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1
Oliveira Júnior, Amilton Roberto, Weslla Albuquerque De Paula, and Marília Cruz Gouveia Câmara Guerra. "Pain in the newborn: a transversal study about nursing care in neonatal units." Revista de Enfermagem UFPE on line 5, no. 7 (August 12, 2011): 1582. http://dx.doi.org/10.5205/reuol.1262-12560-1-le.0507201102.
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ABSTRACT Objective: to determine how the assistance is for newborns, submitted to painful procedures by nurses in neonatal units. Method: a transversal study, held in july 2010, in the Neonatal Units in the city of Caruaru-PE. Data collection was performed with eight nurses, through a structured interview. These data were analyzed quantitatively by means of absolute and relative frequencies. The project was approved by the Ethics Committee in Research Involving Human Subjects from ASCES College, according to protocol No. 063/10. Results: from nurses interviewed, only 12.5% reported always using analgesia during painful procedures in neonates. When asked about the pharmacological interventions used against the neonate with pain, the most cited was the administration of non-opioid analgesic (62.5%). Among the various behavioral changes made by infants with pain, alluded by all nurses, include: motor activity and crying. Conclusion: the nurses notices that the newborn feels pain and uses pharmacological and no-pharmacological interventions for pain’s relief and treatment. However, these results suggest the need of this theme to be worked with these professionals. Descriptors: pain; newborn; neonatal intensive care units; neonatal nursing.RESUMOObjetivo: verificar como ocorre a assistência ao recém-nascido, submetido a procedimentos dolorosos, pelos enfermeiros de unidades neonatais. Método: estudo transversal, realizado em julho de 2010, nas Unidades Neonatais do município de Caruaru-PE. A coleta de dados foi realizada com oito enfermeiros (as), através de entrevista estruturada. Esses dados foram analisados quantitativamente por meio das frequências absoluta e relativa. O projeto foi aprovado pelo Comitê de Ética em Pesquisa Envolvendo Seres Humanos da Faculdade ASCES, conforme protocolo nº 063/10. Resultados: dos enfermeiros entrevistados, apenas 12,5% referiu sempre utilizar analgesia durante procedimentos dolorosos no recém-nascido. Quando questionados quanto às intervenções farmacológicas utilizadas frente ao neonato com dor, a mais citada foi a administração de analgésico não-opióide (62,5%). Dentre às diversas alterações comportamentais apresentadas pelos neonatos com dor, as aludidas por todos os enfermeiros, incluem-se: choro e atividade motora. Conclusão: os enfermeiros estão enxergando que o recém-nascido sente dor e utilizando intervenções farmacológicas e não-farmacológicas para o seu alívio e tratamento. Entretanto, estes resultados sugerem a necessidade desta temática ser trabalhada com estes profissionais. Descritores: dor; recém-nascido; unidades de terapia intensiva neonatal; enfermagem neonatal.RESUMEN Objetivo: averiguar como ocurre la asistencia al recién nacido, sometido a procedimientos dolorosos por los enfermeros en las unidades neonatales. Método: estudio transversal, realizado en julio de 2010, en las Unidades Neonatales del municipio de Caruaru-PE. La recolección de datos se realizó con ocho enfermeros, mediante entrevista estructurada. Estos datos se analizaron por medio de frecuencias absolutas y relativas. El proyecto fue aprobado por Comité de Ética en Investigación Envolviendo Seres Humanos del Facultad ASCES, bajo protocolo Nº 063/10. Resultados: de los enfermeros entrevistados, sólo 12,5% tiene el uso de analgesia durante procedimientos dolorosos en los neonatos. Cuando se le preguntó acerca de las intervenciones farmacológicas utilizadas en recién nacidos con el dolor, el más citado fue administración de analgésico no opióides (62,5%). Entre los diversos cambios de comportamientos de los niños con dolor, que alude a todos los enfermeros, son: la actividad motora y llanto. Conclusión: las enfermeras perciben el dolor de los recién nacidos y usan las intervenciones farmacológicas y no-farmacológicas para su alivio y tratamiento. Sin embargo, estos resultados hacen pensar en la necesidad de este tema ser trabajado con estos profesionales. Descriptores: dolor; recién nacido; unidades de cuidados intensivos neonatales; enfermería neonatal.
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Bitew, Zebenay Workneh, Ayinalem Alemu, Ermias Getaneh Ayele, Desalegn Abebaw Jember, Michael Tamene Haile, and Teshager Worku. "Incidence Density Rate of Neonatal Mortality and Predictors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis." International Journal of Pediatrics 2020 (October 15, 2020): 1–14. http://dx.doi.org/10.1155/2020/3894026.
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Background. Neonatal mortality in Sub-Saharan countries is remarkably high. Though there are inconsistent studies about the incidence density rate of neonatal mortalities (IDR) and predictors in Sub-Saharan Africa, they are inconclusive to policymakers and program planners. In this study, the IDR of neonatal mortalities and predictors was determined. Methods. Electronic databases (Web of Science, PubMed, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), World Cat, Google Scholar, and Google) were explored. 20 out of 818 studies were included in this study. The IDRs and predictors of neonatal mortality were computed from studies conducted in survival analysis. Fixed and random effect models were used to compute pooled estimates. Subgroup and sensitivity analyses were performed. Results. Neonates were followed for a total of 1,095,611 neonate-days; 67142 neonate-days for neonates treated in neonatal intensive care units and 1,028,469 neonate-days for community-based studies. The IDRs of neonatal mortalities in neonatal intensive care units and in the community were 24.53 and 1.21 per 1000 person-days, respectively. The IDRs of early and late neonatal mortalities neonatal intensive care units were 22.51 and 5.09 per 1000 neonate-days, respectively. Likewise, the IDRs of early and late neonatal mortalities in the community were 0.85 and 0.31, respectively. Not initiating breastfeeding within one hour, multiple births, rural residence, maternal illness, low Apgar score, being preterm, sepsis, asphyxia, and respiratory distress syndrome were independent predictors of time to neonatal mortality in neonatal intensive care units and male gender, perceived small size, multiple births, and ANC were predictors of neonatal mortality in the community. Conclusion. The incidence density rate of neonatal mortality in Sub-Saharan Africa is significantly high. Multiple factors (neonatal and maternal) were found to be independent predictors. Strategies must be designed to address these predictors, and prospective studies could reveal other possible factors of neonatal mortalities.
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Sultana, Jesmin, Nure Ishrat Nazme, and Nurun Nahar Fatema Begum. "Patterns of Neonatal Admission and Outcome in Neonatal Intensive Care Unit of a Tertiary Care Hospital." Journal of Armed Forces Medical College, Bangladesh 13, no. 2 (May 13, 2019): 49–53. http://dx.doi.org/10.3329/jafmc.v13i2.41376.
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Introduction: Analyzing the neonatal admission pattern helps the policymakers to make better strategies for healthcare provider to deliver better service.
Objective: To demonstrate the admission pattern and outcome of patients in the Neonatal Intensive Care Unit (NICU) in a tertiary care hospital of Bangladesh.
Materials and Methods: This retrospective descriptive study was conducted on all neonates admitted to the NICU of Combined Military Hospital (CMH), Dhaka from January to December 2015. Data were collected from file records of the patients regarding age, gender, mode of delivery, working diagnosis, length of stay in NICU and immediate outcome.
Results: A total of 502 neonates were admitted during the study period. Majority of the patients (77.3%) were admitted on the 1st day of life. There were 279(55.6%) males with a male to female ratio 1.2:1. The major cause of admission was prematurity (23.1%) and other leading causes were birth asphyxia (BA)14.9%, infant of a diabetic mother (IDM) 13.5%, neonatal sepsis 12.5%. Most of the neonates (82.7%) were delivered by caesarean section. About 84.1% were discharged after improvement, 65(12.94%) died and 15(3%) were referred to other specialties for further management. Within the first 24 hours of admission, 9.4% deaths occurred and two common causes of neonatal death were preterm (49.18%) and birth asphyxia (23%).
Conclusion: Good outcome of a neonate depends on adequate management, monitoring and good nursing care in an intensive care unit. By paying good attention to perinatal services and improving the facilities in the unit, morbidity and mortality in neonates can be reduced.
Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 49-53
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Walker, Paul, and Vito Forte. "Failed Extubation in the Neonatal Intensive Care Unit." Annals of Otology, Rhinology & Laryngology 102, no. 7 (July 1993): 489–95. http://dx.doi.org/10.1177/000348949310200701.
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One of the roles of the pediatric otolaryngologist in the neonatal intensive care unit (NICU) is the assessment and management of the neonate who fails a trial of extubation. This paper reviews the recent 5-year institutional experience at The Hospital for Sick Children, Toronto, with neonates who failed extubation and who subsequently underwent diagnostic endoscopy. One hundred twenty-eight neonates from the NICU underwent diagnostic endoscopy. Of these, 58 neonates underwent diagnostic endoscopy for failure to extubate. Nine neonates were extubated after diagnostic endoscopy and retrial (16% of the series). Eleven neonates were extubated after additional endoscopic procedures (19% of the series). Twenty-four neonates underwent anterior cricoid split, of whom 20 or 83% (34% of the series) were eventually successfully extubated with no further airway intervention required during the study period (minimum 6 months' follow-up). Eleven neonates underwent tracheotomy (19% of the series). Four neonates underwent another external procedure to allow extubation (7% of the series). Three neonates died while still intubated (5% of the series). Our management of the neonate who fails a trial of extubation is discussed.
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Mannan, MA, Nazmun Nahar, Firoz Ahmed, Ismat Jahan, Taskina Mosleh, Kamrul Ahsan Khan, Sanjoy Kumer Dey, and Mohammod Shahidullah. "Neonatal Pneumonia in NICU of a Tertiary Care Center." Bangladesh Journal of Child Health 42, no. 3 (December 15, 2018): 112–17. http://dx.doi.org/10.3329/bjch.v42i3.39250.
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Background: Pneumonia is one of the causes of neonatal infection and responsible for significant morbidity and mortality, especially in developing countries. The study was aimed to reveal frequency and outcome of pneumonia among hospitalized sick newborn of neonatal intensive care unit.
Methodology: This observational study was carried out in the NICU of Bangabandhu Sheikh Mujib Medical University (BSMMU) on 94 neonates with the diagnosis of pneumonia admitted from July 2012 to June 2014. All studied neonates were subjected to history taking, clinical examination, routine investigations, chest radiography and blood culture and sensitivity.
Results: Incidence of neonatal pneumonia was 43% among admitted neonates with respiratory distress. Mean birth weight and gestational age were 2392±854 and 33±3.9 weeks respectively. Of enrolled infants with pneumonia, 38 (40.4%) were early onset, 24 (25%) were hospital acquired pneumonia and community acquired pneumonia was documented in 14 (14.8 %) and the rest 18 (19%) were ventilator associated pneumonia. Blood culture was positive in 18 (19%) of cases with neonatal pneumonia; most common pathogen isolated was acinetobacter. Mean duration of hospital stay was 19±8 days. Most of the neonatal pneumonia were cured 72 (76%) with therapy, whereas 17 (18%) died during their hospital course.
Conclusion: Overall incidence among admitted sick neonates was 8.4% which constituted 34% of distressed neonate.
Bangladesh J Child Health 2018; VOL 42 (3) :112-117
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Shah, Juveriya, Ali Akbar Siyal, and Tabinda Taqi. "NEONATAL CARE UNIT." Professional Medical Journal 25, no. 12 (December 8, 2018): 1945–48. http://dx.doi.org/10.29309/tpmj/18.4655.
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Objectives: The objective of this study was to take a look at main causes associated with highest neonatal morbidity and mortality in neonatal care unit of People’s medical college hospital Nawabshah. Study Design: Retrospective study. Period: January 2015 to December 2015. Setting: Paediatric medicine ward of People’s medical college hospital Nawabshah. Methods: The data collected included; sex, gestational age, postnatal age atadmission, weight at admission, main cause of admission, outcome, cause of death. Results: The number of neonates admitted in NICU was 2863 (14.4%) of the total admissions (19882) to the paediatric unit including neonatal unit during the study period. There were more males 1750 (61.9%) than females. Prematurity, neonatal sepsis and birth asphyxia were the most common morbidities (27.5%, 14.9% and 14.6%, respectively). The overall mortality was 21.93% (628 out of 2863 babies). The morbidities with the highest mortality were birth asphyxia 244(38.85%), neonatal sepsis and meningitis 77 (12.26%), and V.L.B.W (9.03%). Conclusion: Birth Asphyxia, neonatal sepsis and meningitis, and low birth weight were the major contributors in admission as well as mortality of newborns, depicting a lack of care and attention in antenatal duration and there is a major lack of training and retraining of birth attendants.
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Lake, Eyasu A., Gerezgiher B. Abera, Gedion A. Azeze, Natnaeal A. Gebeyew, and Birhanu W. Demissie. "Magnitude of Neonatal Jaundice and Its Associated Factor in Neonatal Intensive Care Units of Mekelle City Public Hospitals, Northern Ethiopia." International Journal of Pediatrics 2019 (April 10, 2019): 1–9. http://dx.doi.org/10.1155/2019/1054943.
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Background. Jaundice in the neonate is one of the most common clinical problems. Globally, every year about 1.1 million babies develop it and the vast majority reside in sub-Saharan Africa and South Asia. Study on magnitude and local factors associated with neonatal jaundice is limited in Ethiopia. So this study was aimed at assessing magnitude and predictors of neonatal jaundice among neonates admitted to neonatal intensive care unit of public hospitals in Mekelle city, Northern Ethiopia. Methods. Institution based cross-sectional study was conducted from February to April 2016 in neonatal intensive care unit of Mekelle city public hospitals. Systematic random sampling technique was used to select study participants. Data was collected by interviewing mothers through structured questionnaire and reviewing neonates’ medical records using checklist. Multivariable binary logistic regression analyses were employed to identify factors associated with neonatal jaundice. Results. A total of 209 neonates with their mothers were included. The proportion of neonatal jaundice was found to be 37.3%. Prolonged labor [AOR = 4.39; 95% CI (1.8-10.69)], being male [AOR = 3.7; 95% CI (1.54-8.87)], maternal “O” blood group [AOR = 5.05; 95% CI (1.53-16.72)], sepsis [AOR = 2.64; 95% CI (1.15-6.05)], and blood type incompatibility [AOR = 18.21; 95% CI (6.36-52.13)] were positively associated with neonatal jaundice while night time delivery [AOR 0.42; 95% CI (0.18-0.96)] showed negative association. Conclusion. The magnitude of neonatal jaundice among neonates was found to be high. Duration of labor, time of delivery, sexes of neonate, sepsis, maternal blood group, and blood type incompatibility were significantly associated with neonatal jaundice. Therefore, improving newborn care and timely intervention for neonates with ABO/Rh incompatibility are recommended.
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Demet Cabar, Huriye, Adeviye Aydin, and Ulgen Gullu. "Care in neonatal jaundice." International Journal of Academic Research 6, no. 3 (May 30, 2014): 8–14. http://dx.doi.org/10.7813/2075-4124.2014/6-3/a.2.
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Torfs, Marlien, Titia Hompes, Michael Ceulemans, Kristel Van Calsteren, Christine Vanhole, and Anne Smits. "Early Postnatal Outcome and Care after in Utero Exposure to Lithium: A Single Center Analysis of a Belgian Tertiary University Hospital." International Journal of Environmental Research and Public Health 19, no. 16 (August 16, 2022): 10111. http://dx.doi.org/10.3390/ijerph191610111.
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Knowledge of the impact of in utero exposure to lithium during the postnatal period is limited. Besides a possible teratogenic effect during the first trimester, exposure during the second and third trimesters might lead to neonatal effects. Uniform guidelines for postnatal management of these neonates are lacking. The aim was to retrospectively describe all neonates admitted to the University Hospitals Leuven after in utero exposure to lithium (January 2010 to April 2020), and to propose a postnatal care protocol. Descriptive statistics were performed. For continuous parameters with serial measurements, median population values were calculated. In total, 10 mother-neonate pairs were included. The median gestational age was 37 (interquartile range, IQR, 36–39) weeks. Neonatal plasma lithium concentration at birth was 0.65 (IQR 0.56–0.83) mmol/L with a median neonate/mother ratio of 1.02 (IQR 0.87–1.08). Three neonates needed respiratory support, 7/10 started full enteral (formula) feeding on day 1. The median length of neonatal stay was 8.5 (IQR 8–12) days. One neonate developed nephrogenic diabetes insipidus. This study reported in detail the postnatal characteristics and short-term neonatal outcomes. A postnatal care protocol was proposed, to enhance the quality of care for future neonates, and to guide parental counselling. Future prospective protocol evaluation is needed.
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Shead, Sandra L. "Pathophysiology of the Cardiovascular System and Neonatal Hypotension." Neonatal Network 34, no. 1 (2015): 31–40. http://dx.doi.org/10.1891/0730-0832.34.1.31.
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ABSTRACTHypotension is common in low birth weight neonates and less common in term newborns and is associated with significant morbidity and mortality. Determining an adequate blood pressure in neonates remains challenging for the neonatal nurse because of the lack of agreed-upon norms. Values for determining norms for blood pressure at varying gestational and postnatal ages are based on empirical data. Understanding cardiovascular pathophysiology, potential causes of hypotension, and assessment of adequate perfusion in the neonatal population is important and can assist the neonatal nurse in the evaluation of effective blood pressure. This article reviews cardiovascular pathophysiology as it relates to blood pressure and discusses potential causes of hypotension in the term and preterm neonate. Variation in management of hypotension across centers is discussed. Underlying causes and pathophysiology of hypotension in the neonate are described.
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Siddiqui, Muhammad Asif, Sehrish Masood, Tayyaba Khawar Butt, and Shahla Tariq. "Neonatal outcomes of birth asphyxia in tertiary care hospital of low-income country." Journal of Fatima Jinnah Medical University 15, no. 1 (March 15, 2021): 23–26. http://dx.doi.org/10.37018/unkh2664.
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Background: Pakistan has highest neonatal mortality in the region and birth asphyxia is one of the main preventable contributors to this. Objective of this study is to determine the frequency of different neonatal outcomes in neonates with birth asphyxia.
Subjects & Methods: It was descriptive case series study conducted in Department of Pediatrics Medicine, Services Hospital, Lahore in 6 months period during 6th Dec 2016 to 5th June 2017. 150 cases were included using non probability, consecutive sampling with 95% confidence level, 6% margin of error taking an expected percentage of neonate mortality as 15%. Data was analyzed with SPSS version 23. Categorical variables i.e., gender and neonatal outcomes in terms of neonatal mortality, discharge and neurological complications were expressed by frequency and percentage. Post stratification chi square test was applied. A p-value of <0.05 was taken as significant.
Results: The mean age of neonates was 3.09±0.8 hours. Outcomes of these neonates was seen in terms of mortality, discharge and neurological problems. Out of total 150 patients, 51 (34%) neonates expired and 99 (66%) neonates were survived. And neonates 69 (46%) neonates were diagnosed with neurological complications.
Conclusion: We found, birth asphyxia has significant association with neonatal mortality and neurological complications. Prevention of birth asphyxia with appropriate resuscitation at birth may be helpful in reduction of morbidity and mortality due to birth asphyxia.Neonates
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Choure, Mangal Kishanrao, Rakesh Ramratan Jadhav, and Sudhir Laxmanrao Padwal. "DRUG UTILIZATION STUDY IN NEONATAL INTENSIVE CARE UNIT AT RURAL TERTIARY CARE HOSPITAL." Asian Journal of Pharmaceutical and Clinical Research 10, no. 4 (April 1, 2017): 102. http://dx.doi.org/10.22159/ajpcr.2017.v10i4.16111.
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Objectives: To study the trends of drug utilization pattern in neonatal intensive care unit (NICU) at rural tertiary care hospital using the World HealthOrganization core indicators.Methods: The study was cross-sectional, observational study in NICU of Government Medical College, Ambajogai, Maharashtra. Data were collected byscrutinizing the prescriptions written by pediatricians in NICU. The consent of parents of neonate was obtained for inclusion in the study. Parameterssuch as age, gender, birth weight, current illness, congenital anomalies, gestational age at birth, and drugs prescription analyzed.Results: A total 220 prescription were scrutinized. Out of 220 neonates, 53.6% was males and 46.3% females. The total number of drugs prescribedwas 808 and the average number of drugs per prescription was 3.6. The most frequently prescribed therapeutic class of drugs antimicrobial agents(60.64%) followed by vitamin K (26.7%) and aminophylline (9.4%). The maximum number (50%) of neonate born with birth weight <2.5. Themaximum number (42%) of neonate was born at 34-36 weeks of gestation. Preterm low birth weight was the most common observed reason foradmission to NICU. The drugs are prescribed by branded name outnumbered than generic name.Conclusion: This study highlights the problem of overprescribing of antibiotics, inadequate labeling and a trend toward polypharmacy.Keywords: Drug utilization study, Neonatal intensive care unit, Prescription, Neonate.
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Johnson, Ann. "Disability and Perinatal Care." Pediatrics 95, no. 2 (February 1, 1995): 272–74. http://dx.doi.org/10.1542/peds.95.2.272.
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The declining infant mortality is carefully documented year by year in the Annual Summary of Vital Statistics in this journal.1 Although socioeconomic factors play an important role in this decline, the falling death rate among neonates weighing <1500 g at birth is widely attributed to changing patterns of neonatal intensive care. For neonates weighing 1000 g at birth, this assumption is probably correct. Thirty years ago, almost all these neonates died; now, over half survive to leave the neonatal unit and this proportion is as high as 70% in large tertiary centers.2 In terms of "rescue from death," neonatal intensive care can be described as a remarkably successful medical technology.
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Csoma, Zsanett Renáta, Péter Doró, Gyula Tálosi, Tamás Machay, and Miklós Szabó. "Neonatal skin care in tertiary Neonatal Intensive Care Units in Hungary." Orvosi Hetilap 155, no. 28 (July 2014): 1102–7. http://dx.doi.org/10.1556/oh.2014.29910.
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Introduction: Skin physiology of neonates and preterm infants and evidence-based skin care are not well explored for health care providers. Aim: The aim of our present study was to investigate the skin care methods of the tertiary Neonatal Intensive Care Units in Hungary. Method: A standardized questionnaire was distributed among the 22 tertiary Neonatal Intensive Care Units with questions regarding skin care methods, bathing, emollition, skin disinfection, umbilical cord care, treatment of diaper dermatitis, and use of adhesive tapes. Results: The skin care methods of the centres were similar in several aspects, but there were significant differences between the applied skin care and disinfectant products. Conclusions: The results of this survey facilitate the establishment of a standardized skin care protocol for tertiary Neonatal Intensive Care Units with the cooperation of dermatologists, neonatologists and pharmacists. Orv. Hetil., 2014, 155(28), 1102–1107.
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Ibrahim, Riyadh M. "Morbidity and Mortality Pattern of Neonates Admitted to Neonatal Care Unit.Central Teaching Pediatric Hospital Baghdad." AL-Kindy College Medical Journal 16, no. 1 (September 5, 2020): 38–48. http://dx.doi.org/10.47723/kcmj.v16i1.188.
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Background; Neonatal period is a very vulnerable period of life due to many problems, In spite of advances in perinatal and neonatal care still, the mortality rate of neonate high especially in developing country The World Health Organization estimates that globally four million neonatal deaths per year, Developing countries account for around 99% of the neonatal mortality in the world, In Iraq. Neonatal mortality rate about 19 per 1000 live births which represent 56% of child death below 5 years age in 2012. .Objectives The aims of the study were to determine the institutional new-born case fatality rate and the cause of admission and death in the neonatal care unit.Method; Across-section study was carried out of the Neonatal Care Unit of Central Teaching Hospital of Pediatric in Baghdad Al-krakh Health DirectorateResult; During 2015, 1977 neonates were admitted, Mortality rate was 9%, Four main causes of death were identified; Respiratory related condition, Bacterial sepsis, premature neonate (Disorder related to short gestational and low birth weight not relayed to elsewhere classification) and congenital malformation 37.5%, 33.3%, 7.1% and 7.1% respectively , The main causes of morbidity were Neonatal jaundice, Respiratory related condition, Bacterial sepsis 37.5%, 35.2%. 14.1% respectively Conclusions: The majority of neonatal morbidity and mortality can be prevented by appropriate interventions
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Sood, Ambika, Rakesh Sharma, Raju Katoch, and Sanya Sharma. "Mortality Pattern of In-Born vs Out-Born Neonates - Comparative Study of Neonates Admitted to Special New Born Care Units of a Tertiary Care Hospital of Hilly Region of North India." Journal of Evolution of Medical and Dental Sciences 10, no. 44 (November 30, 2021): 3757–61. http://dx.doi.org/10.14260/jemds/2021/760.
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BACKGROUND The high incidence of global neonatal mortality has triggered several efforts to improve facility-based neonatal care but despite these many advances in perinatal and neonatal care, the outcomes achievable at different levels are comparable. This study was undertaken to compare the mortality pattern among both the inborn and outborn neonates admitted to the special new born care units (SNCU)s of tertiary care hospital of Shimla city, in the hilly state of Himachal Pradesh. METHODS A cross-sectional study involving a record review of all neonates admitted to the specialized neonatal care units of the paediatric ward of IGMC, Shimla & Kamla Nehru Hospital (KNH) over five years from January 2016 to December 2020 was conducted. The most important causes of mortality and its associated factors were analysed, and a statistical inference was made. RESULTS Among the 4018 outborn neonates admitted to the SNCU of the pediatric ward of IGMC, Shimla, 2440 (60.73 %) were males and 1578 (39.27 %) were females while 6607 inborn neonates were admitted to the SNCU of KNH Shimla and among them 3655 (55.32 %) were males and 2952 (44.68 %) were females. In the outborn SNCU of IGMC Shimla, 307 (7.64 %) died while in the inborn SNCU of KNH Shimla, 366 (5.54 %) neonates died over a span of 5 years. In outborn SNCU of IGMC Shimla, a maximum of 110 (35.83 %) neonates died due to sepsis/pneumonia/meningitis, followed by 60 (19.54 %) due to respiratory distress syndrome and 50 (16.29 %) due to HIE/moderate-severe birth asphyxia while in case of inborn SNCU of KNH, maximum deaths of 115 (31.42 %) were due to respiratory distress syndrome, followed by 93 (25.41 %) due to sepsis/pneumonia/meningitis and 69 (18.85 %) due to HIE/moderate-severe birth asphyxia. At outborn SNCU of IGMC, Shimla, most of the neonates who died 118 (38.44 %) weighed about 1500-2499 gm, while in inborn SNCU of KNH, Shimla, most of the neonates 147 (40.16 %) had weight between 1000-1499 gm. At outborn SNCU of IGMC Shimla, 131 (42.67 %) were preterm while at inborn SNCU of KNH, 305 (83.3 %) were preterm. CONCLUSIONS Sepsis, birth asphyxia and RDS are the important causes of mortality, which must be urgently addressed. Improving antenatal care, improved access to health facilities, early identification of danger signs, timely referral, capacity building, can reduce neonatal mortality. KEY WORDS Comparison, Neonatal Mortality, SNCUs, Tertiary Care Hospital, Inborn Neonate, Outborn Neonate.
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Fredrickson, M. J., and P. Seal. "Ultrasound-guided Transversus Abdominis Plane Block for Neonatal Abdominal Surgery." Anaesthesia and Intensive Care 37, no. 3 (May 2009): 469–72. http://dx.doi.org/10.1177/0310057x0903700303.
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This paper describes four neonates having abdominal procedures with intraoperative and early postoperative analgesia provided by a transversus abdominis plane regional block. Analgesia for neonatal upper and midabdominal surgery usually involves regional anaesthesia and/or systemic opioid. All these analgesia techniques have problems specific to the neonatal period. Neonates are sensitive to the respiratory depressant effects of systemic opioid, while the low threshold for local anaesthetic toxicity limits regional anaesthesia/analgesia, which in neonatal upper abdominal surgery is often limited to local anaesthetic infiltration. The transversus abdominis plane block has been shown to provide effective analgesia following a variety of abdominal surgeries in both adults and children. We report four neonates who underwent minor or major abdominal surgery under general anaesthesia supplemented by ultrasound-guided transversus abdominis plane block. Perioperative opioids were administered to one neonate who required postoperative ventilation. Ultrasound-guided transversus abdominis plane bock is a technically feasible alternative to local anaesthetic wound infiltration in the neonate and warrants further evaluation.
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Yengkhom, Rameshwor, Pradeep Suryawanshi, Rahul Murugkar, Bhavya Gupta, Sujata Deshpande, and Yogen Singh. "Point of Care Neonatal Ultrasound in Late-Onset Neonatal Sepsis." Journal of Neonatology 35, no. 2 (April 15, 2021): 59–63. http://dx.doi.org/10.1177/09732179211007599.
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Background and Objectives: Point of care neonatal ultrasound is a useful tool in evaluation of heart, brain, lungs, and abdomen in neonatal sepsis. The objective of our study was to perform bedside ultrasound screening of heart, brain, lungs, and abdomen in neonates with late onset culture positive sepsis and study the patterns of abnormalities and also their role in change of patient management. Methods: This prospective observational study was conducted at a tertiary level neonatal care unit from March 2017 to May 2018. All neonates with suspected late onset sepsis on the basis of clinical and laboratory findings underwent point of care neonatal ultrasound of heart, brain, lungs, and abdomen. Results: Of 153 suspected and eligible late-onset neonatal sepsis (LONS) cases, 67 (44%) had positive blood culture and were analyzed. Of this 67 neonates, 30 (45%) had abnormal neurosonography, 38 (57%) had abnormal cardiac output, 14 (20%) had abnormal cardiac contractility, 17 (25%) had abnormal pulmonary pressure, 18 (27%) had pulmonary arterial hypertension, 19 (28%) had pneumonia, and 7 (10%) had free fluid in abdomen. Clinical management was changed in 26 (39%) neonates. Conclusion: Bedside point of care neonatal ultrasound is a useful tool in assessment of heart, brain, lungs, and abdomen in a LONS. It could help in making appropriate decisions in the management, and therefore potentially reduce morbidity and mortality.
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Azzizadeh Forouzi, Mansooreh, Marjan Banazadeh, Jila Soltan Ahmadi, and Farideh Razban. "Barriers of Palliative Care in Neonatal Intensive Care Units." American Journal of Hospice and Palliative Medicine® 34, no. 3 (July 11, 2016): 205–11. http://dx.doi.org/10.1177/1049909115616597.
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Objective: Neonatal nurses face numerous barriers in providing end-of-life (EOL) care for neonates and their families. Addressing neonatal nurses’ attitudes could provide insight into barriers that impede neonatal palliative care (NPC). This study thus conducted to examine neonatal nurses’ attitude toward barriers in providing NPC in Southeast Iran. Method: In this cross-sectional study, a translated modified version of Neonatal Palliative Care Attitude Scale was used to examine attitudes of 70 nurses toward barriers of palliative care in 3 neonatal intensive care units in Southeast Iran. Results: Findings indicated that overall 42.63% of nurses were strongly agreed or agreed with the proposed barriers in NPC. Among all categories, the highest and the lowest scores belonged to the categories of “insufficient resources” (3.42 ± 0.65) and “inappropriate personal and social attitudes” (2.33 ± 0.48), respectively. Neonatal nurses who had less education and study regarding NPC reported the presence of more barriers to NPC in the categories of “inappropriate organizational culture” and/or “inadequate nursing proficiency.” Also, younger nurses had more positive attitudes toward the category of inappropriate organizational culture as being a barrier to provision of NPC (4.62). Conclusion: The findings suggest that developing a context-based instrument is required to represent the barrier more precisely. Neonatal palliative care can be improved by establishing a special environment to focus on infants’ EOL care. This establishment requires standard palliative care guidelines and adequate NPC-trained nurses.
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Sharma, Ashutosh Kumar, and Ajay Gaur. "Profile of neonatal mortality in special newborn care unit of tertiary care hospital." International Journal of Contemporary Pediatrics 6, no. 6 (October 21, 2019): 2319. http://dx.doi.org/10.18203/2349-3291.ijcp20194205.
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Background: In India presently around 8 million LBW infant are born each year. India accounts for 24% of global neonatal mortality. Improving NMR is an essential component of reducing U-5MR. The aim of this study was to determine the causes of morbidity and mortality in neonates admitted in our hospital.Methods: This study was conducted at SNCU of Kamala Raja Hospital, Gwalior providing level III neonatal care. This is a retrospective hospital based observational study. Data from SNCU online database were taken for a period of 3 year from March 2016 to March 2019. Data obtained included sex, birth weight, Gestation age, morbidity profile, Diagnosis, and Mortality profile, Duration of stay and outcome. Categorical variables were tabulated and Statistical analysis was done.Results: A total of 12,027 neonates were recruited, 63.07% were males and 36.92% were females. 54.87% were extramural, while 45.13% were intramural neonates. Prematurity was the most common morbidity 56.98% in the admitted neonates. Major contributors to the neonatal morbidity were Birth asphyxia (24.61%), others (21.60%), Respiratory Distress(14.06%), Sepsis(13.77%). The mortality rate in the present study is 25.45%. Major contributors for neonatal mortality includes Respiratory distress (37.76%), Birth Asphyxia (26.75%), Sepsis(13.91%). Mortality was more in out born babies 33.03% compared to inborn babies 22.03%. Conclusions: Improving antenatal care, more deliveries at institutions with SNCU facility, improved access to health facility, early identification of danger signs, timely referral of high risk cases, capacity building, can reduce neonatal mortality and its complications.
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Kamal, MA, and Mahbubul Hoque. "Predictors of Mortality in Newborn Admitted in Special Care Baby Unit (SCABU) of Dhaka Shishu Hospital." Dhaka Shishu (Children) Hospital Journal 35, no. 2 (October 12, 2020): 123–29. http://dx.doi.org/10.3329/dshj.v35i2.49693.
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Background: The current neonatal mortality rate of Bangladesh is very high compared to developed countries.
Objective: The objective of the study was to find out the predictors that are associated with mortality in newborn admitted in Special Care Baby Unit (SCABU) of Dhaka Shishu (Children) Hospital.
Methods: This prospective study was conducted in the SCABU of Dhaka Shishu (Children) Hospital from 1st June 2016 to 30 November 2016. A semi-structured questionnaire was prepared before the study. Data were collected from the attendents of each neonate by asking questions who died at the neonatal period after hospital admission. Detail history regarding gestational age, birth weight, place of birth, person conducting delivery, mood of delivery, problem at birth, residence, reasons of referral, vehicle during transport, condition of baby at arrival, time taken during transport and need for any resuscitation was recorded. Data were analyzed by using SPSS version 16.
Result: Total 970 neonates were admitted during data collection period out of them 98(10.10%) died. Majority (58.16%) of the death occurred in neonate who was admitted before 72 hours of age having gestational age <37 weeks (65.31%). Majority of the neonates were from urban area (56.12%) but from poor socioeconomic status (54.08%) and only 32.65% were on regular antenatal care. Majority were delivered by normal delivery at home and attended by TBA. Among the neonates 30.61% reached hospital only by ambulance and 64.29% were found hypothermic during admission. Majority 70(71.43%) were died within 24 hours of hospital admission. Neonatal sepsis, perinatal asphyxia and prematurity contributed majority of neonatal death.
Conclusion: Early (age <72 hours) and premature neonates, neonates from poor socioeconomic background, lack of antenatal care, home delivery, lack of facility in local areas, inadequate transport and unstable initial condition contributed majority of neonatal death. Neonatal sepsis, perinatal asphyxia and prematurity contributed most of neonatal death.
DS (Child) H J 2019; 35(2) : 123-129
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Rashid, Rehana, and Mudasir Nazir. "Evaluation of neonatal admission to neonatal intensive care unit in a tertiary care hospital in Kashmir." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 2 (January 28, 2022): 527. http://dx.doi.org/10.18203/2320-1770.ijrcog20220183.
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Background: Neonatal period is the most unguarded period which influences the survival and overall wellbeing of a child. Many illnesses affecting the neonates lead to morbidities and mortality among them. According to 2015 Global health observatory (GHO) data, neonatal deaths constitute roughly 45% of all under five deaths. Worldwide, neonatal mortality rate has seen a steady decline by 47% between 1990 and 2015 from 36 to 19 per 1000 live birth. India contributes to nearly 25% of the mortality around the world.Methods: This descriptive retrospective study was carried out at LallaDed hospital, only tertiary care obstetrics and gynaecology hospital of Kashmir valley from August 2020 to January 2021. The study was conducted with records of the neonates who were admitted to NICU of this hospital during the above mentioned time period. The data regarding gestational age, sex, mode of delivery, birth weight, Apgar score at birth, indication for admission and outcome was recorded.Results: The total number of NICU admission during this time period was 252. The mode of delivery was FTVD in 144 (57.1%) and LSCS in 108 (42.9%). The number of preterm babies was 175 (69.4%) and number of term babies was 77 (30.6%). Among the admitted neonates, 141 (56%) were male and 111 (44%) were female babies. The birth Apgar score 0 minutes was 8 in 24, 7 in 75, 6 in 130 and 4 in 23 babies.Conclusions: This study identified RDS and MAS among the most common reasons for NICU admission. Early neonatal period is the major contributor to neonatal mortality which is influenced by birth weight and Apgar score. Understanding causes of neonatal mortality, education and training of medical and para medical staff and implementation of interventions regarding neonatal resuscitation will play major role in decreasing the neonatal NICU admission and mortality thereof.
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&NA;, &NA;. "NEONATAL CARE." Critical Care Nursing Quarterly 10, no. 1 (June 1987): 85. http://dx.doi.org/10.1097/00002727-198706000-00012.
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Shah, Mubashir Hassan, and Reashma Roshan. "Mortality and morbidity of neonatal shock in premature babies in a tertiary care neonatal intensive care unit." International Journal of Contemporary Pediatrics 8, no. 6 (May 25, 2021): 1058. http://dx.doi.org/10.18203/2349-3291.ijcp20212048.
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Background: Despite advances in understanding of pathophysiological changes in neonatal shock, its effect on morbidity and mortality is still an ongoing process. The primary objective was to study etiology-specific mortality and the secondary objective was to study the short-term morbidities of neonatal shock in premature babies born less than 34 weeks of gestation.Methods: This single centre prospective cohort study was conducted from 01 January 2017 to 31 March 2018. Neonatal shock was defined on clinical and laboratory criteria. Outcomes in terms of mortality and short-term morbidities like intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), acute kidney injury (AKI), chronic lung disease (CLD) and retinopathy of prematurity (ROP) were recorded for analysis.Results: A total of 119 preterm neonates with shock were enrolled. The most common etiology of neonatal shock was late-onset-sepsis (LOS: 34.4%; n=41) followed by transient circulatory compromise (22.6%; n=27) and early-onset-sepsis (EOS: 14.2%, n=17). The overall mortality of neonatal shock was 15.9% (n=19) out of which 36.8% (n=7) had EOS, 26.3% (n=5) had myocardial dysfunction and 21% (n=4) had LOS (p<0.05). On logistic regression, none of the independent variables were significant for mortality. Neonatal morbidities of IVH (> Grade 2), NEC, CLD, AKI and ROP developed in 4.2% (n=5), 11.7% (n=14), 15% (n=18), 27.7% (n=33) and 33. 6% (n=40) respectively.Conclusions: LOS was the commonest etiology of neonatal shock in preterm neonates. Neonatal shock due to EOS was the major cause of mortality in preterm neonates thus highlighting the need for preventing EOS to improve survival and to reduce neonatal morbidities.
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Tahir, Asmaa G., Manal B. Baythoon, and Yasir I. AL Saddi. "The Timing of Elective Caesarean Deliveries and Early Neonatal Respiratory Morbidity in Term Neonates." Journal of the Faculty of Medicine Baghdad 60, no. 1 (April 1, 2018): 38–42. http://dx.doi.org/10.32007/jfacmedbagdad.60138.
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Background: Respiratory distress is one of interesting presentation of elective caesarean delivery, the presence of labor before elective caesarean delivery decrease the risk of Respiratory distress. adverse respiratory problem in neonate delivered before 39 weeks of gestation are increased.Objective: To evaluate the association between gestational age at delivery and neonatal respiratory outcomes after elective caesarean delivery between 37 and 41completed weeks.Patients and Methods: Descriptive study with prospectively collected data from Baghdad teaching hospital/Medical city at neonatal care unit. All infants of gestational age from 37 to 41 completed weeks, with uncomplicated pregnancy, of which 1407 were born by elective caesarean delivery compared to 1304, delivered by spontaneous vaginal delivery between 1st of September 2015 and 31st of January 2016. The neonates delivered by elective caesarean delivery were stratified into five groups according to the gestational age.Result: There were 1407 neonates delivered by elective caesarean delivery compared with 1304 by spontaneous vaginal delivary of overall 118 neonates were admitted to the Neonatal care unit with Respiratory distress and receiving oxygen therapy or assisted ventilation. Early neonatal Respiratory distress risk was significantly higher in neonate delivered by elective caesarean delivery the rate of Respiratory distress increased with earlier gestational age for both group. The hospitalization days, also decreased with increased gestational age.Conclusion: Term neonates delivered by elective caesarean section are at increased risk for developing Respiratory distress compared vaginal delivery. The neonatal Respiratory distress decreased if elective caesarean delivery performed after 39 gestational weeksKeywords: RD (Respiratory distress), ECS (elective caesarean delivery), TTN (transient tachypnea of the newborn), GA (gestational age), O2 (oxygen therapy), SVD (spontaneous vaginal delivary), NCU (Neonatal care unit).
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Abera, Tesfaye, Lami Bayisa, Teshome Bekele, Mulugeta Dessalegn, Diriba Mulisa, and Lalisa Chewaka Gamtessa. "Neonatal Mortality and Its Associated Factors among Neonates Admitted to Wollega University Referral Hospital Neonatal Intensive Care Unit, East Wollega, Ethiopia." Global Pediatric Health 8 (January 2021): 2333794X2110301. http://dx.doi.org/10.1177/2333794x211030157.
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Ethiopia has a high neonatal mortality rate in spite of dearth of study. Therefore we aimed to assess magnitude and associated factors of neonatal mortality among neonates admitted to neonatal intensive care units of Wollega University Referral Hospital. Accordingly, a facility based cross-sectional study was conducted on 289 by reviewing medical records of neonates admitted to neonatal intensive care unit. The collected data were entered in to Epi data version 3.1 and Stata version 14 used for analysis. Variables with P-value < 0.25 at with 95% confidence interval in binary logistic regression analysis were taken to the multiple logistic regression analysis. Finally, variables with Likewise, variable with P-value < 0.05 at 95% confidence interval in multiple logistic regression analysis were considered as statistically significant. Among 289 neonates admitted to neonatal intensive care unit, 53 (18.34 %) were died. Majority 42(79.25%) of those deaths occurred at ≤ 7 days of birth. Preterm [AOR 4.15, 95% CI (1.67-10.33)], neonates faced birth asphyxia [AOR 3.26, 95% CI (1.33-7.98)], neonates who developed sepsis [AOR 2.29 95% CI (1.01-5.20)] and neonates encountered with jaundice [(AOR 11.08, 95% CI (1.03-119.59)] were more at risk to die. In general, the magnitude of neonatal mortality among neonates admitted to neonatal intensive care unit was high. Gestational age (maturity of new born), birth asphyxia, neonatal sepsis and neonatal jaundice were predictors of neonatal mortality. Neonates admitted to neonatal intensive care unit with sepsis, jaundice, and birth asphyxia demand special attention to reduce neonatal mortality.
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Tola, Melese Adugna, Agumasie Semahegn, Getahun Tiruye, and Abera Kenay Tura. "Magnitude of neonatal near miss in public hospitals in Eastern Ethiopia: A cross-sectional study." SAGE Open Medicine 10 (January 2022): 205031212211089. http://dx.doi.org/10.1177/20503121221108926.
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Objectives: Although neonatal near miss is an emerging concept and a tool for improving neonatal care, its magnitude and associated factors are less researched in Ethiopia. Thus, this study was aimed to uncover the magnitude of neonatal near miss and its associated factors in public hospitals in Eastern Ethiopia. Methods: A facility-based cross-sectional study was employed on a randomly selected 405 mother–neonate pairs. An interview using a structured questionnaire accompanied by review of medical records was used to collect data from the mothers and records of the neonates. Neonatal near miss was defined as having any of the pragmatic (gestational age < 33 weeks, birth weight < 1750 g, and fifth minutes Apgar score < 7) or management criteria. Crude and adjusted logistic regression analysis was done to identify associated factors and presented with adjusted odds ratio with 95% confidence interval. Results: Of 401 mother–neonate pairs included in the study, 126 (31.4%, 95% confidence interval = [26.9, 36.2]) neonates had at least one neonatal near miss event at discharge. Neonatal near miss was more likely among neonates from referred women (adjusted odds ratio = 2.24, 95% confidence interval = [1.25, 4.03]), no antenatal care (adjusted odds ratio = 2.08, 95% confidence interval = [1.10, 3.93]), antepartum hemorrhage (adjusted odds ratio = 4.29, 95% confidence interval = [2.16, 8.53]), premature rupture of membrane (adjusted odds ratio = 4.07, 95% confidence interval = [2.05, 8.07]), obstructed labor (adjusted odds ratio = 2.61, 95% confidence interval = [1.23, 5.52]), non-vertex presentation (adjusted odds ratio = 3.03, 95% confidence interval = [1.54, 5.95]), and primiparous (adjusted odd ratio = 2.67, 95% confidence interval = [1.49, 4.77]). Conclusions: In this study, we found that neonatal near miss is higher than previous findings in Ethiopia. Improving neonatal near miss requires promoting antenatal care, maternal referral system, and early identification and management of obstetric complications.
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Madhavi, Deepak, Shamama Subuhi, and Mohammed Zubai. "Outcome of neonatal thrombocytopenia in tertiary care NICU." Journal of Pediatrics & Neonatal Care 10, no. 3 (June 29, 2020): 92–96. http://dx.doi.org/10.15406/jpnc.2020.10.00418.
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Thrombocytopenia is one of the commonest haematological disorders in the neonatal period, affecting up to a third of those admitted to neonatal intensive care units. It is well recognized that many fetomaternal and neonatal conditions are associated with thrombocytopenia. The majority of episodes of neonatal thrombocytopenia are relatively mild, self-limiting and of short duration but it may cause severe morbidity & mortality due to severe complication like IVH. Methods & material: 140 Newborn admitted in tertiary care NICU were selected to find out outcome and etiology of neonatal thrombocytopenia. Detail maternal history and neonatal physical examination done and Neonates were followed for outcome, relevant investigation done according to cases. Result: Out of 140 neonates 63 neonates had thrombocytopenia (45%).42.8% neonates were premature out of which 63.3% had thrombocytopenia. Other neonatal risk factor for thrombocytopenia are sepsis 38 (74.5%), SGA/IUGR 28(80%) and NEC 9(100%). Maternal risk factor for thrombocytopenia are eclampsia81.8% and infection during pregnancy 72.72%. 95.5 % of all study population were discharged.4.5 % cases of whole study population didn’t survive. 4.54% of mild, 9.09% of moderate and 60 % of severe thrombocytopenic babies didn’t survive. Conclusion: Bleeding manifestations i.e. mucosal, cutaneous and intracranial bleed were significantly associated with severe thrombocytopenia. 60% of mortality was found in severe thrombocytopenic group. Thus, severe thrombocytopenia was found to be a predictor of poor outcome in sick neonates of NICU.
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VERLOOVE-VANHORICK, S. PAULINE, R. A. VERWEY &, and R. BRAND. "Neonatal care and neonatal survival." Paediatric and Perinatal Epidemiology 2, no. 1 (January 1988): 105–6. http://dx.doi.org/10.1111/j.1365-3016.1988.tb00187.x.
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Jaraiseh Abcarius, Margaret, Berly Alejandra Zambrano Bravo, Manuel Eugenio Morocho-Cayamcela, and Ana Belén Tulcanaza-Prieto. "FACTORES DE RIESGO ASOCIADOS A LA MORTALIDAD Y PESO AL NACER DE PACIENTES NEONATOS, CASO DE ESTUDIO: HOSPITAL PEDIÁTRICO BACA ORTIZ." Enfermería Investiga 7, no. 1 (January 3, 2022): 17. http://dx.doi.org/10.31243/ei.uta.v7i1.1473.2022.
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Introducción: El peso al nacer es uno de los principales indicadores pronóstico de mortalidad neonatal, en el que influyen factores asociados con la madre, el neonato, y también con las características socioeconómicas del núcleo familiar. Los factores de riesgo implican comorbilidades al momento del nacimiento, por lo que, la intervención adecuada y el oportuno acceso a los servicios de salud constituyen elementos primordiales para la reducción de la mortalidad neonatal. Objetivo: establecer los factores de riesgo asociados a la mortalidad y peso al nacer de pacientes neonatos, de la Unidad de Cuidados Intensivos Neonatales del Hospital Pediátrico Baca Ortiz. Métodos: Se realizó una investigación de diseño observacional, transversal de tipo descriptivo que con una muestra de 204 recién nacidos ingresados en la Unidad de Cuidados Intensivos Neonatales del Hospital Pediátrico Baca Ortiz en la ciudad de Quito, Ecuador, durante el año 2019. Resultados: El peso al nacimiento tiene una asociación lineal negativa significativa con la mortalidad neonatal, siendo los neonatos de género masculino los más susceptibles a fallecer. También, existe mayor frecuencia de mortalidad neonatal en las madres que residen en el área urbana de la sierra ecuatoriana. Conclusiones: El peso al nacer es una variable de gran influencia en la salud y supervivencia infantil, debido a que los datos epidemiológicos muestran que un niño que nace con un peso por debajo de los límites normales tiene un mayor riesgo de fallecer, en comparación con los niños nacidos con un peso dentro del rango considerado normal. Palabras clave: Mortalidad infantil, factores de riesgo, recién nacido de bajo peso, enfermería neonatal, mortalidad neonatal. Abstract Introduction: Birth weight is one of the main prognostic indicators of neonatal mortality, which is influenced by factors associated with the mother, the neonate, and the socioeconomic characteristics of the family. Moreover, the risk factors imply comorbidities at birth. Therefore, adequate intervention and timely access to health services constitute essential elements to reduce neonatal mortality. Objective: establish the risk factors associated with mortality and birth weight of neonatal patients, from the Neonatal Intensive Care Unit of the Baca Ortiz Pediatric Hospital. Methods: An observational, cross-sectional, descriptive research was carried out with a sample of 204 newborns admitted to the Neonatal Intensive Care Unit of the Baca Ortiz Pediatric Hospital in the city of Quito, Ecuador, during the year 2019. Results: The birth weight shows a significant negative linear association with neonatal mortality, where the male infants are the most susceptible to death. Furthermore, there is a higher frequency of neonatal mortality in mothers who live in the urban area of the Ecuadorian highlands. Conclusions: The birth weight is a highly influential variable for child health and survival since epidemiological data show that a newborn with a weight below the range considered normal, has a higher risk of death as compared to children with a normal weight. Keywords: Infant mortality, risk factors, low birth weight, neonatal nursing, neonatal mortality.
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Das, Amit Kumar, Deepak Mishra, Nitu Kumari Jha, Rakesh Mishra, and Soniya Jha. "Role of Lumbar Puncture in Late Onset Neonatal Sepsis." Journal of Nepal Paediatric Society 39, no. 3 (December 31, 2019): 155–61. http://dx.doi.org/10.3126/jnps.v39i3.28459.
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Introduction: Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. It is responsible for about 30-50% of the total neonatal deaths in developing countries. Neonatal sepsis can be divided into two sub-types depending upon whether the onset of symptoms within the first 72 hours of life (Early Onset Neonatal Sepsis) or after 72 hours of life (Late Onset Neonatal Sepsis ). Meningitis is an important complication of late onset neonatal sepsis.
Method: This was hospital based prospective observational study conducted among the neonates admitted with diagnosis of late onset neonatal sepsis in Neonatal Intermediate Care Unit (NIMCU) and Neonatal Intensive Care Unit (NICU) of Kanti Children’s Hospital from July 2016 to June 2017. The objective of this study was to evaluate the importance of performing LP in neonates with LONS.
Results: 16.8% neonates with late onset neonatal sepsis were found to have meningitis. Among the neonates with meningitis CRP was positive 57.2% and negative in 42.8 %. Among the cases with abnormal CSF findings, blood culture was sterile in 85% cases and organism was isolated 15% cases. In 88.8% cases with positive blood culture, no meningitis was detected. Lumbar puncture was traumatic in 1 neonate (0.8%) in first attempt. Apart from this no other complication of performing lumbar puncture was noted.
Conclusion: Lumbar puncture and CSF examination is mandatory in all cases with late-onset sepsis.
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Kumari, Manjari, Suparna Chatterjee, Tapas Som, and Pinaki Chattopadhyay. "Antimicrobial usage and its quantification for neonatal sepsis at a tertiary care hospital neonatal intensive care unit." International Journal of Basic & Clinical Pharmacology 8, no. 9 (August 28, 2019): 2046. http://dx.doi.org/10.18203/2319-2003.ijbcp20194114.
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Background: Antimicrobial therapy for neonatal sepsis is challenging as its judicious use can save neonates while its inappropriate use can lead to rapid emergence of resistant strains. Quantification of consumption of antimicrobial agents (AMA) has not been undertaken in Indian neonatal intensive care units (NICU) setting. This prospective observational study evaluated the antimicrobial prescribing pattern and quantified its consumption in clinically suspected neonatal sepsis (NS) cases.Methods: Clinically suspected NS cases admitted over study period of 18 months in a tertiary care level III NICU were enrolled. Data of antimicrobials prescribed, its consumption, culture sensitivity profile of organisms isolated were collected.Consumption was quantified by computing the days of therapy (DOT) per 1000 patient-days (PD).Results: 150 clinically suspected NS cases were enrolled; 37.33% were culture positive. The most common AMA prescribed were netilmicin (94.67%), piperacillin-tazobactam (88.67%). Only 0.67% cases received reserve antimicrobials like colistin, vancomycin and linezolid. 58% received 2 AMA, 39.33% received ≥3 agents. Total antimicrobial consumption was 614.86 DOT/1000 PD and 21.68 DOT/ neonate. Statistically significant difference in total AMA consumption amongst culture positive versus negative cases (p <0.001) was observed but difference was not significant in EOS versus LOS (p=0.95).Conclusion: Usage of antimicrobials for neonatal sepsis was guided by sensitivity pattern of local prevalent flora and clinical response. Usage of reserve antimicrobials were restricted. However, consumption of AB was higher compared to developed countries and we intend to use the study outcome data for antibiotic stewardship program to reduce antibiotic consumption and modify prescribing trends at the study setting.
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Falsaperla, Raffaele, Laura Mauceri, Milena Motta, Ettore Piro, Gabriella D’Angelo, Eloisa Gitto, Giovanni Corsello, and Martino Ruggieri. "From Neonatal Intensive Care to Neurocritical Care: Is It Still a Mirage? The Sicilian Multicenter Project." Critical Care Research and Practice 2021 (August 13, 2021): 1–9. http://dx.doi.org/10.1155/2021/1782406.
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Background. Neonatal brain injury (NBI) can lead to a significant neurological disability or even death. After decades of intense efforts to improve neonatal intensive care and survival of critically ill newborns, the focus today is an improved long-term neurological outcome through brain-focused care. The goal of neuroprotection in the neonatal intensive care unit (NICU) is the prevention of new or worsening NBI in premature and term newborns. As a result, the neonatal neurocritical care unit (NNCU) has been emerging as a model of care to decrease NBI and improve the long-term neurodevelopment in critically ill neonates. Purpose. Neurocritical care (NCC) Sicilian project includes three academic sites with NICU in Sicily (Catania, Messina, and Palermo), and its primary goal is to develop neurocritical neonatal care unit (NNCU). Methods. In 2018, the three NICUs created a dedicated space for neonates with primary neurological diagnosis or at risk for neurological injuries—NNCU. Admission criteria for eligible patients and treatment protocols were created. Contact with parents, environmental protection, basic monitoring, brain monitoring, pharmacological therapy, and organization of the staff were protocolized. Results. Evaluation of the efforts to establish NNCU within existing NICU, current protocols, and encountered problems are shown. Implications for Practice. Our outcome confirmed the need for dedicated NNCU for neuroprotection of critically ill neonates at risk for a neurological injury. Although the literature on neonatal neurocritical care is still scarce, we see the value of such targeted approach to newborn brain protection and therefore we will continue developing our NNCU, even though there have been problems encountered. The project of building NNCU will continue to be closely monitored. Conclusions. The development of our neonatal neurocritical model of care is far from being completed. Although it is currently limited to the Sicilian area only, the goal of this paper is to share the development of this multicenter interdisciplinary project focused on a newborn brain protection. After evaluating our outcome, we strongly believe that a combined expertise in neonatal neurology and neonatal critical care can lead to an improved neurodevelopmental outcome for critically ill neonates, from the extremely preterm to those with brain injuries.
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Andrade, Priscila Araujo, Maria Aparecida Beserra, Maria Suely Medeiros Corrêa, and Ysmário Francisco Valeriano de Andrade. "Profile of the mortality of infants affected by infections in neonatal intensive care unit." Revista de Enfermagem UFPE on line 4, no. 4 (October 9, 2010): 1785. http://dx.doi.org/10.5205/reuol.1125-9558-1-le.0404201028.
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ABSTRACTObjective: to characterize the mortality of newborns suffering from neonatal infections in the intensive care unit of a maternity clinic in Recife. Method: retrospective, descriptive, transverse study, from January 2006 to December 2007, involving medical records of infants who died of neonatal infection. Results: neonatal mortality due to infection occurred in 47.73% of neonatal deaths, of which 91.42% were of infants weighing less than 2,500g; 88.57% aged less than 37 weeks, 51.43 % female. The early infections were 92.38%. Mothers aged 20 or older accounted for 71.43% and 55.24% were illiterate. Urinary tract infection represented 63.41%. With respect to prenatal, 83.81% of the mothers had less than six visits. Conclusions: this study noticed that with the reduction of risk factors for neonatal infection, you can minimize the number of neonatal deaths, which currently remains high. Therefore, it is important to concentrate efforts for prioritizing this public health problem. Descriptors: neonatal mortality; infection neonatal; intensive care unit; health profile .RESUMOObjetivo: caracterizar o perfil da mortalidade de recém-nascidos acometidos por infecções neonatais na unidade de tratamento intensivo de uma maternidade de Recife. Método: trata-se de um estudo retrospectivo, descritivo, transversal, no período de janeiro de 2006 a dezembro de 2007, utilizando prontuários de recém-nascidos que foram a óbito por infecção neonatal. Resultados: mortalidade neonatal por infecção ocorreu em 47,73% dos óbitos neonatais, dos quais 91,42% foram de recém-nascidos com peso inferior a 2.500g, 88,57% com idade gestacional inferior a 37 semanas, 51,43% do sexo feminino. As infecções precoces representaram 92,38%. As mães com 20 anos ou mais representaram 71,43% e 55,24% eram analfabetas. A infecção do trato urinário representou 63,41%. Quanto ao pré-natal, 83,81% das mães realizaram menos de seis consultas. Conclusões: este estudo mostrou que com a diminuição dos fatores de risco para a mortalidade neonatal por infecção, pode-se minimizar o número de óbitos neonatais, que atualmente permanece alto. Portanto, é importante que sejam concentrados esforços para que se priorize esse problema de saúde pública. Descritores: mortalidade neonatal; infecção neonatal; unidade de terapia intensiva; perfil epidemiológico. RESUMENObjetivos: caracterizar la mortalidad de los recién nacidos que sufren de infecciones neonatales en la unidad de cuidados intensivos de una maternidad em Recife. Método: estudio retrospectivo, descriptivo, transversal, desde enero 2006 hasta diciembre 2007, utilizando registros médicos de los niños que murieron de infección neonatal. Resultados: la mortalidad neonatal debido a la infección se produjo en 47,73% de las muertes neonatales, de los cuales 91,42% eran niños que pesaban menos de 2.500g, 88,57% con menos de 37 semanas, 51,43 % de mujeres. Las infecciones tempranas fueron 92,38%. Las madres de 20 años o más representaban 71,43% y 55,24% eran analfabetas. Infección del tracto urinario representaban 63,41%. Cuanto al pre-natal, 83,81% de lãs madres tenían menos de seis visitas. Conclusiones: este estudio observió que con la reducción de factores de riesgo de infección neonatal, puede reducir al mínimo el número de muertes de recién nacidos, que actualmente sigue siendo alta. Por lo tanto, es importante concentrar los esfuerzos para dar prioridad a este problema de salud pública a fin de tratar de resolver a través de un cuidado de alta calidad durante la atención prenatal, perinatal y neonatal. Descriptores: mortalidad neonatal; infección neonatal; unidade de terapia intensiva; perfil epidemiológico.
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Yadav, Sunil Kumar, and Arun Giri. "Bacteriological Profile of Neonatal Sepsis in a Neonatal Intensive Care Unit of a Tertiary Care Hospital of Eastern Nepal." Journal of College of Medical Sciences-Nepal 15, no. 2 (June 30, 2019): 93–97. http://dx.doi.org/10.3126/jcmsn.v15i2.20747.
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Background: Neonatal sepsis is a common and serious problem of neonates who are admitted for intensive care. It is a leading cause of neonatal morbidity and mortality worldwide. The objective of the study was to detect the common causative microorganisms of neonatal sepsis and their antibiotic susceptibility patterns in NICU of Nobel Medical College Teaching Hospital (NMCTH).
Methods: This was a cross-sectional study conducted in a 17- bedded teaching and referral NICU of NMCTH from March to August, 2018. All neonates of clinical sepsis were enrolled in the study, blood cultures taken and were followed up till final outcome, which was discharge or death, irrespective of culture report. Descriptive statistics including percentages and frequencies was used.complications.
Results: Among the 55 neonates with diagnosis of clinical sepsis, 13(23.6%) had shown bacteria in the culture. The predominant organisms were Staphylococcus aureus and Klebsiella pneumoniae and most of them were resistant to Ampicillin and Amikacin.
Conclusions: The culture positivity rate among the neonates with clinical sepsis in the study was 23.6%. Pathogens isolated were resistant to the first line drugs for management of neonatal sepsis. Hence, the need for a review of first line drug for empirical treatment of neonatal sepsis.
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Wood, Tara, Margret Johnson, Taryn Temples, and Curry Bordelon. "Thermoneutral Environment for Neonates: Back to the Basics." Neonatal Network 41, no. 5 (August 1, 2022): 289–96. http://dx.doi.org/10.1891/nn-2022-0003.
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Thermoregulation is an essential component to the stability and long-term outcomes of newborns and critically-ill neonates. A thermoneutral environment (TNE) is an environment in which a neonate maintains a normal body temperature while minimizing energy expenditure and oxygen consumption. Neonates who experience thermal stability within a TNE demonstrate enhanced growth, decreased respiratory support, decreased oxygen requirements, increased glucose stability, reduced mortality, and reduced morbidities associated with hyperthermia and hypothermia. Heat exchange occurs between the neonate and surrounding environment through four mechanisms: evaporation, conduction, convection, and radiation. By recognizing the methods by which heat is lost or gained, the neonatal provider can prevent adverse conditions related to abnormal thermal control and support a thermoneutral neonatal environment.
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Ibrahim, Riyadh Mraweh, and Bushra Jabbar Hashem. "The outcome of newborn admitted in neonatal care unit, center teaching hospital of pediatric , Baghdad Al-krakh, 2015." AL-Kindy College Medical Journal 15, no. 1 (September 12, 2019): 43–51. http://dx.doi.org/10.47723/kcmj.v15i1.77.
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Background: Neonatal period is a very vulnerable period of life due to many problems, In spite of advances in perinatal and neonatal care still, the mortality rate of neonate high especially in developing country The World Health Organization estimates that globally four million neonatal deaths per year, Developing countries account for around 99% of the neonatal mortality in the world, In Iraq. Neonatal mortality rate about 19 per 1000 live births which represent 56% of child death below 5 years age in 2012. The hospital in the study represents the larger pediatric hospital in Iraq. It contains 400 children's beds and 24 neonatal incubators.
Aims of the study: are to determine the institutional new-born case fatality rate and the cause of death in the neonatal care unit.
Method; The study is cross-section study of the population sample of neonatal care unit of central teaching hospital of pediatric in Baghdad Al-krakh health directorate
Result: Study appear total neonate admission during 2015 was 1977 neonates mortality rate 9% Four main causes of death were Respiratory related condition, Bacterial sepsis, Disorder related to short gestational and low birth weight not relayed to elsewhere classification and congenital malformation 37.5%, 33.3%, 7.1% and 7.1% respectively while the main primary cause of morbidity were Neonatal jaundice, Respiratory related condition, Bacterial sepsis and 37.5%, 35.2%. 14.1% respectively Conclusions: The majority of morbidity and mortality can prevent by appropriate intervention
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Acharya, Niraj, and Chandra Prasad Paneru. "Prevalence and Etiology of Neonatal Jaundice in a Tertiary Care Hospital." Journal of Nepalgunj Medical College 18, no. 2 (August 9, 2021): 35–38. http://dx.doi.org/10.3126/jngmc.v18i2.38891.
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Introduction: Neonatal jaundice is a major clinical condition worldwide occurring in upto 60% of term and 80% preterm newborn in the first week of life. Neonatal jaundice is defined as total serum bilirubin level above 7 mg/dl.
Aims: This study was done to find out the prevalence and etiology of neonatal jaundice in neonates admitted to Neonatal Intensive Care Unit (NICU) of Nepalgunj Medical College Teaching Hospital (NGMCTH) Kohalpur, Banke.
Methods: It was a prospective cross sectional hospital based study conducted from November 2018 to November 2019 in Neonatal Intensive Care Unit of Nepalgunj Medical College Teaching Hospital. All neonates with clinical jaundice and hyperbilirubinemia with total serum bilirubin of ≥7 mg/dl were subjected to complete history taking, through physical examination and investigations.
Results: Out of 892 neonates who developed clinical jaundice, 640 neonates whose parents gave consent were included in the study. The prevalence of neonatal jaundice was found to be 39.85% with male to female ratio of 1.79:1. In the present study pathological jaundice was seen in 74.94% whereas physiological jaundice in 23.66%. Among the various etiologies of pathological jaundice, neonatal sepsis (44.52%) was found to be the most common cause followed by ABO incompatibility (12.18%) and Rh incompatibility (7.03%).
Conclusion: The prevalence of neonatal jaundice in present study was 39.85% and the most common cause was neonatal sepsis .The prevalence of jaundice was more in preterm than in term neonates. Neonatal jaundice is very common morbidity in NICU especially in preterm babies.
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Fissha Adem, Yonas, Yosef Haile, and Moges Milashu. "Time to death and its predictors among early neonatal patients in neonatal intensive care unit of Dessie referral hospital, South Wollo Zone, Northeast Ethiopia." Journal of Pediatrics & Neonatal Care 12, no. 3 (September 9, 2022): 143–49. http://dx.doi.org/10.15406/jpnc.2022.12.00471.
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Background: Early neonatal death is a serious concern, both in the developing and developed worlds. Early neonatal death remains a health problem and is the biggest component of the neonatal mortality rate. Therefore, substantial reduction in early neonatal mortality is a crucial pre-requisite for achieving further gains in child survival in the country. However, the distribution of deaths in the community within the first week is poorly understood. Therefore, this study was conducted to assess time to death and its predictors among early neonates in the neonatal intensive care unit of Dessie Referral Hospital. Method: A retrospective cohort study was conducted in the early neonatal patient in Dessie referral hospital on the total sample size of 416 selected patients by using a simple random sampling technique. Data were collected by document review. Life table used to estimate the probability of survival, log-rank test to compare survival in two or more groups and the Cox proportional hazard model was used to determine factors associated with time to death of early neonate. The hazard ratio with 95% confidence level was used to declare statistical significant association. Result: A total of 416 early neonates were included in the study. There were 224(53.8%) male neonates. The overall early neonatal mortalities were 47(11.3%), of which 23.41% of them died on the first day of age. early neonatal mortality was associated with neonatal sepsis (AHR=3.349,95% CI,1.842-6.089), low birth weight of neonates (AHR=3.563%,95% CI,1.925-6.595), unable to breastfeeding during delivery (AHR=4.094,95% CI,1.603-10.452), neonatal respiratory distress (AHR=4.018,95% CI,1.733-9.371), perinatal asphyxia (AHR =2.540,95% CI,1.186-5.847). Conclusion: The causes of early neonatal death described in this study were preventable. Managing low birth weight, initiating exclusive breastfeeding, refining quality of service, and confirming the continuity of care are recommended to increase the survival of neonates.
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Kumar, Ashwani, Gursharan Singh Narang, Gurmeet Singh, Navneet Virk, and Ashiana Singh. "Clinico-epidemiological spectrum of early onset neonatal sepsis in neonates admitted in NICU of a tertiary care institute." International Journal of Contemporary Pediatrics 6, no. 3 (April 30, 2019): 1046. http://dx.doi.org/10.18203/2349-3291.ijcp20191071.
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Background: Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. Neonatal sepsis may be classified into two groups : early onset sepsis and late onset sepsis . Early onset neonatal sepsis is generally associated with the acquisition of microorganisms from the mother and usually presents with respiratory distress and pneumonia.Methods: The study included one hundred term neonates with early onset neonatal sepsis. A septic screen including total leukocyte count, absolute neutrophil count, blood smear evaluation, blood cultures and C-reactive protein (CRP) were performed in all neonates with suspected sepsis to corroborate early onset sepsis diagnosis. Epidemiological parameters including gender of the neonate, mode of delivery, rural/urban residence were recorded in addition to clinical profile.Results: Respiratory distress was the most common presentation in the form of tachypnea, seen in 63 (63.0%) neonates. In present study, Staphylococcus aureus was the most common organism isolated followed by Staphylococcus epidermidis, Staphylococcus hominis, Acinetobacter baumannii and Klebsiella pneumonae.Conclusions: Early onset neonatal sepsis was seen more in males. Among the gram-positive Staphylococcus aureus and among gram negative Acinetobacter baumannii and Klebsiella pneumonae were most common organisms to be isolated.
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Yadav, Nikita Singh, Pranav Kumar Yadav, Rajeshwar Reddy Kasarla, and Pramila Parajuli. "Incidence and Risk Factors Associated with Blood Culture Proven Neonatal Sepsis." Journal of Universal College of Medical Sciences 9, no. 01 (June 22, 2021): 28–32. http://dx.doi.org/10.3126/jucms.v9i01.37963.
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INTRODUCTION
Neonatal sepsis (sepsis neonatorum) is a clinical syndrome resulting from the pathophysiologic effects of local or systemic infection. This is a major cause of morbidity and mortality around the world affecting newborns up to one month of age with clinical symptoms and positive blood cultures. This study aimed at examining the risk factors of neonatal sepsis at pediatric tertiary care hospital.
MATERIAL AND METHODS
This was a hospital based cross-sectional case control study conducted among 350 neonates admitted within April to September 2015 at the Kanti Children’s Hospital, Kathmandu Nepal. Cases were neonates who had sepsis and controls were neonates who did not have sepsis with their index mothers. CRP screening tests and blood culture was performed. Data were entered using the SPSS (Version 22). Bivariate and multivariate logistic regression was used to determine the risk of neonatal sepsis.
RESULTS
A total of 59 (17%) neonates who had sepsis (cases) with their index mothers’ and 291 (83%) neonates who had no sepsis (controls) with their index mothers were enrolled. Maternal factors that predicted the occurrence of sepsis among neonates were parity (p<0.027), mode of delivery (p<0.001) and PROM (p<0.001). Neonatal risk factors which predicted the occurrence of sepsis were duration of stay in the facility (p<0.001) and neonatal age on admission (p<0.001).
CONCLUSION
The study found both maternal and neonatal factors to have a strong association with the risk of developing neonatal sepsis. Encouraging maternal antenatal care utilization would help identify the risk factors during prenatal and postnatal care and appropriate interventions implemented to reduce the likelihood of the neonate developing sepsis.
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Shrivastava, Ajit Kumar, Prema Ram Choudhary, and Santosh Kumar Roy. "Bacteriological profile of neonatal and pediatrics sepsis in intensive care unit at a tertiary care hospital in western India." International Journal of Contemporary Pediatrics 8, no. 3 (February 23, 2021): 460. http://dx.doi.org/10.18203/2349-3291.ijcp20210521.
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Background: Neonatal and pediatrics sepsis are one of the main causes of mortality in neonatal and pediatric intensive care units of developing countries. This study was conducted to determine bacteriological profile of neonatal and pediatrics sepsis in the intensive care unit. Methods: A prospective cross-sectional study was conducted in the neonatal and pediatric intensive care unit, for the period of two years. All 400 neonates and pediatrics patients admitted with suspected clinical sepsis were included. Sepsis screens and cultures were sent under aseptic conditions. Isolation of microorganisms and their identification was done according to standard microbiological techniques bacteriological profile was analyzed with descriptive statistics.Results: Incidence of septicemia is 35.34% in neonates, 9.83% in post neonates and 22.95% in older children. Most common associated factor in neonates were preterm 41.46% in neonates, fever of unknown origin 50% and 78.57% in post neonates and children respectively. Out of 232 suspected cases on neonates in 36.07% cases bacterial pathogen were isolated, 62 suspected cases on post neonates in 9.83% cases bacterial were isolated and 106 suspected cases of older children in 22.95% cases bacterial pathogen were isolated. Common bacterial species isolated were Klebsiella sp. 39.02% in neonates, S. aureus 50% and 35.71% in post neonates and older children respectively.Conclusions: There is entail prevention of infection control measures and rational antibiotic strategy to decrease the economic burden of hospital and community.
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Adhikari, Sudhir, Kalipatanam Seshagiri Rao, Ganesh B.K., and Namraj Bahadur. "Morbidities and Outcome of a Neonatal Intensive Care in Western Nepal." Journal of Nepal Health Research Council 15, no. 2 (September 15, 2017): 141–45. http://dx.doi.org/10.3126/jnhrc.v15i2.18203.
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Background: Neonatal mortality rate of developing countries is declining over decades. In the recent years increasing number of preterm and high risk neonates have facilities for tertiary care treatment. The aim of the study was to assess the morbidities and outcome of neonatal intensive care admissions.Methods: It was a retrospective observational study carried out in neonatal intensive care unit of the Manipal Teaching Hospital, Pokhara, Nepal from January 2014 to December 2015. Neonatal details including place of delivery, birth weight, gestation, diagnosis at admission, hospital course and final outcome were recorded in predesigned proforma. Risk of mortality was calculated using odds ratio and 95% confidence interval. Results: There were total 1708 admission during study period and inborn as well as out born neonates were equally admitted. Neonatal hyperbilirubinemia (37.1%), neonatal sepsis 532 (31.2%), prematurity, 314 (18.4%) perinatal asphyxia 112 (6.6%), meconium aspiration syndrome 79 (4.6%) and intrauterine growth restriction 49 (2.8%) were main indications for hospitalization. A total of 1410 (82.6%) the patients were discharged after treatment, 167 (9.7) left against medical advice, 115 (6.7%) died in hospital and 16 (1%) cases were referred. Preterm neonates had twice the risk of mortality than term neonates (OR =2.1664). Birth weight < 2500 grams had three times more risk of neonatal mortality than normal birth weight (OR =3.0783).Conclusions: Neonatal hyperbilirubinemia, prematurity and neonatal sepsis were common morbidities inneonatal intensive care unit.
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Rezai, Tania, Kedar Baral, Samir Koirala, Sudarshan Paudel, and Saraswati Kache. "Assessing neonatal care practices in rural Nepal." Journal of Patan Academy of Health Sciences 2, no. 2 (December 1, 2015): 23–27. http://dx.doi.org/10.3126/jpahs.v2i2.20326.
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Introductions: Child health indicators of under-five and infant mortality has improved in Nepal, but neonatal mortality remains high. The aim of this study is to assess neonatal care practices among mothers in rural Nepal.Methods: A household survey was conducted in the village of Daman in Makwanpur district, Nepal. All households that had an infant less than one year of age, and had been residing in Daman for greater than six months were included in the study.Results: There were 117 mothers with neonate assessed. The average age of mothers was 24 years and 39 (33.3%) were illiterate, 53 (45.3%) were home births and 36 (30.8%) births were registered. Ninety seven (82.9%) neonates cried immediately after birth, 95 (81.1%) used a new or boiled blade for umbilical cord, 20 (16.7%) applied oil to the cord stump and 71 (61%) breastfed within first hour of birth. There was a significant relationship between non-exclusive breastfeeding and sickness.Conclusions: In Daman village community awareness for umbilical cord care and breastfeeding after birth was high. For thermal regulation of the infant, more health education is required.Journal of Patan Academy of Health Sciences, Vol. 2, No. 2, 2015. page: 23-27
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Tiwari, Rajiv Ranjan, Srinivasa Murthy D, Anil S. Bilimale, Sunil Kumar D, Rituparna Kundu, and Padma Sakhi. "Factors Associated with Mortality of Neonates Admitted to a Tertiary Care Neonatal Unit." International Journal of Pediatric Nursing 8, no. 3 (December 27, 2022): 99–105. http://dx.doi.org/10.21088/ijpen.2454.9126.8322.4.
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Background: The neonatal period is the most susceptible phase of life. In the aim of this study was to assess the causes and factors associated with neonatal mortality. Methodology: This study was a Retrospective study of medical records for 2 years (Jan. 2020- Dec. 2021). The age, sex, gestational age, and morbidity and mortality profile of all SNCU admissions in 1 year were determined, and the difference between inborn (those born in Hospital) and out born (neonates delivered outside and referred) was calculated. Results: Of the 1600 neonates admitted, 61.5% neonates were males, 57.4% were Inborn and 42.8% were outborn. Approximately, 33.4% were preterm, and renal cardiovascular (20.4%), Neurological disorder (18.6%), and Respiratory related infection (19.1%) were the chief morbidities. The chief causes of mortality were low birth weight with AOR 1.29 (0.836-2.0120), respiratory support that includes O2 with AOR 5.817 (3.367-10.051), CPAP with AOR 4.902 (2.745-8.754), CMV with AOR 4.251(2.184-8.274) and Level of Care with AOR 4.85 (3.102-11.471). This factor was statistically associated with neonatal mortality. Conclusion: Low birth weight, respiratory support, neonate size, and degree of care were all found to be associated with newborn mortality in this study. As a result, hospitals ought to emphasize enhancing antenatal, intrapartum, and standardized care for newly admitted infants. A prospective study is what we suggest.
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Abdul Bari, Abdul Naseer, Habib G. Pathan, and Prashant R. Kokiwar. "Incidence and outcome of neonatal seizures at a tertiary care hospital." International Journal of Contemporary Pediatrics 4, no. 6 (October 24, 2017): 2165. http://dx.doi.org/10.18203/2349-3291.ijcp20174750.
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Background: Seizures are associated with poor neuro developmental outcome if not diagnosed early and treated properly. During newborn period, seizures indicate underlying neurological disease. Neonatal seizures lead to increased morbidity and mortality usually found in neonatal intensive care unit. The objective of this study was to evaluate incidence and outcome of neonatal seizures.Methods: Present study was hospital based prospective study conducted among 117 neonates of 0-28 days of age at a tertiary care hospital for a period of one year. The data like history, clinical examination and investigation findings was recorded in the pre-designed, pre-tested, semi structured questionnaire.Results: The incidence of neonatal seizures was higher in male neonates. Subtle types of seizures were the commonest type of seizures. In term neonates, the birth asphyxia was the most common cause of neonatal seizures. The incidence of intra-ventricular hemorrhage (IVH) was significantly higher in preterm than term neonates. Out of biochemical abnormalities, the hypocalcemia was the most common cause of the neonatal seizures. Common causes of neonatal deaths in our center were severe birth asphyxia, intra-ventricular hemorrhage (IVH), septicemia and meningitis. Conclusions: Most of the causes of neonatal seizures are preventable by good perinatal care and early interventions while metabolic seizures need a sharp vigilance and early suspicion.
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Khraisat, Omar M., Ahmad M. Al-Bashaireh, Raed Khafajeh, and Ola Alqudah. "Neonatal palliative care: Assessing the nurses educational needs for terminally ill patients." PLOS ONE 18, no. 1 (January 6, 2023): e0280081. http://dx.doi.org/10.1371/journal.pone.0280081.
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Background For terminally sick neonates and their families, it’s crucial to provide holistic nursing care that incorporates both curative and palliative care as much as feasible. It is well known that the biggest obstacle to delivering palliative care for neonatal children is a lack of training for nurses. Aim: The aim of this research is to investigate the experiences of nurses who provide care for neonates who are terminally ill as well as their educational requirements for neonatal palliative care. Method A cross-sectional descriptive study was conducted among 200 nurses working in a tertiary center providing care for terminally ill neonates in Saudi Arabia. Data was collected from using Neonatal Palliative Care Questionnaire (QNPC) from January 2021 to March 2021. Results Two hundred nurses were surveyed (the response rate was 79%). The mean age of the 158 participants was 35.67 (standard deviation (SD): 7.43), and the majority were female (151; 95.6%). The majority were bachelor’s holders (119; 75.3%), with more than 5 years of experience in providing care for neonates (100; 63.3%). Most of the participants reported not receiving any education about palliative care (115; 72.8%). Nurses reported a moderate level of experience in all areas of neonatal palliative care. The total mean score of palliative care experiences of neonates was 3.42 (SD: 1.35). However, the majority of nurses reported little experience discussing the transition period to palliative care for neonates 2.95 (SD: 1.93), the discussion of code status (DNR) during terminal illness of neonates 3.11 (SD: 1.54) and spiritual support 2.90 (SD: 1.55). Conclusion The assessment of the fundamental skills of neonatal palliative care by nurses was insufficient. To enhance the quality of care, it is crucial to incorporate education on neonatal palliative care into programs for nursing staff development.
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Geta, Temesgen, Tsiyon Kassa, and Eskinder Israel. "Magnitude of sepsis and its predictors among neonates admitted to neonatal intensive care unit at Hawassa University comprehensive specialized hospital in Southern Ethiopia 2022." Journal of Pediatrics & Neonatal Care 12, no. 3 (November 14, 2022): 175–80. http://dx.doi.org/10.15406/jpnc.2022.12.00476.
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Background: Neonatal sepsis is a leading cause of neonatal death across the globe, which accounted for 15% and 30% of neonatal mortality in low and middle-income countries and developing countries including Ethiopia, respectively. Despite various efforts have been made by the Ethiopian government to prevent neonatal mortality and morbidity, sepsis-related to neonatal mortality is still high. So the objective of this study was to assess the magnitude and affecting factors of neonatal sepsis among neonates admitted to neonate intensive care units in Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia. Methods and materials: Facility based cross-sectional study was conducted from January to February 2022 at Hawassa university comprehensive specialized hospital, Southern Ethiopia. A total of 216 neonate-mother pairs who were admitted to the intensive care unit was included in the study and a systematic random sampling technique was used to select study participant. A structured questionnaire was used to collect data. The data was entered into EPI Data 3.1 version and transported to SPSS version 25 for data analysis. Multi regression analysis was done for predictor variables associated at p-value <0.05 with the dependent variable. Result: A total of 74 (34.3%) neonates were admitted with neonatal sepsis. A surgical procedure is done before sepsis (AOR=2.9, 95% of CI(1.5 to5.6), last pregnancy wanted (AOR=2.8, 95% of CI(1.0 to 7.3), more frequent per-vaginal examination (AOR=2.6, 95% of CI (1.3 to 5.3), educational level unable to read and write(AOR=5.4, 95% of CI(1.0 to 27.7), low birth weight (AOR=5.4, 95% of CI(3.0 to 9.8), and getting care from unskilled health workers(AOR=2.7, 95% of CI(1.5 to 4.9) were significantly associated with neonatal sepsis at multivariable with less than 0.05 p values. Conclusion: This study indicated that the prevalence of neonatal sepsis was still high. Thus, immediate action should be taken before it leads to neonatal mortality and further complications. The study used only physician diagnosis to confirm neonatal sepsis, which may affect its prevalence and needs further investigation.
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Kilicci, Cetin, Cigdem Yayla Abide, Enis Ozkaya, Evrim Bostancı Ergen, İlter Yenidede, Neriman Basak Baksu, Resul Karakus, and Seda Kucukoglu. "Confounders for Neonatal Intensive Care Unit Admission ın Neonates of Mothers with Preeclampsia." Gynecology Obstetrics & Reproductive Medicine 24, no. 3 (December 25, 2018): 162. http://dx.doi.org/10.21613/gorm.2018.804.
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<p><strong>Objective:</strong> The aim of this study was to investigate the effect of some maternal and neonatal clinical parameters on the neonatal intensive care unit admission rates of neonates born to mothers who had preeclampsia. </p><p><strong>Study Design:</strong> Study included 402 singleton pregnant women with preeclampsia who admitted to Maternal-Fetal Medicine Unit of Zeynep Kamil Children and Women’s Health Training and Research Hospital. Pregnancies with uterine rupture, chorioamnionitis and congenital malformations were excluded. Some maternal and neonatal clinical characteristics were assessed to predict neonatal intensive care unit admission.</p><p><strong>Results:</strong> Among 402 neonates, 140 (35%) of them had an indication for neonatal intensive care unit admission, among 140 neonates, 136 (97%) of them were preterm neonates. Comparison of groups with and without neonatal intensive care unit admission indicated significant differences between groups in terms of gestational age, Apgar scores at 1st and 5th minutes, birth weight, some maternal laboratory parameters (Hemoglobin, hematocrit, alanine aminotransferase, aspartate aminotransferase, albumin). In multivariate analysis, among all study population, gestational age at delivery, birth weight and Apgar scores were found to be significantly associated with neonatal intensive care unit admission. On the other hand, in subgroup of term neonates, none of the variables was shown to be associated with neonatal intensive care unit admission.</p><p><strong>Conclusion:</strong> Gestational age at delivery and the birth weight are the main risk factors for neonatal intensive care unit admission of neonates born to mothers who had preeclampsia.</p>
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Mrisho, Mwifadhi, David Schellenberg, Fatuma Manzi, Marcel Tanner, Hassan Mshinda, Kizito Shirima, Beverly Msambichaka, Salim Abdulla, and Joanna Armstrong Schellenberg. "Neonatal Deaths in Rural Southern Tanzania: Care-Seeking and Causes of Death." ISRN Pediatrics 2012 (January 24, 2012): 1–8. http://dx.doi.org/10.5402/2012/953401.
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Introduction. We report cause of death and care-seeking prior to death in neonates based on interviews with relatives using a Verbal Autopsy questionnaire. Materials and Methods. We identified neonatal deaths between 2004 and 2007 through a large household survey in 2007 in five rural districts of southern Tanzania. Results. Of the 300 reported deaths that were sampled, the Verbal Autopsy (VA) interview suggested that 11 were 28 days or older at death and 65 were stillbirths. Data was missing for 5 of the reported deaths. Of the remaining 219 confirmed neonatal deaths, the most common causes were prematurity (33%), birth asphyxia (22%) and infections (10%). Amongst the deaths, 41% (90/219) were on the first day and a further 20% (43/219) on day 2 and 3. The quantitative results matched the qualitative findings. The majority of births were at home and attended by unskilled assistants. Conclusion. Caregivers of neonates born in health facility were more likely to seek care for problems than caregivers of neonates born at home. Efforts to increase awareness of the importance of early care-seeking for a premature or sick neonate are likely to be important for improving neonatal health.