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A four year study on neonatal morbidity in a New Delhi hospital
M Singh1, A K Deorari, R C Khajuria
1Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
Insights
This study on 7015 neonates reveals significant rates of low birth weight (26.7%), prematurity (13.5%), and birth asphyxia (5.9%). Respiratory distress syndrome, particularly hyaline membrane disease in preterm infants, was a key concern.
Area of Science:
- Neonatal Medicine
- Pediatrics
- Public Health
Background:
- Neonatal morbidity presents a significant challenge in healthcare.
- Understanding the incidence of various neonatal conditions is crucial for effective intervention.
- The study focuses on a large cohort from a tertiary care hospital in India.
Purpose of the Study:
- To investigate the incidence and patterns of neonatal morbidity.
- To identify common conditions such as low birth weight, prematurity, birth asphyxia, respiratory distress syndrome, hyperbilirubinemia, infections, and malformations.
- To explore potential reasons for observed trends, including hyaline membrane disease in preterm infants.
Main Methods:
- Retrospective analysis of 7015 neonates born at All India Institute of Medical Sciences Hospital, New Delhi.
- Data collection on birth weight, gestational age, Apgar scores, and clinical diagnoses.
- Categorization of morbidities including low birth weight, preterm birth, small-for-dates, birth asphyxia, respiratory distress syndrome, neonatal hyperbilirubinemia, infections, and congenital malformations.
Main Results:
- Incidence of low birth weight: 26.7%.
- Preterm neonates: 13.5%; Small-for-dates: 6.6%.
- Birth asphyxia: 5.9%; Respiratory distress syndrome: 5.7% (hyaline membrane disease in 14.1% of preterm infants).
- Neonatal hyperbilirubinemia: 5.9%; Bacterial infections: 1.8% (minor), 3.0% (major).
- Major malformations: 2.3%.
Conclusions:
- Low birth weight and prematurity are significant contributors to neonatal morbidity.
- Hyaline membrane disease is a major concern in preterm infants.
- Further research is needed to understand the low incidence of bacterial infections and the high prevalence of hyaline membrane disease in this population.
Abstract:
The neonatal morbidity was studied in 7015 neonates born at the All India Institute of Medical Sciences Hospital, New Delhi. The incidence of low birth weight babies was 26.7 per cent; one seventh (13.5%) of the series were preterm (less than 37 wk), while 6.6 per cent were 'small-for-dates'. Birth asphyxia of varying severity developed in 5.9 per cent infants. Respiratory distress syndrome was diagnosed in 5.7 per 100 live-births; most being due to hyaline membrane disease (33.5%), which affected 14.1 per cent of preterm babies. Neonatal hyperbilirubinemia occurred in 5.9 per cent, most of whom were premature. In nearly one-fifth, the cause of jaundice could not be identified after detailed investigations. Minor bacterial infections (conjunctivitis, pyoderma, oral thrush, umbilical sepsis) were observed in 1.8 per cent while major infections (septicemia, meningitis, diarrhoea) in 3.0 per cent. The overall incidence of major malformations was 2.3 per cent. Reasons for low incidence of bacterial infections and common occurrence of hyaline membrane disease in premature infants, are highlighted.