A four year study on neonatal morbidity in a New Delhi hospital.

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.

Perinatal & neonatal mortality in a hospital.

A total of 7109 consecutive births were studied over four years to assess perinatal and neonatal mortality. The extended perinatal mortality rate was 57 while conventional perinatal mortality rate (PNMR) was 41 per 1000 total births. Perinatal hypoxia (28.7%), immaturity (24.8%), congenital malformations (14.6%) and infections (5.6%) accounted for most perinatal deaths. The ranking of causes of neonatal deaths was immaturity, birth asphyxia, bacterial infections and congenital malformations. Neonatal mortality rate was 31 per 1000 live births and nearly 90 per cent mortality occurred in low birth weight (LBW) neonates. Hyaline membrane disease accounted for 13.4 per cent of early neonatal deaths. The case fatality rate among LBW babies and preterm babies was 10 per cent and 20 per cent respectively. There is a need to identify strategies to reduce the incidence of prematurity and LBW babies. Comprehensive antenatal coverage and adequate care followed by optimal management of infants at birth is likely to reduce PNMR and improve quality of life among the survivors.