Investigating the effects of the neonatal factors and therapeutic modalities on neonatal mortality in neonatal intensive care unit of Shahid Motahhari Hospital, Urmia

Abstract

ABSTRACT

Background: A newborn is highly fragile whose death can be caused by embryonic, intra partum, and postpartum factors. Identifying the causes of death is the first step to be taken in order to decrease the death rate. The present study was aimed at finding out how neonatal factors and therapeutic actions affect death of newborn babies.

Materials and Methods: This is a case-control study where the case group included 250 dead neonates who were hospitalized in the neonatal intensive care unit during 2007-2009. The control group also included 250 newborn neonates who were hospitalized in the same unit and were discharged alive and healthy after they were treated appropriately. Researcher-designed questionnaires including demographic characteristics of mothers and infants, causes of hospitalization, treatment and its complications, and causes of death were used to collect the required data. Chi-square test, odds ratio (OR), and logistic regression were applied to analyze how the variables were related. P < 0.05 were considered signifi cant. Statistical analyses were carried out using software SPSS 16.0.

Results: The results of advanced logistic regression model showed that fi rst-minute Apgar less than 6 (OR = 4.02), existence of birth asphyxia (OR = 6.16), hyaline membrane disease (OR = 4.08), and sepsis (OR = 6.42) increased the death rate of neonates hospitalized in the intensive care unit, and applying nasal continuous positive airway pressure and multiparity decreased the death rate of newborn babies. There was no signifi cant correlation between variables such as low birth weight, consanguinity, blood group, pr eterm labor history, and baby’s gender, and the death rate of neonates.

Conclusions: The results of the study show that factors such as low Apgar score, asphyxia, hyaline membrane disease, sepsis, prematurity and congenital anomalies, and method of delivery have a positive effect on the death of neonates. They also prove that suitable management and carrying out appropriate therapeutic actions and intensive care decrease the death rate of newborn babies.

Key words: Case-control study, intensive care unit, neonatal death, neonatal factors, therapeutic care