Vaishnav Kritika, Galhotra Abhiruchi, Jindal Atul, Parhad Priyanka
School of Public Health, AIIMS Raipur, Chhattisgarh, India.
Department of CFM, AIIMS Raipur, Chhattisgarh, India.
J Family Med Prim Care. 2023 Jun;12(6):1165-1171. doi: 10.4103/jfmpc.jfmpc_2309_22. Epub 2023 Jun 30.
The neonatal period is the crucial and vulnerable period of the human life cycle. Various research has been conducted worldwide that provide the baseline data on clinical profiles and predictors of outcomes of babies admitted to sick newborn care units (SNCUs). Nonetheless, studies on tribal areas and community outreach areas are rare. In the present study, predictors and profiles of patients admitted to SNCU, in the Dantewada and Bijapur districts of Chhattisgarh, India, were evaluated which shall help prioritize patient care and preventive approaches.
This retrospective study was undertaken from January 2019 to December 2020 in the SNCUs of Dantewada and Bijapur. Neonatal and maternal characteristics, course during labor, treatment given to the neonates, and outcome data were obtained and analysed.
In total, 1,531 neonates were enrolled in the study. Mothers had a mean age of 25.6 years (standard deviation [SD] ±4.9) with birth spacing less than 2 years (60.3%) and antenatal care (ANC) visits less than 4 (50.4%). Neonates were low birth weight (43.75%) and were home-delivered (15.8%). One hundred forty-nine neonates died. In the multivariate regression model, extremely low birth weight babies, less than 1 kg (odds ratio [OR]: 11.59 confidence interval [CI] 4.625-31.58), gestational age less than 34 weeks (OR: 2.13 CI 1.291-3.532), central cyanosis (OR: 10.40 CI: 3.269-32.35), duration of IV fluid > 3 days (OR: 2.16 CI 0.793-0.880), duration of antibiotic >3 days (OR 0.63 CI 0.408-0.979) were found to be independent predictors of mortality among neonates.
The prevalence of newborns aged less than 12 h is higher among the study population. Birth asphyxia, prematurity, neonatal jaundice, and sepsis were fundamental and leading causes of morbidity. Preterm birth and low birth weight babies had significantly high mortality. The government needs to focus on marginalized communities with target-based interventions and policies.
新生儿期是人类生命周期中的关键且脆弱阶段。全球已开展了多项研究,提供了入住新生儿重症监护病房(SNCUs)婴儿的临床特征及预后预测指标的基线数据。尽管如此,针对部落地区和社区外展地区的研究却很少。在本研究中,对印度恰蒂斯加尔邦丹特瓦达和比贾布尔地区入住SNCU的患者的预测指标和特征进行了评估,这将有助于确定患者护理和预防措施的优先顺序。
本回顾性研究于2019年1月至2020年12月在丹特瓦达和比贾布尔的SNCUs进行。获取并分析了新生儿和母亲的特征、分娩过程、给予新生儿的治疗以及结局数据。
共有1531名新生儿纳入研究。母亲的平均年龄为25.6岁(标准差[SD]±4.9),生育间隔小于2年(60.3%),产前检查(ANC)次数少于4次(50.4%)。新生儿为低出生体重儿(43.75%),且在家中分娩(15.8%)。149名新生儿死亡。在多变量回归模型中,极低出生体重儿,即体重小于1千克(比值比[OR]:11.59,置信区间[CI] 4.625 - 31.58)、胎龄小于34周(OR:2.13,CI 1.291 - 3.532)、中心性发绀(OR:10.40,CI:3.269 - 32.35)、静脉输液持续时间>3天(OR:2.16,CI 0.793 - 0.880)、抗生素使用持续时间>3天(OR 0.63,CI 0.408 - 0.979)被发现是新生儿死亡的独立预测因素。
研究人群中12小时内新生儿的患病率较高。出生窒息、早产、新生儿黄疸和败血症是发病的主要和根本原因。早产和低出生体重儿的死亡率显著较高。政府需要通过基于目标的干预措施和政策关注边缘化社区。