Abstract

Background: India is still among the high infant mortality rate countries and two third of the infant deaths occur during neonatal period. Neonatal mortality rates have reduced much less than postneonatal death. Morbidity and mortality during neonatal period are mostly due to endogenous factors and survival of the baby depends on timely referral, mode of transportation and treatment available to them. Objectives: Objectives of this study were to describe morbidity pattern among admitted neonates, to find out the association between various biological factors and neonatal morbidity and to study various factors related to referral among outborn neonates.
Materials and Methods: The study was a hospital based cross- sectional study conducted at neonatal intensive care unit of Guru Gobind Singh Government Hospital, Jamnagar among 300 admitted neonates.
Results: In the study 30.00% neonates were outborn, 88.00% were <7 days of age, and 63.67% were male. 32.33% were preterm babies, 59.67% had low birth weight, and 17% were of the birth order 3 or more. Antenatal and intranatal complications were reported by 36.33% and 23.33% mothers, respectively. Chief morbidities were neonatal jaundice (29.33%), respiratory distress syndrome (RDS) (16.33%), perinatal asphyxia (12.00%), infection/sepsis (10.00%), meconium aspiration syndrome (5.33%), and congenital anomalies (8.67%). Infection/sepsis was developed by 19.61% neonates of the birth order 3 or more and 17.14% neonates with intranatal complications. RDS was developed by 24.74% preterm babies and 25.71% with intranatal complications. Out of total outborn neonates, 36.67% were transferred to NICU after 2 days, 67.78% were referred from private institutions, 52.22% used ambulance or 108 services, and 46.67% had to travel for more than 100 km. Conclusion: Birth order 3 or more and any intranatal complication was significantly associated with infection/sepsis. Preterm neonates and intranatal complications showed the significantly higher proportion of RDS. Two third of the outborn neonates were referred by private institutes, and half of the outborn neonates had to travel more than 100 km to reach to NICU.