Sribas Das1 , Sujit Kumar Chakrabarti2 , Tapash Ghosh3 , Sanjib Kumar Debbarma4
BACKGROUND In India, 26 million babies are born every year and 1.2 million die in the newborn period, which accounts for a quarter of global neonatal death. Tripura is a hilly state in the north eastern part of India with minimum budget allocation in its health care. The national Neonatal Mortality Rate (NMR) is 22.73/1000 live births in 2018. But no authentic publication on NMR of Tripura is available as of date. The neonatal care unit of Agartala Government Medical College (AGMC) was started in the year 2005 where patients from all over the state are being referred and cared. Therefore, a retrospective study was carried out to study the profile of morbidity and mortality in the admitted newborns for identifying problem areas which will in turn help in developing policies. METHODS All live newborns weighing 500 grams or more and with gestational age of 24 weeks or more, admitted in the neonatal care unit during the period between 1/1/19 and 31/12/19 in the Department of Paediatrics, AGMC, Agartala were included in the study. Data in terms of gender, ethnicity, religion, place of delivery, mode of delivery, birth weight, gestational age, primary diagnosis and outcome were tabulated and analysed. RESULTS A total of 2157 neonates were enrolled with a slight male preponderance. The incidence of low birth weight (LBW) was 74.68% of the total enrolled cases. The common causes for morbidity were perinatal asphyxia (31.15%), neonatal sepsis (23.22%), neonatal hyperbilirubinemia (18.08%), HMD/RDS (9.17%) and MAS (6.67%). The overall mortality was 18.49% of the total enrolled cases. Perinatal asphyxia, neonatal sepsis, HMD/RDS and MAS contributed maximally to the mortality (33.08%, 27.80%, 14.03% and 07.01% of total death respectively). However, the morbidity and mortality profile among the intramural and extramural groups were not statistically significant. CONCLUSIONS Perinatal asphyxia, neonatal sepsis, prematurity and its complications are the leading causes of morbidity and mortality in this study which are preventable to a considerable extent. The high incidence of low birth weight (LBW) neonates reflects high rate of referral of LBW neonates to this institute. Therefore, improvement of obstetric care and scaling up of neonatal care skill at all levels should be priorities in policies to achieve reduction in neonatal mortality.
