To assess the survival rate, readmission rate, its causes, and outcomes among the preterm neonates that were discharged from the neonatal units of a tertiary care center of northern India.
Methods:
A retrospective study was conducted in neonatal units of a tertiary care center in northern India. Preterm neonates (<=35 weeks) were admitted in these neonatal units, and their parents were included as participants by total enumeration sampling between July–December 2018. The data was collected from the admission records for the last 6 months from neonatal intensive care unit and from the parents whose babies were discharged. The parents were telephonically interviewed regarding readmissions and mortality. The data relating to the sociodemographic profile of parents, clinical profile of preterm neonates, readmission profile of discharged preterm neonates, and risk predictors for readmission of preterm neonates was collected.
Results:
A total of 249 preterm neonates were admitted in 6 months. It was found that the survival rate was 197 (79.1%); the readmission rate was 23 (16.4%). Out of total readmitted, majority 22 (95.7) had low maternal education as risk predictor of readmissions, followed by habitats of rural area.
Conclusion:
Preterm neonates are at more risk for getting multiple readmissions as compared to other neonates. Thus, there is a need to find out the strategies to overcome the burden of readmissions.
UNICEF. 2013 IGME child mortality Report [Internet]. [cited 2020 Jun 24]. https://www.unicef.org/media/files/2013_IGME_child_mortality_Report.pdf. Accessed November 24, 2021.
4.
GodinhoMA, MurthyS, LakiangT, PuranikA, NairSN.Mapping neonatal mortality in India: a closer look. Indian J Community Med Off Publ Indian Assoc Prev Soc Med. 2017;42(4):234-237.
5.
PrinjaS, BahugunaP, MohanP, et al.Cost-effectiveness of implementing integrated management of neonatal and childhood illnesses program in district Faridabad, India. PLoS One [Internet]. 2016 Jan 4 [cited 2020 Jun 24];11(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699694/. Accessed November 24, 2021.
6.
PandaPK, PandaPK.Clinical profile and outcome of newborns admitted to a secondary-level neonatal intensive care unit in the tribal region of Odisha. J Clin Neonatol. 2019;8(3):155.
7.
GBD 2016 Mortality Collaborators. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Lond Engl [Internet]. 2017 Sep 16 [cited 2021 Sep 12];390(10100):1084-1150.
8.
NeogiSB, KhannaR, ChauhanM, et al.Inpatient care of small and sick newborns in healthcare facilities. J Perinatol. 2016;36(Suppl 3):S18-23.
9.
Million Death Study Collaborators;BassaniDG, KumarR, AwasthiS, et al.Causes of neonatal and child mortality in India: nationally representative mortality survey. Lancet. 2010;376(9755):1853-1860.
10.
RavindraP, RaghavendraswamyK, ShreeshailB.Clinical profile and outcome of babies admitted to neonatal intensive care unit (NICU), Mc Gann teaching hospital Shivamogga, Karnataka: a longitudinal study [Internet]. [cited 2021 Sep 15]. https://www.semanticscholar.org/paper/Clinical-Profile-and-Outcome-of-Babies-Admitted-to-Ravindra-Raghavendraswamy/6699ff567dc10dc96639b7f224a58b775c1f95b3
11.
HedstromA, RymanT, OtaiC, et al.Demographics, clinical characteristics and neonatal outcomes in a rural Ugandan NICU. BMC Pregnancy Childbirth. 2014;14(1):327.
12.
MalikS, GohiyaP, KhanIA.Morbidity profile and mortality of neonates admitted in neonatal intensive care unit of a Central India Teaching Institute: a prospective observational study. J Clin Neonatol. 2016;5(3):168.
13.
IyerDCR, GornaleVK, PjH, KatweN, PrasadS, KeerthivardhanY.Morbidity and mortality pattern of neonatal intensive care unit in a Medical College Hospital from South India. Pediatr Rev Int J Pediatr Res. 2015;2(4):77-82.
14.
SekiK, IwasakiS, AnH, et al.Early discharge from a neonatal intensive care unit and rates of readmission. Pediatr Int. 2011;53(1):7-12.
15.
KramerAA, HigginsTL, ZimmermanJE.Intensive care unit readmissions in U.S. hospitals: patient characteristics, risk factors, and outcomes. Crit Care Med. 2012;40(1):3-10.
16.
RayKN, LorchSA.Hospitalization of early preterm, late preterm, and term infants during the first year of life by gestational age. Hosp Pediatr. 2013;3(3):194-203.
17.
KuzniewiczMW, S-JParker, Schnake-MahlA, EscobarGJ.Hospital readmissions and emergency department visits in moderate preterm, late preterm, and early term infants. Clin Perinatol. 2013;40(4):753-775.
18.
SlimingsC, EinarsdóttirK, SrinivasjoisR, LeonardH.Hospital admissions and gestational age at birth: 18 years of follow up in Western Australia. Paediatr Perinat Epidemiol. 2014;28(6):536-544.
19.
SaleemS.Modified Kuppuswamy scale updated for year 2018. undefined [Internet]. 2018 [cited 2021 Sep 15]. https://www.semanticscholar.org/paper/MODIFIED-KUPPUSWAMY-SCALE-UPDATED-FOR-YEAR-2018-Saleem/e65405b5c984d77808596dfd4b62ecbaf8aa9672. Accessed November24, 2021.
20.
DeviPP, SwamyCG, DeediMK.Incidence of NICU admissions of neonates born to teenage mothers in East Godavari District[Internet]. 2015 Jul 24 [cited 2020 Jun 28];(8497). https://jemds.com/latest-articles.php?at_id=8497. Accessed November 24, 2021.
21.
SimiyuDE.Morbidity and mortality of neonates admitted in general paediatric wards at Kenyatta National Hospital. East Afr Med J. 2003;80(12):611-616.
22.
ShresthaS, ShahA, PrajapatiR, SharmaY.Profile of neonatal admission at Chitwan Medical College. J Chitwan Med Coll. 2014;3(4):13-16.
23.
ShakyaA, ShresthaD, ShakyaH, ShahS, DhakalA.Clinical profile and outcome of neonates admitted to the neonatal care unit at a teaching hospital in Lalitpur, Nepal. J Kathmandu Med Coll. 2015;3:144.
24.
ReshmiR, ManjunathaM, BharamakkanavarS.Clinicoetiological profile of respiratory distress in neonates. J Evol Med Dent Sci. 2019;8:889-892.
25.
HermansenCL, LorahKN.Respiratory distress in the newborn. Am Fam Physician [Internet]. 2007 Oct 1 [cited 2021 Sep 15];76(7):987-994.
26.
RüdigerM, KüsterH, HertingE, et al.Variations of Apgar score of very low birth weight infants in different neonatal intensive care units. Acta Paediatr. 2009;98(9):1433-1436.
27.
CaseyBM, McIntireDD, LevenoKJ.The continuing value of the Apgar score for the assessment of newborn infants | NEJM [Internet]. [cited 2021 Sep 15]. https://www.nejm.org/doi/full/10.1056/NEJM200102153440701. Accessed November 24, 2021.
28.
ForsbladK, KallenK, MarsalK, Hellström-WestasL.Apgar score predicts short-term outcome in infants born at 25 gestational weeks. Acta Paediatr. 2007;96(2):166-171.
29.
ListonFA, AllenVM, O’ConnellCM, JangaardKA.Neonatal outcomes with caesarean delivery at term. Arch Dis Child - Fetal Neonatal Ed. 2008;93(3):F176-182.
30.
MartinJA, HamiltonBE, SuttonPD, VenturaSJ, MenackerF, MunsonML.Births: final data for 2002. Natl Vital Stat Rep [Internet]. 2003 Dec 17 [cited 2021 Sep 15];52(10):1-113.
31.
SauveRS, Molnar-SzakacsH, McCourtC.Highlights of the Canadian Perinatal Health Report 2003. Paediatr Child Health. 2004;9(4): 225-227. [Internet]. [cited 2021 Sep 15].
32.
GoyalN, ZubizarretaJR, SmallDS, LorchSA.Length of stay and readmission among late preterm infants: an instrumental variable approach. Hosp Pediatr. 2013;3(1):7.
33.
EscobarGJ, GreeneJD, HulacP, et al.Rehospitalisation after birth hospitalisation: patterns among infants of all gestations. Arch Dis Child. 2005;90(2):125-131.
34.
MartinsonML, ReichmanNE.Socioeconomic inequalities in low birth weight in the United States, the United Kingdom, Canada, and Australia. Am J Public Health. 2016;106(4):748-754.
