Publication:

Mortality and major morbidity profile of extremely preterm newborns at a tertiary level neonatal intensive care unit in Western India

Background Extremely premature newborns are at highest risk of mortality and long-term morbidities. A few studies were conducted on the outcomes of extreme preterm newborns in developing countries like India.

Methods This retro prospective observational study was done at neonatal intensive care unit of Deenanath Mangeshkar hospital, Pune, a tertiary care hospital in Maharashtra. Study included all extremely preterm newborns over a period of 32 months.

Results Among 64 eligible newborns, overall mortality rate was 35.9%. Overall survival to discharge among study population was 53.1%. Survival to discharge increased with advancing gestational age:20 % at 23 weeks, 12.5% at 24 weeks, 37.5% at 25 weeks, 46.7% at 26 weeks, 81.5% at 27 weeks of gestational age. 90.6% newborns had any 1 major morbidity and 17.4% newborns survived without any major morbidity. The major morbidities in this study were 60.9% moderate -severe BPD, 9.4% PVL,4.7% severe IVH ,1.6% definite NEC, 45.3 % sepsis, 1.6 % severe ROP. Other morbidities such as RDS (95%), Apnoea of prematurity (83%), Anaemia of prematurity (69%), HsPDA (56%) and SIP (11%) were also observed. The survival rate was observed more among intramural newborns as compared to extramural newborns.

Conclusions The mortality and morbidities of extreme preterm newborn are still higher. Survival increases with advancing gestational age. Knowing the outcome of extremely preterm newborns guides in clinical decision making, framing resuscitation guidelines, standard protocols as well as in parent counselling.