Analysis of trends and patterns in neonatal mortality, A comprehensive audit from SNCU of tertiary care hospital-A Retrospective study

Abstract

This study looks at trends and patterns of the retrospective audit of neonatal mortality
trends and patterns over 8 years (April 2017 to September 2024) in a Special
Newborn Care Unit (SNCU) of a tertiary care hospital. During the study period,
71,366 neonates were admitted, of which 60,798 were live births and 869 were
stillbirths. It shows a regular NMR decline from 2.57% in 2017 down to 2.38% in
2024, pointing out to improvement of neonatal care. Mortality variations between
inborn (12,248 admissions) and outborn (9,255 admissions) neonates are also studied
and found to be higher in outborn neonates because of delayed referrals and critical
conditions at the time of admission. The neonatal mortality seasonally follows trends
suggesting higher mortality in the monsoon months especially in August when there
is a rise in infection incidence. Gender-based mortality analysis revealed that male
neonates contributed to 56.7% of neonatal deaths indicating possible gender-specific
vulnerabilities. Regression analysis showed a significant negative relationship
between higher admissions and mortality rate and a positive relationship between
increased deaths and mortality rate. They show that strengthening referral systems,
upgrading maternal and neonatal care, and controlling seasonal infections will be
necessary to reduce neonatal mortality even further in such settings.