Singh Jasbir, Dalal Poonam, Gathwala Geeta
Senior Resident, Department of Pediatrics, PGIMS, Rohtak, Haryana, India.
Professor, Department of Pediatrics, PGIMS, Rohtak, Haryana, India.
Trop Doct. 2020 Jul;50(3):221-227. doi: 10.1177/0049475520921675. Epub 2020 May 7.
The National Family Health Survey (NFHS-4) shows encouraging improvement in infant and under-five mortality rates in India. However, the neonatal mortality rate (NMR) still remains high as India contributes to about one-fifth of global deaths. This prospective study was conducted from 15 January to 30 April 2016 to examine the clinical profile and predictors of mortality among referred neonates at our centre. Among 301 neonates, prematurity (40%) was the most common indication for referral followed by need for ventilation (38%) and birth asphyxia (28%). Approximately 73% neonates were referred within 24 h of birth. Ninety (29.9%) neonates died; of these, 63% died within 24 h of presentation. Prematurity, birth asphyxia, hypothermia, shock at presentation and extreme low birth weight were the most significant predictors of mortality. Adequate training of peripheral health personnel, dedicated teams for neonatal referral and strengthening of peripheral sick newborn care units (SNCUs) seem to be promising interventions for favourable outcome.
全国家庭健康调查（NFHS - 4）显示，印度的婴儿和五岁以下儿童死亡率有了令人鼓舞的改善。然而，新生儿死亡率（NMR）仍然居高不下，因为印度的新生儿死亡数约占全球的五分之一。这项前瞻性研究于2016年1月15日至4月30日进行，旨在研究我院转诊新生儿的临床特征及死亡预测因素。在301名新生儿中，转诊的最常见原因是早产（40%），其次是需要通气（38%）和出生窒息（28%）。约73%的新生儿在出生后24小时内被转诊。90名（29.9%）新生儿死亡；其中，63%在转诊后24小时内死亡。早产、出生窒息、体温过低、就诊时休克和极低出生体重是死亡的最显著预测因素。对外围卫生人员进行充分培训、组建专门的新生儿转诊团队以及加强外围新生儿重症监护病房（SNCUs）建设，似乎是取得良好结局的有前景的干预措施。
