Khyathi Ambatipudi¹, Gajanan Venkatrao Surewad^2*, Rajashree Sayanna Totawad³

^1,2Assistant Professor, Department of Paediatrics, ³Senior Resident, Department of Radiology, Nimra Institute Medical Sciences, Jupudi (V) Vijayawada, Krishna (Dist) Andhra Pradesh – 521456, INDIA.

Email: gvsurewad@gmail.com

OBSERVATION AND RESULTS

Table 1: Study of Neonatal Mortality and Morbidity with their Birth weight (Total No.: 500)

Table 2: Aetiology of Respiratory distress in Neonates (Total No.: 180)

Table 3: Study of Neonatal Hyperbilirubinemia  No. of patients: 98 (19.6%)

Table 4: Study of sepsis as Neonatal Morbidity No. of Patients: 222 (44.4%)

Table 5: Type of presentation at delivery in Neonatal deaths No. of Patients: 63 (12.6%)

Table-1: Study of Neonatal mortality and morbidity with their birth weight (BW). In the morbidity group out of 500, 432 (86.4%) neonates were observed.

1. 310 (71.70%) neonates were with BW >2000 gm and 122 (28.2%) neonates with LBW < 2000 gm were observed.
2. There were deaths of 63 (12.6%) neonates out of 500. Mortality observed in the birth weight > 2000 gm were 25 (39.6%) and 38 (60.3%) in the low birth weight < 2000 gm.

Table-2: 180 (36%) neonates had respiratory distress. Aetiology wise 48 (26.6%) had HMD, 17 (9.4%) had Meconium aspiration syndrome, 99 (55%) had transient tachypnea of newborn, 07 (3.88%) had congenital heart disease and 9 (5%) had congenital malformation.

Table-3: 98 (19.6%) neonates had neonatal hyperbilirubinemia. Aetiology in 83 (84.2%) neonates were prematurity with ABO incompatibility, 12 (12.24%) had ABO incompatibility alone and 3 (3.06%) had Rh in compatibility.

Table-4: There were 222 (44.4%) cases of neonatal sepsis out of which, 119 (53.6%) had Culture negative Sepsis, 82 (36.9%) had culture positive Sepsis and 21 (9.45%) had Congenital pneumonia.

Table-5: Type of presentation at delivery in 63 (12.6%) cases of neonatal deaths were 40 (63%) vertex, 17 (26.9%) Breech, 4 (6.34%) transverse lie and 02 (3.17%) cord prolapse.

DISCUSSION

In the present study of factors affecting mortality and morbidity in Andhra Pradesh population – 432 (83.4%) had morbidity, 310 (71.7%) had Body weight (B.W) > 2000 gm, 122 (28.2%) had BW< 2000 gm. There were 63 (12.6%) neonatal deaths, 25 (39.6%) had BW > 2000 gm and 38 (60.3%) had LBW was < 2000 gm (Table-1). Out of 180 (36%) neonates having respiratory distress – 48 (26.6%) had HMD, 17 (9.4%) had Meconium aspiration syndrome, 99 (55%) had transient tachypnea of newborn, 7 (3.8%) had congenital heart disease, 9 (5%) had congenital malformation (Table-2). Out of 98 (19.6%) neonates having neonatal hyperbilirubinemia, 83 (84.0%) had prematurity with ABO incompatibility, 12 (12.2%) had ABO incompatibility alone, 3 (3.06%) had Rh incompatibility as aetiological factor (Table-3). There was sepsis in 222 (44.4%) neonates, 119 (53.6%) had culture negative Sepsis, 82 (36.9%) had culture positive Sepsis and 21 (9.45%) had Congenital pneumonia (Table-4). Type of presentation at delivery in 63 neonatal death cases, 40 (63%) had vertex, 17 (26.9%) had Breech, 4 (6.34%) had transverse lie, 2 (3.17%) had cord prolapse (Table-5). These findings are more or less in agreement with previous studies^8.9,10. The main root cause of morbidity and mortality was associated birth asphyxia. It was mainly observed in rural tribal and remote area of the cities i.e., Lower middle socio-economic status mothers ⁽¹¹⁾ moreover, in urban or district place where Laboratory facilities available. It was also observed that majority of morbidity and mortality due to sepsis. Socio-economic factors like education and occupation of parents. Maternal factors include age, parity, height, Blood pressure, fever, and ability to perform physical activities. These play vital role in Antenatal care (ANC) services, maternal morbidity along with treatment and referrals (before and during pregnancy) and maternal mortality¹² The additional risk factors are duration or term of pregnancy delivery outcomes and complications, weight gain after birth immunization fever, infections.

SUMMARY AND CONCLUSION

In the present study of factors affecting neo-natal morbidity and mortality in Andhra Pradesh population will be useful to Paediatrician, Obstetrician and Gynaecologist, Radiologist. So that early diagnose can prevent the undue complications. But this study demands further, embryological, genetic, nutritional, hormonal patho-physiological studies because exact mechanism and formation of stages of zygote, formation of germ layers is still unclear.

This research paper was approved by Nimra Institute of Medical sciences, Jupudi (V) Vijayawada, Krishna (district) Andhra Pradesh-521456.

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