MORBIDITY AND MORTALITY OF EXTREMELY LOW BIRTH WEIGHT BABIES IN A TERTIARY CARE CENTRE IN EASTERN INDIA

Abstract

Background: Being born preterm increases the risk of both morbidity and mortality but with improved care the chances of survival is increasing.\nThe age of viability was earlier de\uf001ned at 28weeks but in the best of centres it has now come down to 25weeks. Extremely low birth weight\n(ELBW) babies who weigh less than 1000gms are particularly at risk of dying with the overall mortality in this group ranging from 30% to 50 % in\nthe best of centres. This study was conducted to \uf001nd out the immediate outcome of extremely low birth weight babies born in a tertiary care centre,\nof a resource poor country like India.\nObjective:To evaluate the immediate morbidity and mortality of Extremely Low Birth Weight Babies in the NICU setup of a tertiary care hospital.\nStudy Design:Retrospective Observational Cohort Study\nPlace of Study: Department of Paediatrics, Ramakrishna Mission Seva Pratishthan, Vivekananda Institute of Medical Sciences, Kolkata, India\nPeriod of Study:January 2018 to December 2020\nMethods: The study was a retrospective analysis of data of babies born with a birth weight of less than 1000gms and admitted to the Neonatal\nIntensive care unit of Ramakrishna Mission Seva Pratishthan. The maternal demographic pro\uf001le and delivery outcome were recorded along with\nthe neonatal morbidity and mortality in a predesigned proforma. These data were then pooled and analysed.\nResults: The total number of ELBW babies born during this period was 31 out of whom 15 succumbed(48%). The studies in the developed world\ntoo shows the mortality in this group to range between 30 to 50 %. Most of the deaths occurred in the \uf001rst few days of life due to birth asphyxia. The\ncommonest morbidity was Respiratory Distress Syndrome (RDS) (71%), followed by sepsis (64.5%), anemia (54.8%) and hyperbilirubinemia\n(51.6%). Necrotising Enterocolitis (NEC) was found in 9.7% of babies. 16 babies (52%) survived and went home in a stable condition. Retinopathy\nOf Prematurity (ROP) was detected in 11 of these babies for whom laser therapy was done with the advise for follow up.\nConclusion: This study shows that in a resource poor country like India too, the percentage of babies who can be salvaged amongst the extremely\nlow birth weight babies, matches with those in the developed countries, though a question remains about their long term morbidity