Bhatia Bd

Neonatal mortality pattern in rural based medical college hospital

The present study was undertaken to establish priorities in neonatal care and to find out neonatal mortality pattern in a rural based medical college hospital. One hundred and twentythree neonatal deaths out of 1461 live births constituted the study material. The neonatal mortality rate was 84.2/1000 live births. The mortality in preterm, full term and post term infants was 43.13,4.02,7.02 percent respectively (p<0.001). The mortality in relation to birth weight was 100 percent (<1000 g); 71.43 percent (1000–1499 g); 37.14 percent (1500–1999 g); 7.63 percent (2000–2499 g) and 2.94 percent (>2500 g). Almost 70 percent of all deaths were because of severe birth anoxia and septicemia (including meningitis) either alone or in combination.

A study of perinatal mortality rate from rural based Medical College Hospital

The present study conducted in a rural medical college aimed at analysing the perinatal mortality and its determinants in a rural set up. Fiftyeight still births and sixty two early neonatal deaths among 1107 consecutive deliveries gave a perinatal mortality rate of 108.4 per 1000 deliveries. Fifty percent of the total deliveries were unbooked. The perinatal mortality was higher in unbooked cases (16.3%), twins (33.2%) and preterms (33.9%) as compared to that in booked cases (5.3%), singletons (9.6%) and term deliveries (6.7%). Sixty nine percent of the still births were due to causes like obstructed labour, toxemia of pregnancy, antepartum hemorrhage, hand prolapse, and cord prolapse where timely intervention would have reduced the perinatal mortality significantly. Early neonatal deaths were mainly associated with prematurity and were largely due to birth anoxia, intraventricular hemorrhage, aspiration and infections.

Fetal growth: relationship with maternal anthropometery, hemoglobin and serum albumin status

Three hundred fortyone primiparous mothers in the age group of 20 to 28 yr were subjected to anthropometery (weight, height and head circumference), hemoglobin and serum albumin estimations. Their offsprings were weighed at birth and birth weight was studied in relation to these maternal variables. The means for birth weight increased with increase in maternal weight, height, head circumference, hemoglobin and serum albumin levels. The subgroups of maternal weight, height and hemoglobin explained almost equal per cent variation in birth weight. Subgroups of gestation explained maximum per cent variation in birth weight. High degree of correlation (p<0.001) persisted between birth weight and maternal weight, height, head circumference and hemoglobin levels even after controlling gestation. The partial correlation coefficient value(r) between birth weight and serum albumin levels fell down considerably when gestation was controlled (p<0.05). Orthogonal polynomial equations were derived between birth weight(y) and maternal variables using coefficients of determination (R2) value of suitable degree.

G6PD deficiency in newborn infants

Five hundred consecutive newborns were screened for erythrocytic G6PD deficiency in cord blood. The overall incidence of G6PD deficiency was found to be 2.80 percent. The incidence of G6PD deficiency was higher among males (3.77%) compared to females (1.44%). The incidence of erythrocytic G6PD deficiency was higher in Muslims (16.67%) compared to Hindus (2.63%). No definite relationship of erythrocytic G6PD deficiency was observed with consanguinity. Fifty per cent mothers of G6PD deficient newborns were also found to be G6PD deficient. Among brothers and sisters of G6PD deficient children the incidence of G6PD deficiency was 50.00 and 9.10 per cent respectively. There was no significant difference in the incidence of hyperbilirubinemia between erythrocytic G6PD deficient and non deficient newborns.

Neonatal infections: I—Maternal and cord serum IgG levels in relation to gestation and intrauterine growth

Fifty low birth weight babies (both preterms and intrauterine growth retarded) and their mothers were the subjects of the study. Ten fullterm babies weighing more than 3.0 kg and their mothers served as controls. The cord serum IgG levels were significantly lower in preterm babies compared to fullterm appropriate for gestational age (FT-AGA) and fullterm intrauterine growth retarded (FT-IUGR) babies. The cord serum IgG levels were not significantly different between FT-AGA and FT-IUGR babies. The maternal serum IgG levels were significantly higher than the cord serum IgG levels in preterm group whereas in fullterm AGA and IUGR groups cord serum IgG levels were significantly higher then the maternal serum IgG levels. There was no correlation between maternal and cord serum IgG levels. The cord serum IgG levels were significantly correlated with gestation even after controlling birth weight. The correlation between cord serum IgG levels and birth weight disappeared once qestation was controlled.