Pattern of Neonatal Admissions and Care Outcomes in Special Care Newborn Unit of Cox’s Bazar District Hospital, Bangladesh

Abstract

Background: Neonatal morbidity and mortality contribute significantly to under‑five morbidity and mortality. A substantial reduction in neonatal mortality is therefore necessary to achieve the Sustainable Development Goals targets. Aims: Assessed the pattern of neonatal admission and care outcomes. Place and Duration of Study: Special Care Newborn Unit of Cox’s Bazar District hospital, Bangladesh conducted in September 2022. Methodology: Hospital-based retrospective study. Data extracted from the admission register and the records of 3982 newborns admitted between August 2021 and July 2022. Bivariate analysis using the Chi-square test, was performed to determine factors associated with neonatal mortality and p value was set at significant level of 5%. Results: 3982 neonates were admitted, 2426 (61%) were male and 1556 (39%) were female with1071 (27%) from the hospital and 2911(73%) from outside the hospital. Birth asphyxia was the commonest morbidity,49% followed by Low Birth Weight/prematurity (18%) and neonatal sepsis 17%. 3,225 (81.4%) of the neonates admitted survived while 538 (13.5%) died and 203(5.1%) were discharged against medical advice. There was significant association between birth weight, morbidity pattern and mortality p<0.05) with most deaths associated with prematurity/LBW. There was significant association between neonatal mortality and the place of delivery, death among outborn was 16% compared with 7% among inborn (p<0.05) but no significant association between neonatal mortality and gender. Conclusion: There was a high burden of neonatal care at the hospital and majority of causes of neonatal morbidity and mortality were preventable. There is need for holistic approach to pregnancy, delivery and newborn care to reduce neonatal morbidity and mortality in the district.