Assessment of neonatal mortality in the Neonatal Intensive Care Unit in Sabzevar City for the period of 2006-2013

Authors

  • Mohammad Hassan Rakhshani Ph.D. in Biostatistics, Department of Biostatistics, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran

Keywords:

neonatal mortality, neonatal intensive care unit, Sabzevar

Abstract

Introduction: The neonatal mortality rate (NMR) is an essential index in the assessment of community health. With the rapid advancement of neonatal care, the causes of death in this group and the overall mortality rate have changed. For these reasons, the aim of this study was to determine the current NMR and its causes in Sabzevar City’s Neonatal Intensive Care Unit (NICU).

Methods: This cross-sectional study was conducted in the NICU at Sabzevar Hospital from 2006 through 2013. Based on previous studies, the sample size was determined to be 365 neonates who were admitted to the NICU and died before they were discharged. The study tool was a researcher-developed checklist related to deceased neonates in the NICU. The checklist was confirmed based on the validity of its content and its inter-rater reliability. We used chi-squared, the Mann-Whitney U test, and the Spearman correlation to analyze the data. 

Results: The NMR in Sabzevar’s NICU was 6.44 per 1000 during the seven-year period; this rate included the following cases per 1000 live births: very early mortality (2.16), early mortality (3.33), and late mortality (0.96). Among 58,270 live births, 3,667 of the neonates were admitted to the NICU during the seven-year period, which was equivalent to 62.93 admissions per 1000 live births. Of the 3,667 neonates admitted to the NICU, 375 (10.23%) died before they were discharged. The most recurrent diagnoses were respiratory distress syndrome (46%), followed by sepsis (12%). The one-sample chi-squared test as a goodness-of-fit test (95% CI) showed that the mortality rates were significantly different based on gender (p = 0.004), birth weight (p < 0.001), gestational age (p < 0.001), different causes of death (p < 0.001), and different years of death (2006 -2013) (p < 0.001). There also was a significant difference between the duration of survival (very early mortality, early mortality, and late mortality) (p < 0.001). 

Conclusion: Neonatal mortality in the present study was comparable with that reported in similar studies in Iran and in other countries. The strong association between the mortality rate in the NICU with premature birth and low birth weight indicates the necessity of prenatal care aimed at preventing pre-term labor. Comprehensive programs from antenatal care and care at and after birth are recommended, including the investigation of the risks for neonatal death and offering preventive strategies

References

Cunningham G, Leveno K.J, Bloom S.T, Spong C.Y, Dashe J.S, Hoffman B.L,et al. Williams obstetrics.

th. New York: Mc Graw-Hill; 2014.

Bala Ghafari A, Siamian H, Aligolbandi K, Rashida S. Survey of characteristics of neonatal death in

neonatal intensive care unit of Boo-Ali Sina educational & therapeutic center between 2003-2006. J

Mazand Univ Med Sci. 2009; 20(74): 79-83.

Chaman R, Holakouie Naieni K, Golestan B, Nabavizadeh H, Yunesian M. Neonatal Mortality Risk

Factors in a Rural Part of Iran: A Nested Case-Control Study. Iranian J Publ Health. 2009; 38(1): 48-52.

Golestan M, Fallah R, Akhavan Karbasi S. Neonatal mortality of low birth weight infants in Yazd, Iran.

Iran J Reprod Med. 2008; 6(4): 205-8 . DOI: 10.1016/j.earlhumdev.2008.09.065.

Sareshtedari M, Shahamat H, Sadeghi T. Causes and Related Factors of Neonatal Mortality in Qazvin

NICU, 2010. Hakim Health Sys Res. 2012; 14(4): 227-32.

Behrman RE, Kligman R. Jenson H. Nelson Text book of Pediatrics. United States: Philadelphia; 2011.

Javanmardi Z, Beigi M, Nouhpisheh E, Memarzadeh M, Radan M R. The reported causes for neonatal

death in hospitals of Isfahan province in 2005. IJNMR. 2008; 13(2): 87-9.

Mirzarahimi M, Abedi A, Shahnazi F, Sa'adati H, Enteshari A. Causes and Rate of Mortality among the

Newborns in NICU and Newborns Unit at Ardabil hospitals. J Ardabil Univ Med Sci. 2009; 8(4): 424-30.

Mohamed EM, Soliman AMA, El-Asheer OM. Predictors of mortality among neonates admitted to

neonatal intensive care unit in pediatric Assiut University Hospital, Egypt. J Am Sci. 2011; 7(6): 606-11.

Ghaffari Saravi V, Khani S, Kosarian M, Zaeri aqamshhady H. Predictive value of SNAP-PE, SNAP,

CRIB indices for prediction of disease severity and determination of death in infants admitted to NICU. J

Mazandaran Univ Med Sci. 2009; 19(73): 1-9.

Mohsen Zade A, Shah Karami K, Verkouhi A. KH. Assessment the characteristics of died neonates in

NICU of Shahid Madani hospital of Khoramabad- Lorestan, 2002. (Abstract of the 5th International

Congress on Pulmonary Diseases and Intensive Care). Available from:

http://ganj.irandoc.ac.ir/articles/329722; accessed date: 1 Jan 2015.

Khani S, Mohammadpour Tahamtan R.A, Saravi V. Ghaffari, Abdollahi F, Sabbaghi R, Bavand M.

Neonatal survival rate and its related causes in NICU of private and governmental hospitals in Sari by

survival analysis technique during 2005-2007. J Mazandaran Univ Med Sci. 2008; 17(62): 54-62.

Kadivar M, Sagheb S, Bavafa F, Moghadam L, Eshrati B .Neonatal Mortality Risk Assessment in a

Neonatal Intensive Care Unit (NICU). Iran J Ped. 2007; 17(4): 325-31.

Basu S, Rathore P, Bhatia BD. Predictors of mortality in very low birth weight neonates in India. Singapore

Med J. 2008; 49(7): 556 -60. PMID: 18695864

Sankaran K, Chien LY, Walker R, Seshia M, Ohlsson A, Lee S. K, et al. Variations in mortality rates

among Canadian neonatal intensive care units. CMAJ. 2002; 166(2): 173–8. PMCID: PMC99269.

Published

2022-03-08