Risk factors and causes of death in neonates.

ABSTRACT Objectives To identify the common causes and risk factors of neonatal mortality in a tertiary care Hospital. Patients and Methods This descriptive study was carried out at department ppediatrics/nursery, Liaquat University Hospital Hyderabad from July 2006 to December 2007. A total of 1203 neonates were admitted in the nursery during the study period; out of them 284 expired. These deaths were evaluated for age, gender, gestational age, birth weight, risk factors and cause of death. Results Out of 284 neonates 218 (76.7%) were low birth weight and 66 (23.2%) full term normal. Most deaths occurred in males except in preterm SGA females. The main risk factors identified were maternal anemia in 184 (65%), maternal malnutrition in 176 (62%), poor antenatal care in 109 (38.38%), grand multi-parity in 68 (23.9%), PROM in 50 (17.6%) followed by maternal fever in 24 (8.4%), APH in 23 (8.09%) and maternal UTI in 19 (6.6%). The most common causes of death were sepsis in 129 (45.4%), birth asphyxia in 68 (23.9%), respiratory distress syndrome in 38 (13.3%) and congenital anomalies in 14 (4.9%) neonates. Conclusion The mortality rate was high in preterm and low birth weight neonates. Measures to prevent neonatal mortality must be exercised with emphasis on skilled attendance at birth and appropriate care of preterm and low birth weight neonates. Key words Risk factors, neonatal mortality, birth asphyxia. INTRODUCTION Neonatal deaths account for about half of infant death in our country.1 The neonatal period is defined as less than 28 days of life. It is a highly vulnerable period of life when a neonate may develop certain serious problems which lead to death.2 Neonatal mortality in United States declined largely due to improvement in obstetric and neonatal intensive care as well as advances in diagnosis and treatment.3 Neonatal morbidity and mortality is still high in developing countries and is due primarily to negligence of female health, nutrition, deliveries by un-skilled personnel and poor antenatal care.4 Globally the major causes of neonatal death are estimated to be pre maturity, low birth weight, birth asphyxia and severe neonatal infections.5 In Pakistan, high neonatal mortality is a major problem with its high relation to certain risk factors. The purpose of this study was to ascertain some of the potential risk factors associated with neonatal deaths in our institution. PATIENTS AND METHODS This descriptive analytic study was conducted from July 2006 to December 2007 at neonatal unit of pediatric department in Liaquat University Hospital Hyderabad. During the study period, 1203 neonates were admitted in the nursery. Out of these 1203, 849 were full term and 354 were preterm. Out of these 1203 neonates, 919 were discharged, referred or left against medical advice. These 919 neonates were excluded from the study. The remaining 284 neonates expired and constitute this study. After taking informed consent, a mat