A Study of Short-Term Outcomes in Neonates Referred to the Tertiary Care Hospital in Central India

Background: The neonatal mortality rate reflects the utilization of the health services and the quality of the health services in a country. In developing countries like India neonatal mortality rate is one of the highest in the world. India has a high NMR of 28/1000 live births. Mortality in babies referred to a tertiary care unit has a fair contribution toward the NMR. This study aims to find the factors affecting mortality in neonates referred to a tertiary care neonatal ICU. Material & Methods: In this prospective observational study all neonates referred to our hospital over a period of 2 years from July 2018- June 2020 were enrolled after informed voluntary consent. Detailed history and transport characteristics were noted in a Performa. The clinical course and treatment with short term outcomes i.e. death or discharge was noted Results: Out of 300 neonates 51% were transported by ambulance and 49% were transported by private vehicle. Among the clinical and biochemical variable (TOPS score) there was a significant mortality associated with hypothermia, prolonged CRT and SpO2 <90% and cyanosis on admission. The most common cause of mortality was sepsis followed by hypoxic ischemic encephalopathy and respiratory distress syndrome. Statistically significant death was found in low-birth-weight babies, home delivered, those transported by a private vehicle, with whom referral note was not available and referral reasons, airway advice and treatment during transport were not given. Conclusion: Transporting a sick neonate is very stressful event for the neonate and more so if his physiological parameters are not maintained, possess a great risk for mortality. Strengthening of this link is required to improve survival in neonates requiring transport.