Skip to main content
Top
Published in: BMC Pediatrics 1/2012

Open Access 01-12-2012 | Research article

The study of etiological and demographic characteristics of neonatal mortality and morbidity - a consecutive case series study from Pakistan

Authors: Nabeel Manzar, Bushra Manzar, Anum Yaqoob, Muneer Ahmed, Jai Kumar

Published in: BMC Pediatrics | Issue 1/2012

Login to get access

Abstract

Background

To determine the etiology, management, bacteriological spectrum and outcome of neonatal patients admitted in Civil Hospital Karachi (CHK) and to examine the factors associated with it.

Methods

This hospital based descriptive study of 1463 patients from both sexes who were admitted to Paediatric department, CHK from 1st January 2008 till 31st December 2010 with an established cause according to modified Wigglesworth classification and fulfilling other inclusion criteria were included in the study. Data regarding their demographic profile and potential risk factors was collected on a well structured proforma. Cases were followed until discharge or expiry. Data was analyzed using descriptive statistics.

Results

The male to female ratio in our study was 1.12:1. Seven hundred and thirty-four patients were delivered at home (50.2%) and 1010 were less than 7 days old (69%). Out of the total cohort of expired subjects, 89 participants (74.8%) were < 7 days of life. Mortality was more in neonates born at home in rural areas to illiterate mother; 74 patients (62.2%). Most of the deaths; 57 were in neonates suffering from specific infections (47.9%) followed by 38 deaths in immaturity group (31.9%) and 19 related to asphyxial conditions (15.9%). The most common isolates were Staphylococcus aureus (28.7%) followed by Klebsiella (24.8%) and Pseudomonas aeruginosa (16.6 ). One hundred and nineteen (8.13%) of the neonates died in our study group.

Conclusions

These results suggest that neonates with illiterate mothers with high parity and below average socioeconomic level were more susceptible to mortality in the early neonatal period. Most of the cases of mortality were due to specific infections.
Literature
1.
go back to reference Zupan J: Perinatal mortality in developing countries. N Engl J Med. 2005, 352: 2047-2048. 10.1056/NEJMp058032.CrossRefPubMed Zupan J: Perinatal mortality in developing countries. N Engl J Med. 2005, 352: 2047-2048. 10.1056/NEJMp058032.CrossRefPubMed
2.
go back to reference Ngoc NT, Merialdi M, Abdel-Aleem H, Carroli G, Purwar M, Zavaleta N, et al: Causes of stillbirths and early neonatal deaths: Data from 7933 pregnancies in six developing countries. Bull World Health Organ. 2006, 84: 699-705. 10.2471/BLT.05.027300.CrossRefPubMedPubMedCentral Ngoc NT, Merialdi M, Abdel-Aleem H, Carroli G, Purwar M, Zavaleta N, et al: Causes of stillbirths and early neonatal deaths: Data from 7933 pregnancies in six developing countries. Bull World Health Organ. 2006, 84: 699-705. 10.2471/BLT.05.027300.CrossRefPubMedPubMedCentral
3.
go back to reference Lander T: Neonatal and perinatal mortality: country, regional and global estimates. 2006, Geneva: WHO Lander T: Neonatal and perinatal mortality: country, regional and global estimates. 2006, Geneva: WHO
4.
go back to reference Lawn JE, Cousens S, Zupan J: 4 million neonatal deaths: when? Where? Why?. Lancet. 2005, 365: 891-900. 10.1016/S0140-6736(05)71048-5.CrossRefPubMed Lawn JE, Cousens S, Zupan J: 4 million neonatal deaths: when? Where? Why?. Lancet. 2005, 365: 891-900. 10.1016/S0140-6736(05)71048-5.CrossRefPubMed
5.
go back to reference Darmstadt GL, Walker N, Lawn JE, Bhutta ZA, Haws RA, et al: Saving newborn lives in Asia and Africa: cost and impact of phased scale-up of interventions within the continuum of care. Health Policy Plan. 2008, 23: 101-117.CrossRefPubMed Darmstadt GL, Walker N, Lawn JE, Bhutta ZA, Haws RA, et al: Saving newborn lives in Asia and Africa: cost and impact of phased scale-up of interventions within the continuum of care. Health Policy Plan. 2008, 23: 101-117.CrossRefPubMed
6.
go back to reference Bhutta ZA, Darmstadt GL, Hasan BS, Haws RA: Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence. Pediatrics. 2005, 115: 519-617.PubMed Bhutta ZA, Darmstadt GL, Hasan BS, Haws RA: Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence. Pediatrics. 2005, 115: 519-617.PubMed
7.
go back to reference Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, et al: Evidence-based, costeffective interventions: how many newborn babies can we save?. Lancet. 2005, 365: 977-988. 10.1016/S0140-6736(05)71088-6.CrossRefPubMed Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, et al: Evidence-based, costeffective interventions: how many newborn babies can we save?. Lancet. 2005, 365: 977-988. 10.1016/S0140-6736(05)71088-6.CrossRefPubMed
8.
go back to reference Abhimanyu N, Sanjay PZ, Suresh U, Shrikant IB: Neonatal Morbidity and Mortality in Tribal and Rural Communities in Central India. Indian J Community Med. 2011, 36 (2): 150-158. 10.4103/0970-0218.84137.CrossRef Abhimanyu N, Sanjay PZ, Suresh U, Shrikant IB: Neonatal Morbidity and Mortality in Tribal and Rural Communities in Central India. Indian J Community Med. 2011, 36 (2): 150-158. 10.4103/0970-0218.84137.CrossRef
9.
go back to reference Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, et al: Neonatal Mortality Levels for 193 Countries in 2009 with Trends since 1990: A Systematic Analysis of Progress, Projections, and Priorities. PLoS Med. 2011, 8 (8): e1001080-10.1371/journal.pmed.1001080.CrossRefPubMedPubMedCentral Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, et al: Neonatal Mortality Levels for 193 Countries in 2009 with Trends since 1990: A Systematic Analysis of Progress, Projections, and Priorities. PLoS Med. 2011, 8 (8): e1001080-10.1371/journal.pmed.1001080.CrossRefPubMedPubMedCentral
10.
go back to reference Baqui AH, Darmstadt GL, Williams EK, Kumar V, Kiran TU, et al: Rates, timings and causes of neonatal deaths in rural India: implications for neonatal health programmes. Bull World Health Organ. 2006, 84: 706-713. 10.2471/BLT.05.026443.CrossRefPubMedPubMedCentral Baqui AH, Darmstadt GL, Williams EK, Kumar V, Kiran TU, et al: Rates, timings and causes of neonatal deaths in rural India: implications for neonatal health programmes. Bull World Health Organ. 2006, 84: 706-713. 10.2471/BLT.05.026443.CrossRefPubMedPubMedCentral
11.
go back to reference Mirzrah EM: Neonatal seizures and neonatal epileptic syndrome. Neural Clin. 2001, 19: 427-463. 10.1016/S0733-8619(05)70025-6.CrossRef Mirzrah EM: Neonatal seizures and neonatal epileptic syndrome. Neural Clin. 2001, 19: 427-463. 10.1016/S0733-8619(05)70025-6.CrossRef
12.
go back to reference Jamal H: Estimation of multidimensional poverty in Pakistan. Social policy and development centre. 2009, 79: 1-14. Jamal H: Estimation of multidimensional poverty in Pakistan. Social policy and development centre. 2009, 79: 1-14.
13.
go back to reference Wigglesworth JS: Classification of perinatal deaths. Soz Praventivmed. 1994, 39: 11-14. 10.1007/BF01369938.CrossRefPubMed Wigglesworth JS: Classification of perinatal deaths. Soz Praventivmed. 1994, 39: 11-14. 10.1007/BF01369938.CrossRefPubMed
14.
go back to reference Winbo IG, Serenius FH, Dahlquist GG, Kallen BANICE: A new cause of death classification for still births and neonatal deaths. Neonatal and Intrauterine death classification according to etiology. Int J Epidemiol. 1998, 27: 499-504. 10.1093/ije/27.3.499.CrossRefPubMed Winbo IG, Serenius FH, Dahlquist GG, Kallen BANICE: A new cause of death classification for still births and neonatal deaths. Neonatal and Intrauterine death classification according to etiology. Int J Epidemiol. 1998, 27: 499-504. 10.1093/ije/27.3.499.CrossRefPubMed
15.
go back to reference Chang JY, Lee KS, Hahn WH, Chung SH, Choi YS, Shim KS, et al: Decreasing trends of neonatal and infant mortality in Korea: compared with Japan, USA and OECD nations. J Korean Med Sci. 2011, 26 (9): 1115-1123. 10.3346/jkms.2011.26.9.1115.CrossRefPubMedPubMedCentral Chang JY, Lee KS, Hahn WH, Chung SH, Choi YS, Shim KS, et al: Decreasing trends of neonatal and infant mortality in Korea: compared with Japan, USA and OECD nations. J Korean Med Sci. 2011, 26 (9): 1115-1123. 10.3346/jkms.2011.26.9.1115.CrossRefPubMedPubMedCentral
16.
go back to reference Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al: Global, regional and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010, 375 (9730): 1969-1987. 10.1016/S0140-6736(10)60549-1.CrossRefPubMed Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al: Global, regional and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010, 375 (9730): 1969-1987. 10.1016/S0140-6736(10)60549-1.CrossRefPubMed
17.
go back to reference Shams R, Khan N, Hussain S: Bacteriology & Anti-Microbial Susceptibility of Neonetal Septicemia in NICU, PIMS, Islamabad-A Tertiary Care Hospital of Pakistan. Ann Pak Inst Med Sci. 2010, 6 (4): 191-195. Shams R, Khan N, Hussain S: Bacteriology & Anti-Microbial Susceptibility of Neonetal Septicemia in NICU, PIMS, Islamabad-A Tertiary Care Hospital of Pakistan. Ann Pak Inst Med Sci. 2010, 6 (4): 191-195.
18.
go back to reference Ayaz A, Saleem S: Neonatal Mortality and Prevalence of Practices for Newborn Care in a Squatter Settlement of Karachi, Pakistan: A Cross-Sectional Study. PLoS One. 2010, 5 (11): e13783-10.1371/journal.pone.0013783.CrossRefPubMedPubMedCentral Ayaz A, Saleem S: Neonatal Mortality and Prevalence of Practices for Newborn Care in a Squatter Settlement of Karachi, Pakistan: A Cross-Sectional Study. PLoS One. 2010, 5 (11): e13783-10.1371/journal.pone.0013783.CrossRefPubMedPubMedCentral
19.
go back to reference Kouéta F, Yé D, Dao L, Néboua D, Sawadogo A: Neonatal morbidity and mortality in 2002–2006 at the Charles de gulle pediatric hospital (France). Child Care Health Dev. 2004, 30 (6): 699-709. 10.1111/j.1365-2214.2004.00485.x.CrossRef Kouéta F, Yé D, Dao L, Néboua D, Sawadogo A: Neonatal morbidity and mortality in 2002–2006 at the Charles de gulle pediatric hospital (France). Child Care Health Dev. 2004, 30 (6): 699-709. 10.1111/j.1365-2214.2004.00485.x.CrossRef
20.
go back to reference Owa JA, Osinaike AI: Neonatal morbidity and mortality in Nigeria. Indian J Pediatr. 1998, 65 (3): 441-449. 10.1007/BF02761140.CrossRefPubMed Owa JA, Osinaike AI: Neonatal morbidity and mortality in Nigeria. Indian J Pediatr. 1998, 65 (3): 441-449. 10.1007/BF02761140.CrossRefPubMed
21.
go back to reference Emmanuel D: Study on maternal mortality and neonatal morbidity in Africa. J rural integrated relief service-Ghana. 2007 Emmanuel D: Study on maternal mortality and neonatal morbidity in Africa. J rural integrated relief service-Ghana. 2007
22.
go back to reference Kumar M, Paul VK, Kapoor SK, Anand K, Deoraria AK: Neonatal outcomes at a subdistrict hospital in north India. J Trop Pediatr. 2002, 48 (1): 43-46. 10.1093/tropej/48.1.43.CrossRefPubMed Kumar M, Paul VK, Kapoor SK, Anand K, Deoraria AK: Neonatal outcomes at a subdistrict hospital in north India. J Trop Pediatr. 2002, 48 (1): 43-46. 10.1093/tropej/48.1.43.CrossRefPubMed
23.
go back to reference Zaidi AK, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldman DA: Hospital-acquired neonatal infections in developing countries. Lancet. 2005, 365: 1175-88. 10.1016/S0140-6736(05)71881-X.CrossRefPubMed Zaidi AK, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldman DA: Hospital-acquired neonatal infections in developing countries. Lancet. 2005, 365: 1175-88. 10.1016/S0140-6736(05)71881-X.CrossRefPubMed
24.
go back to reference Modi N, Kirubakaran C: Reasons for admission,causes of death and costs of admission to a tertiary neonatal referral unit in India. J Trop Pediatr. 1995, 4 (2): 99-102.CrossRef Modi N, Kirubakaran C: Reasons for admission,causes of death and costs of admission to a tertiary neonatal referral unit in India. J Trop Pediatr. 1995, 4 (2): 99-102.CrossRef
25.
go back to reference Seyal T, Husnain F, Anwar A: Audit of Neonatal Morbidity and Mortality at Neonatal Unit of Sir Gangaram Hospital Lahore. Ann King Edward Med Uni. 2011, 17 (1): 9-13. Seyal T, Husnain F, Anwar A: Audit of Neonatal Morbidity and Mortality at Neonatal Unit of Sir Gangaram Hospital Lahore. Ann King Edward Med Uni. 2011, 17 (1): 9-13.
26.
go back to reference Rashid AKM, Rasul CHH, Hafiz SM: Neonatal mortality: a scenario in a tertiary level hospital of developing country. Pediatr Rep. 2010, 2 (1): e9-CrossRef Rashid AKM, Rasul CHH, Hafiz SM: Neonatal mortality: a scenario in a tertiary level hospital of developing country. Pediatr Rep. 2010, 2 (1): e9-CrossRef
27.
go back to reference Berg CJ: Prenatal care in developing countries: The World Health Organization technical working group on antenatal care. J Am Med Womens Assoc. 1995, 50: 182-186.PubMed Berg CJ: Prenatal care in developing countries: The World Health Organization technical working group on antenatal care. J Am Med Womens Assoc. 1995, 50: 182-186.PubMed
28.
go back to reference Carroli G, Villar J, Piaggio G, Khan-Neelofur D, Gulmezoglu M, et al: WHO systematic review of randomised controlled trials of routine antenatal care. Lancet. 2001, 357: 1565-1570. 10.1016/S0140-6736(00)04723-1.CrossRefPubMed Carroli G, Villar J, Piaggio G, Khan-Neelofur D, Gulmezoglu M, et al: WHO systematic review of randomised controlled trials of routine antenatal care. Lancet. 2001, 357: 1565-1570. 10.1016/S0140-6736(00)04723-1.CrossRefPubMed
29.
go back to reference Ba'aqeel H, Piaggio G, Lumbiganon P, Miguel Belizan J, et al: WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. Lancet. 2001, 357: 1551-1564. 10.1016/S0140-6736(00)04722-X.CrossRefPubMed Ba'aqeel H, Piaggio G, Lumbiganon P, Miguel Belizan J, et al: WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. Lancet. 2001, 357: 1551-1564. 10.1016/S0140-6736(00)04722-X.CrossRefPubMed
30.
go back to reference Muhammad Z, Ahmed A, Hayat U, Wazir MS, Rafiyatullah , Waqas H: Neonatal sepsis: causative bacteria and their resistance to antibiotics. J Ayub Med Coll Abbottabad. 2010, 22 (4): 33-36.PubMed Muhammad Z, Ahmed A, Hayat U, Wazir MS, Rafiyatullah , Waqas H: Neonatal sepsis: causative bacteria and their resistance to antibiotics. J Ayub Med Coll Abbottabad. 2010, 22 (4): 33-36.PubMed
Metadata
Title
The study of etiological and demographic characteristics of neonatal mortality and morbidity - a consecutive case series study from Pakistan
Authors
Nabeel Manzar
Bushra Manzar
Anum Yaqoob
Muneer Ahmed
Jai Kumar
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2012
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-12-131

Other articles of this Issue 1/2012

BMC Pediatrics 1/2012 Go to the issue