57 percent deaths reported within first 48 hours
Srinagar: A study on the causes and pattern of neonatal mortality by the tertiary-care neonatal unit of GMC Jammu has revealed that prematurity is the main cause of neonatal mortality in Jammu and Kashmir and that about 57 percent neonatal deaths are reported in the first 48 hours.
The survey was conducted by the Department of Paediatrics, Government Medical college, Jammu. “Prematurity was seen in 56.44% of deaths whereas mean gestational age was 34 weeks (SD 4.18 weeks). Sepsis screen was positive in 53.47% of neonatal deaths,” reads the data.
“Congenital malformations were seen in 11.88% of neonatal deaths among which a cyanotic congenial heart disease was most common, seen in 4.95% of deaths,” it says.
“In final diagnosis, the most common cause of death was prematurity (56.44%) followed by neonatal sepsis (37.62%), birth anoxia (30%), and respiratory distress syndrome (26.73%) and seventy-one percent of deaths were from rural, whereas 29% were from urban background,” it says.
“Our findings suggest that the perinatal period is the crucial period as most of the deaths occurred in this period. In order to reduce neonatal mortality, major healthcare interventions and programs should target this time period at all health care levels (primary, secondary as well as tertiary care level). Strengthening immediate neonatal care will reduce both neonatal sepsis as well as birth asphyxia which are 2 and 3 main causes of deaths in our study. Key interventions should target health education regarding breastfeeding, availability of NICU beds with respect to population, adequate NICU bed space, ratio of NICU beds, nursing staff and doctors as per recommended norms. Another finding in our study was the prematurity which was seen in more than half of neonatal deaths. It suggests the need to improve antenatal services to expectant mothers like treatment and prevention of anemia and malnutrition, adequate birth spacing, adequate antenatal check-ups all affected by female literacy,” it recommends.
“It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively with high coverage. Health facility-based interventions can reduce neonatal mortality by 23%-50% in different settings,” it adds.