MORTALITY AND MORBIDITY PATTERN OF SEVERE AND MODERATE PRETERM BABIES IN A TERTIARY CARE HOSPITAL IN KERALA- A RETROSPECTIVE RECORD BASED STUDY.
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 13
Abstract
BACKGROUND Babies of the gestational age group 28 - 34 weeks (Moderate-to-Severe Preterm) constitute a major proportion of preterm births, and in a country like ours they have better outcome in terms of mortality, morbidity, long-term adverse consequences and financial implications when compared to extreme preterm (< 28 weeks) babies. Therefore, surveying of these babies is a need for planning interventional strategies to reduce neonatal mortality and morbidity rate. MATERIALS AND METHODS This is a retrospective, observational, record-based study done in the Department of Neonatology, Government Medical College, Ernakulam over a period of 3 years. All preterm babies in the gestation 28+0 to 33+6 weeks admitted to the Neonatal Intensive Care Unit (NICU) during the period were included in the study. The main outcome measures were major morbidities prior to hospital discharge. RESULTS There were 2491 deliveries during the study period, of which preterm deliveries (< 37 weeks) constituted 20.75%. The incidence of inborn preterm delivery in the gestation 28+0 - 33+6 weeks was 50 per 1000 live births (5.02%). Severe preterm babies (28+0 – 31+6 weeks) constituted (48.72%) with mean weight of 1.29 ± 0.27 kg and moderate preterms (32+0 - 33+6) constituted (51.28%) with mean weight of 1.72 ± 0.35 kg. The mortality in the study group was only (4.48%). Hyperbilirubinaemia was the most common morbidity (63.46 %) followed by respiratory distress syndrome (58.33%) and blood culture positive Sepsis (27.56%). Other morbidities in the study population included apnoea (14.74%), retinopathy of prematurity (12.82%), anaemia (9.61%), meningitis (8.97%) and acute kidney injury (8.97%). Necrotising enterocolitis was seen in 7.69%, seizures in 5.13%, intraventricular haemorrhage in 4.49% and birth asphyxia in 2.56%. CONCLUSION Preterm birth still continues to be a major problem in our setup. Respiratory distress syndrome being a major cause of morbidity in the study group, antenatal measures to improve lung maturity can have an important role in better outcome.
Authors and Affiliations
Sindhu Thomas Stephen, Peter Pathrose Vazhayil, Nahala Puliyulla Kandi
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