Characteristics & outcomes of tribal & non-tribal neonates admitted to a special newborn care unit in rural Gujarat, India
No Thumbnail Available
Date
2024-01
Journal Title
Journal ISSN
Volume Title
Publisher
Wolters Kluwer – Medknow
Abstract
Background & objectives: This study aimed to compare the admission characteristics and outcomes of tribal and non-tribal neonates admitted to a level II special newborn care unit (SNCU) in rural Gujarat. Methods: This was a retrospective observational study that looked at all neonates admitted to a high- volume SNCU between 2013 and 2021. A series of quality improvement measures were introduced over the study period. Admission characteristics, such as birth weight, gestational age, gender and outcomes for tribal and non-tribal neonates, were compared. Results: Six thousand nine hundred and ninety neonates [4829 tribal (69.1%) and 2161 (30.9%) non- tribal] were admitted to the SNCU. Tribal neonates had lower mean birth weight (2047 vs. 2311 g, P<0.01) and gestational week at birth (35.8 vs. 36.7 weeks, P<0.01) compared to non-tribal neonates. Common causes of admissions were neonatal jaundice (1990, 28.4%), low birth weight (1308, 18.7%) and neonatal sepsis (843, 12%). Six hundred and thirty-eight (9.1%) neonates died during the treatment in the SNCU. The odds of death among tribal neonates was similar to non-tribal neonates [adjusted odds ratio: 1.12 (95% confidence interval [CI]: 0.89, 1.42)]. The tribal neonates had significantly higher cause-specific case fatality rate from sepsis [relative risk (RR): 2.18 (95% CI: 1.41, 3.37)], prematurity [RR: 1.98 (95% CI: 1.23, 3.17)] and low birth weight [RR: 1.83 (95% CI: 1.17, 2.85)]. The overall case fatality rate in the SNCU decreased from 18.2 per cent during the year 2013-2014 to 2.1 per cent in the year 2020-2021. Interpretation & conclusions: There was a reduction in the case fatality rate over the study period. Tribal and non-tribal neonates had similar risk of death. Sepsis prevention and management, mechanical respiratory support and timely referral to a higher centre might help further reduction in mortality for these neonates.
Description
Keywords
Neonatal mortality, scheduled tribe, special newborn care unit
Citation
Lusk Rachel, Desai Tushar, Modi Dhiren, Desai Shrey, Donda Jignesh Kumar, Raulji Nirav Kumar, Shah Pankaj, Desai Gayatri. Characteristics & outcomes of tribal & non-tribal neonates admitted to a special newborn care unit in rural Gujarat, India. Indian Journal of Medical Research. 2024 Jan; 159(1): 71-77