Morbidity and mortality among outborn neonates at 10 tertiary care institutions in India during the year 2000

The National Neonatal Perinatal Database (NNPD) network is a collaborative group of leading neonatal units in India involved in the prospective collection of morbidity and mortality data on uniform protocols. The present article reports the morbidity and mortality profile of outborn neonates in the year 2000. Ten centers provided data on outborn neonates. The data were analysed at the nodal center using Epi-Info statistical software version 6 and Excel 97. A total of 3831 neonates were admitted at the participating institutions. A majority of them (87.2 per cent) were delivered in nursing homes and small hospitals. Most of the admissions (68.7 per cent) were male. Nearly half of them (48.7 per cent) were low birthweight and one-third (32.1 per cent) were preterm. Overall mortality was 16.4 per cent, while 7.5 per cent left hospitals against medical advice. Nearly half of all neonatal deaths occurred within the first 48 h following admission. Common primary causes of deaths (n = 630) included: infections (36.0 per cent), prematurity related conditions (26.5 per cent), perinatal hypoxia (10.0 per cent), and malformations (7.8 per cent). Systemic infections (28.4 per cent), hyperbilirubinemia (27.9 per cent), seizures (11.7 per cent), hypoglycemia (11.5 per cent), hypoxic ischemic encephalopathy (8.3 per cent), anemia (8.9 per cent), and hypocalcemia (8.6 per cent) were common morbidities observed. Of systemic infections, 39.2 per cent were culture positive and 51.4 per cent were early onset (< 72 h). Sick babies were managed with antibiotics (75 per cent), oxygen administration (45.3 per cent), phototherapy (34.9 per cent), and assisted ventilation (16.3 per cent). In conclusion, the present study describes the morbidity and mortality profile of a large multicentric cohort of outborn neonates from a developing country.