian J Pediatr 1998, 65(3):441-449.
• [21]Emmanuel D: Study on maternal mortality and neonatal morbidity in Africa. J rural integrated relief service-Ghana 2007.
• [22]Kumar M, Paul VK, Kapoor SK, Anand K, Deoraria AK: Neonatal outcomes at a subdistrict hospital in north India. J Trop Pediatr 2002, 48(1):43-46.
• [23]Zaidi AK, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldman DA: Hospital-acquired neonatal infections in developing countries. Lancet 2005, 365:1175-88.
• [24]Modi N, Kirubakaran C: Reasons for admission,causes of death and costs of admission to a tertiary neonatal referral unit in India. J Trop Pediatr 1995, 4(2):99-102.
• [25]Seyal T, Husnain F, Anwar A: Audit of Neonatal Morbidity and Mortality at Neonatal Unit of Sir Gangaram Hospital Lahore. Ann King Edward Med Uni 2011, 17(1):9-13.
• [26]Rashid AKM, Rasul CHH, Hafiz SM: Neonatal mortality: a scenario in a tertiary level hospital of developing country. Pediatr Rep 2010, 2(1):e9.
• [27]Berg CJ: Prenatal care in developing countries: The World Health Organization technical working group on antenatal care. J Am Med Womens Assoc 1995, 50:182-186.
• [28]Carroli G, Villar J, Piaggio G, Khan-Neelofur D, Gulmezoglu M, et al.: WHO systematic review of randomised controlled trials of routine antenatal care. Lancet 2001, 357:1565-1570.
• [29]Ba'aqeel H, Piaggio G, Lumbiganon P, Miguel Belizan J, et al.: WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. Lancet 2001, 357:1551-1564.
• [30]Muhammad Z, Ahmed A, Hayat U, Wazir MS, Rafiyatullah , Waqas H: Neonatal sepsis: causative bacteria and their resistance to antibiotics. J Ayub Med Coll Abbottabad 2010, 22(4):33-36.