The Neonatal Mortality and Hospitalization Rate among High Risk Neonates who Underwent Home Care Services

Reza Khadiv, Shadi Mirzaeian, Raheleh Toghyani

Abstract


Background: Low birth weight neonates often require intensive care. However, in the absence of resources, Home Care (HC) could replace theoretically the essential health care. HC was presented for high‑risk neonates who were born in 2016 in Isfahan city as a national pilot study. The aims of this study were to evaluate the Neonatal Mortality Rate (NMR) and hospitalization rates in the HRNs who received HC during the neonatal period.

Materials and Methods: In a cohort study without a control group that was performed during 2016–2017, 130 HRNs who received HC in the neonatal period in Isfahan city were evaluated during 1 year. Data about the neonates’ gender, age, birth weight, gestational age, congenital anomalies, cause of death (in terms of prematurity and related problems), and age at death were gathered and analyzed using the Chi‑square test, independent t‑test, Mann–Whitney U test, and multiple linear regression tests.

Results: Out of the 129 HRNs who had received HC and completed a 1‑year follow‑up period, one neonatal death occurred due to multiple anomalies. In this way, the NMR was estimated as 7.75 per 1000 live neonates. In addition, 86 cases (66.66%) were hospitalized for one time in the neonatal period, 10 (6.14%) cases for the second time, and one HRN for the third time for 10 days.

Conclusion: About one‑third of the HRNs who had previously received HC in the neonatal period did not require inpatient care. In addition, the neonatal and infant mortality rates were low.



Keywords


Home care services, infant mortality, low birth weight, neonatal nursing

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References


Caring for the Newborn at Home. World Health Organization. Available from: https://apps.who.int/iris/bitstream/ handle/10665/204273/9789241549295_FacilitatorNotes_eng.pdf; jsessionid=79520B2A8BF08B0817B7525BCBBAA14D?sequen ce=2. [Last accessed on 2019 Aug 27].

Available from: https://childmortality.org/data/Iran%20 (Islamic%20Republic%20of. [Last accessed on 2019 Aug 27].

Sadeghzadeh M, Khoshnevisasl P, Parvaneh M, Mousavinasab N. Early and late outcome of premature newborns with history of NICU admission at 6 years old in Zanjan, Iran. Iran J Child Neurol 2016;10:67-73.

Malak JS, Safdari R, Zeraati H, Nayeri FS. Mohammadzadeh N, Farajollah SS. An age-based architecture for high-risk neonate management at neonatal intensive care unit. Electron Physician 2018;10:6193–200.

Laugier O, Garcia P, Boucékine M, Daguzan A, Tardieu S, Sambuc R, et al. Influence of socioeconomic context on the rehospitalization rates of infants born preterm. J Pediatr 2017;190:174-9.e1.

Kadivar M, Sagheb S, Bavafa F, Moghadam L, Eshrati B. Neonatal mortality risk assessment in NICU. Iran J Ped 2007;17:325-31.

Chen T, Hu Y, Wan X. A retrospective analysis of unplanned hospital readmissions of high-risk neonates in a tertiary hospital. Chin J Practical Nur 2017;33:6-9.

Girgin BA, Cimete G. Rehospitalization of preterm infants according to the discharge risk level. J Spec Pediatr Nurs 2017;22. doi: 10.1111/jspn. 12165.

Gogia S, Sachdev HPS. Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: A systematic review. J Perinatol 2016;36:S55-73.

Hanson C, Manzi F, Mkumbo E, Shirima K, Penfold S, Hill Z, et al. Effectiveness of a home-based counselling strategy on neonatal care. PLoS Med 2015;12:e1001881.

Liu Y, McGowan E, Tucker R, Glasgow L, Kluckman M, Vohr B. Transition home plus program reduces medicaid spending and health care use for high-risk infants admitted to the neonatal intensive care unit for 5 or more days. J Pediatr 2018;200:91-7.e3.

Kirkwood BR, Manu A, Asbroek AH, Soremekun S, Weobong B, Gyan T, et al. Effect of the new hints home-visits intervention on neonatal mortality rate and care practices in Ghana: A cluster randomized controlled trial. Lancet 2013;381:22-8.

Vohr B, McGowan E, Keszler L, Alksninis B, O’Donnell M, Hawes K, et al. Impact of a transition home program on rehospitalization rates of preterm infants. J Pediatr 2017;181:86-92.

Garne K, Brødsgaard A, Zachariassen G, Clemensen J. Telemedicine in neonatal home care: Identifying parental needs. JMIR Res Protoc 2016;5:e100.

Holm KG, Clemensen J, Brødsgaard A, Smith AC, Maastrup R, Zachariassen G. Growth and breastfeeding of preterm infants receiving neonatal tele homecare compared to hospital-based care. J Neonatal Perinatal Med 2019;12:277-84.

Pitt C, Tawiah T, Soremekun S, ten Asbroek AH, Manu A, Tawiah-Agyemang C, et al. Cost and cost-effectiveness of newborn home visits: Findings from the Newhints cluster-randomised controlled trial in rural Ghana. Lancet Global Health 2016;4:45-56.

Kangaroo mother care: A practical guide. Department of Reproductive health and Research. World Health Organization. Geneva 2003. Available from: https://books.google.com/books?hl =en&lr=&id=M2A0DgAAQBAJ&oi=fnd&pg=PP4&dq=Kangaro o+mother+care:+a+practical+guide.+Department+of+Reproducti ve+health+and+Research.+World+Health+Organization.+Geneva .+2003.&ots=NsRpxLnSio&sig=eBfE5iPjLGpIk6BhPUoXGYzP 7Jo#v=onepage&q=Kangaroo%20mother%20care%3A%20a%20 practical%20guide.%20Department%20of%20Reproductive%20 health%20and%20Research.%20World%20Health%20 Organization.%20Geneva.%202003.&f=false. [Last accessed on 2019 Aug 27].

Adamkin DH, Batton DG, Bell EF, Bhutani VK, Denson SE, Martin GI, et al. Hospital discharge of the high-risk neonate. Pediatrics 2008;122:1119-26.

Healthy baby service package. Neonatal Health administration. Office of Population, Family and School Health. Deputy of Health. Iranian Ministry of Health and Medical education. Available from: http://www.sbmu.ac.ir/uploads/nozad1.pdf. [Last accessed on 2021 Apr 10].

Khadivi R, Mirnasiry MS, Fazelian S, Aghababayi-Badi M. The rate and the causes of under-5- year-old children mortality in Isfahan Province, Iran, during the Years 2012-2018. J Isfahan Med Sch 2020;38:469-76.

Honda M, Som R, Seang S, Tung R, Iwamoto A. One-year outcome of high-risk newborn infants discharged from the neonatal care unit of the National Maternal and Child Health Center in Cambodia. Heliyon 2019;5:e01446.

Forouzanfar MH, Sepanlou SG, Shahraz S, Dicker D, Naghavi P, Pourmalek F, et al. Evaluating causes of death and morbidity in Iran, global burden of diseases, injuries, and risk factors study 2010. Arch Iran Med 2014;17:304-20.

Dall’Oglio I, Salvatori G, Bonci E, Nantini B, D’Agostino G, Dotta A. Breastfeeding promotion in neonatal intensive care unit: Impact of a new program toward a BFHI for high‐risk infants. Acta Paediatr 2007;96:1626-31.

Küçükoğlu S, Çelebioğlu A. Effect of natural-feeding education on successful exclusive breast-feeding and breast-feeding self-efficacy of low-birth-weight infants. Iran J Pediatr 2014;24:49-56.

Saber A, Ferdowsi SH, Askari F, Farsi L. The epidemiology of pathologic jaundice between neonates and its relationship with demographic characteristics between neonates in 22th Bahman of Gonabad Hospital. Razi J Med Sci 2013;20:42-8.

Navaei F, Aliabady B, Moghtaderi J, Moghtaderi M, Kelishadi R. Early outcome of preterm infants with birth weight of 1500 g or less and gestational age of 30 weeks or less in Isfahan city, Iran. World J Pediatr 2010;6:228-32.

Basiri B, Esna Ashari F, Shokouhi M, Sabzehei MK. Neonatal mortality and its main determinants in premature infants hospitalized in neonatal intensive care unit in Fatemieh Hospital, Hamadan, Iran. J Compr Ped 2015;6:e26965.

Babaei H, Dehghan M, Mohammadi Pirkashani L. Study of causes of neonatal mortality and its related factors in the neonatal intensive care unit of Imam Reza Hospital in Kermanshah during (2014-2016). Int J Pediatr 2018;6:7641-9.


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