Causes of Death and the Mortality Rate of Newborns in NICU in Mashhad for Five Years

Document Type : Original Article

Authors

1 Neonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Neonatal Health Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran

4 Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: The neonatal period is the riskiest time for child survival. Globally, 2.4 million children died in the first month of life in 2020, and there are approximately 6,700 newborn deaths every day. In this study, the authors have evaluated the causes of death among infants hospitalized in the Neonatal Intensive Care Unit (NICU) of Imam Reza Hospital, Mashhad, Iran, for five years, since 2015.
Methods: A cross-sectional study was conducted on all neonates who died in the NICU under study. Data were collected through one of the proposed questionnaires of the Ministry of Health and Medical Education (NOHME), known as the “Green Questionnaire for the Study of the Dead Infant”. The data were recorded regarding asphyxia, congenital anomalies, sepsis or infection, respiratory distress syndrome (RDS), disseminated intravascular coagulation, pneumothorax, seizures, and the date of death. The extracted data were categorized and analyzed by the SPSS software (version 16). Babies who died at more than 28 days of age were excluded.
Results: Totally, 501 out of 4,348 NICU admissions died (11.52%), 54.5% of whom were male and 45.5% female. The mean birth weight was 1,658±1,018 grams, and the mean gestational age was 32±6 weeks. Most of them were between days one to six. The most common causes of NICU-Mortality Rate (MR) were RDS, congenital heart disease, and congenital anomalies, in descending order. The hospital under study recently expanded to a referral center for congenital heart disease in the east of Iran, which affected the NICU-MR in the ward under study. After the omission of congenital heart disease, the NICU-MR was 10.1%.
Conclusion: The NICU-MR was 10.1-11.5% in this study. After RDS, the second cause of death was congenital heart disease. As it is a new division in the hospital under study, it is hoped to get better improvement in congenital heart disease management.
 
 

Keywords


  1. Stoll BJ, Hansen NI, Bell EF, Walsh MC, Carlo WA, Shankaran S, et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993-2012. JAMA. 2015; 314(10):1039-51.
  2. Cheong-See F, Schuit E, Arroyo-Manzano D, Khalil A, Barrett J, Joseph KS, et al. Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis. BMJ. 2016; 354:i4353.
  3. Jehan I, Harris H, Salat S, Zeb A, Mobeen N, Pasha O, et al. Neonatal mortality: risk factors and causesL a perospective population based cohort study in Pakistan. Bull World Health Organ. 2009; 87(2):130-8.
  4. Carter BS. Pediatric Palliative Care in Infants and Neonates. Children (Basel). 2018; 5(2):1-9.
  5. Isayama T. The clinical management and outcomes of extremely preterm infants in Japan: past, present, and future. Transl Pediatr. 2019; 8(3):199-211.
  6. Helenius K, Sjörs G, Shah PS, Modi N, Reichman B, Morisaki N, et al. Survival in very preterm infants: An international comparison of 10 national neonatal networks. Pediatrics. 2017; 140(6):e20171264.
  7. Sackey AH, Tagoe LG. Admissions and mortality over a 5-year period in a limited-resource neonatal unit in Ghana. Ghana Med J. 2019; 53(2):117-25.
  8. Chow S, Chow R, Popovice M, Lam M, Popovic M, Merrick J, et al. A selected review of the mortality rates of neonatal intensive care units. Front Public Health. 2015; 3:1-18.
  9. http://sbmu.ac.ir/uploads/IPMSS_Forms_1391.Green.pdf
  10. Sankaran K, Chien LY, Walker R, Seshia M, Ohlsson A. Variations mortality rate among Canadian neonatal intensive care unit. CMAJ. 2002; 166(2):173-8
  11. Feng Y, Abdel–Latif ME, Bajuk B, Lui K, Oei JL. Causes of death in infants admitted to Australian neonatal intensive care units between 1995 and 2006. Acta Paediatr. 2013; 102(1):17-23.
  12. Boskabadi H, Parvini Z, Barati T, Moudi A. Study of the causes and predisposing factors in neonatal mortality in Gaem Hospital (March 2009 to May 2010). Iran J Obstet Gynecol Infertil. 2017; 14(7): 6-14.
  13. Mohammadi M, Vaisi-Raygani A, Jalali R, Ghobadi A, Salari N, Hemmati M. Systematic review of the prevalence of neonatal mortality in the intensive care unit of hospitals in Iran. Tehran Univ Med J. 2019; 77(9):539-47
  14. MacDorman MF, Declercq E, Menacker F, Malloy MH. Infant and neonatal mortality for primary cesarean and vaginal births to women with “no indicated risk,” United States, 1998–2001 birth cohorts. Birth. 2006; 33(3):175-82.
  15. Oshvandi K, Soori E, Zamanian L. The rate and causes of neonatal mortality in Hamadan province, 2012. Avicenna J Nurs Midwifery care. 2016; 24(4):281-300.
  16. Bijari B, Niknafs P, Maddahiyan S. Causes of neonatal mortality in Kerman province in 1387- (2008-2009). Stud Med Sci. 2012; 22 (6):501-6.
  17. Gharavi AG, Shoraka HR, Sofizadeh A, Eimani Katuli H. Neonatal mortality risk factors in Maraveh Tapeh County in Golestan province, north of Iran (2011-13). J Gorgan Univ Med Sci. 2016; 18(1):86-93.
  18. Aref Nejad M, Jaberi N, Khalili Pour E, Isfahani P. Survey of neonatal mortality in NICU in Amiralmomenin Hospital of Zabol University of Medical Sciences in 2014: A Short Report. J. Rafsanjan Univ Med Sci Health Serv. 2016; 15(1):91-8.
  19. Shirvani F, Khosroshahi N. A survey of frequency and causes of perinatal mortality in Tehran, 1995. Tehran Univ Med J. 1998; 56 (1):69-73.
  20. Javanmardi Z, Beygi M, Ghoddousi A. study of infant mortality rate in hospitals in Isfahan province. Syst Nashriat Pezashki Iran. 2008; 15(4):229-33
  21. Kumar D, Verna A, Sehgal VK. Neonatal mortality
    in India. Rural Remote Health. 2007; 7(4):1-2.