Journal of Family Medicine and Primary Care (Feb 2023)
Newborn care in Northern India: A study of regional and seasonal peculiarities for desired professionalism and definitive practices
Abstract
Introduction: Improvements in newborn health with study of present status, progressive perfection of practices, and data diligence for future is desirable. Methods: Study of mortality and morbidity patterns. Analyze findings for focus areas and for favourable advancements in practices. Corroborate with existing evidence and practice protocols. Setting: Tertiary care referral hospital. Protocols: Preterm babies given special attention. This includes, in addition to the WHO 10 main recommendations, meticulous monitoring and health education for care. Neonatal jaundice evaluation on the basis of risk factors and clinical monitoring. Results: A total of 1749 live, born babies (2018–2020) were studied. The neonatal mortality rate in the study was 6.29. Preterm births were 102 (5.83%), with mortality of 7.84%, that is, 8 out of 102 preterm babies, and overall 4.57 premature deaths per 1000 live births. Prematurity was the commonest cause of mortality, responsible for 8 out of 11 deaths (72.73%). Birth asphyxia incidence was 5.26% (92 babies) with a case fatality ratio of 4.35%. Newborns with severe birth asphyxia were 7, and of these 4 (all premature) had fatal outcome. The low birthweight (LBW) incidence was 13.32% with the majority (79.83%) in the 2000–2499 g range. Preventive practices for hypothermia were 100% successful. An unusual rise in incidence and severity of hyperbilirubinemia during December 2018 to February 2019 when winter was severe was noted. Conclusion: Mortality reduction requires focusing on prematurity. Meticulous monitoring and health education for them improves results. The unusual rise in incidence and severity of hyperbilirubinemia in severe winter points towards the need for vigilance. We need to be forewarned and forearmed for frequent extreme weather events.
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