Muhammad Akbar Nizamani, Shafi Muhammad Nizamani.
An audit of mortality in hospitalized neonates and young infants at Pediatrics Department Peoples Medical College Nawabshah.
Med Channel Jan ;11(1):7-15.

OBJECTIVES: To assess the causes and main risk factors of mortality in neonates and young infants (0-2 months) over a period of one year at a teaching hospital of rural sindh Pakistan. STUDY DESIGN: One year cross sectional analytical study. SETTINGS: Study was conducted at department of paediatrics People`s Medical College hospital (PMCH) during a period of 1" January 2001 to 31" December 200I. SUBJECTS & METHODS: Admission record of all children is documented at PMCH Nawabshah in a specifically designed register. Admission charts of all neonates and young infants (0-2 Months) who died were kept separately with all details of history, examination, diagnosis and treatment starting from 1st January 2001 to 3Ist December 2001. All information was then reproduced on a Mortality proforma and analyzed at the end of study period. RESULTS: During 2001 total 4255 children were admitted at PMCH Nawabshah,of these 2359 (56.2%) were infants below one year 1458(34.2%) were neonates and further 118 were admitted in second month of life. Hence 1576(37%) young infants 0-2 months of age were admitted at paediatrics department of PMCH Nawabshah. Males were 64.3 % and females 35.7 %. During this period 649 (15.2%) children died, 406(62.5%) were males and 243(37.5%) were females. In first year (Infancy) 435(67% of total deaths) occurred. Of these, 325(50% of total deaths) occurred in young infants (0-2 months), males comprising 67.4% and females 32.6% of deaths. Mortality rate was 20.6% in young infants. Neonatal deaths were 309(2I.% of neonatal admissions), 67% males and 33%females. ln infancy 30.5% deaths occurred on first day of life, 54.4% deaths in 1st week and 71% in 1 four weeks (Neonates) of life only 5.8% deaths occurred in whole second month. 63.5% deaths occurred in young infants whose weight was less than 2.5 Kg at admission. 201 (62%) deaths occurred within 24 hours of hospitalization (23% in first 2 hours of hospitalization) indicating critical condition at the time of admission and requiring advance neonatal intensive care. 59.2% were home deliveries. Birth asphyxia (22.5%), Sepsis & DIC (21.8%), Very Low Birth Weight(IUGR and Prematurety) (20.6%), Neonatal Tetanus (19.4%), Specific Infections (11.7%) (Septic meningitis, severe pneumonia and diarrhea) were main causes of death. CONCLUSION: Low birth weight, critical condition at admission and home delivery are main risk factors leading to early deaths in young infants. Infections and birth asphyxia are major causes of deaths in young infants.

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