Causes of mortality in a neonatal intensive care unit in Iran: one year data
BACKGROUND Neonatal mortality rate is a major health index. Approximately, 65% of all deaths in the first year of life occur during this 4-week period. The present study was conducted to investigate the mortality rates and causes of death in a neonatal intensive care unit (NICU) in Ahvaz, Iran in a year.
METHODS This cross-sectional study was conducted in the NICU of Sina Hospital in Ahvaz. Medical records were studied, and data from 1,040 newborns admitted to the NICU within one year (March 2016 to March 2017) were collected following a checklist. Of these newborns, 123 died, and their relevant data were collected. Data were analyzed using SPSS, version 20 (SPSS Inc., USA).
RESULTS The mortality rate was 11.82% (123 cases) out of 1,040 newborns admitted to NICU. Most of the newborns (48.8%) died on days 1â7. The causes of death were respiratory distress syndrome (RDS) (34.1%), asphyxia (25.2%), anomalies (10.6%), sepsis (7.3%), intracerebral hemorrhage (8.1%), pulmonary hemorrhage (7.3%), and other causes (6.4%), such as hydrops, severe pneumothorax, severe renal failure, and others.
CONCLUSIONS The mortality rate in the NICU of this center was similar to that in other Iranian provinces. The most common causes of NICU mortality included prematurity and its complications, such as asphyxia and RDS. Thus, a strategic plan for reducing preterm delivery and asphyxia are necessary.
Karimi P, Mahmudi L, Azami M, Badfar Gh. Mortality in Neonatal Intensive Care Units in Iran: A Systematic Review and Meta-Analysis. Iran J Neonatol. 2019;10(3):70-80. https://doi.org/10.22038/IJN.2019.36647.1566
Kamath BD, Macguire ER, McClure EM, Goldenberg RL, Jobe AH. Neonatal mortality from respiratory distress syndrome: lessons for low-resource countries. Pediatrics. 2011;127(6):1139-46. https://doi.org/10.1542/peds.2010-3212
Sridhar PV, Thammanna PS, Sandeep M. Morbidity pattern and hospital outcome of neonates admitted in a tertiary teaching hospital. Int J Sci Study. 2015;3(6):126-9. https://doi.org/10.17354/ijss/2015/407
Heidarnia M A, Abadi A, Fsmaeil Motlagh M, Heidarzadeh M, Habibelahi A, Raji F. Profile of neonatal mortality in Iran in 1391. Tehran Univ Med J. 2016; 74(7):475â82.
Stoll B, Kliegman R. Overview of mortality and morbidity. In: Behrman RE, Kliegman RM, Jenson HB. Nelson textbook of pediatrics. 17th ed. Philadelphia: Saunders; 2004.
Aramesh MR, Malekian A, Dehdashtian M, Shahori A, Monjezi L. Determination of neonatal mortality causes among neonates admitted in NICU at Imam Khomeini Hospital, Ahwaz, 2011-2012. RJMS. 2014;21(120):36-43.
Sareshtedari M, Shahamat H, Sadeghi T. Causes and related factors of neonatal mortality in Qazvin NICU, 2010. Hakim Res J. 2012;14(4):227-32.
Gheibi S, Fakoor Z, Karamyyar M, Khashabi J, Ilkhanizadeh B, Asghari-Sana F, et al. Coagulase negative Staphylococcus; the most common cause of neonatal septicemia in Urmia, Iran. Iran J Pediatr. 2008;18(3):237-43.
Hemmati M, Gheini S. Neonatal mortality rate prevalence in Motazedi Hospital of Kermanshah (2002-2003). J Kermanshah Univ Med Sci. 2006;10(2):e81721.
Jaberi Z, Gholami-Fesharaki M, Rahmati-Najarkolaei F, Saburi A. Mortality rate of one neonatal intensive care unit in Tehran, Iran. J Clin Neonatol. 2013;2(1):52. https://doi.org/10.4103/2249-4847.109252
Chow S, Chow R, Popovic M, Lam M, Popovic M, Merrick J, et al. A selected review of the mortality rates of neonatal intensive care units. Front Public Health. 2015;3:225. https://doi.org/10.3389/fpubh.2015.00225
Battin MR, Knight DB, Kuschel CA, Howie RN. Improvement in mortality of very low birthweight infants and the changing pattern of neonatal mortality: the 50-year experience of one perinatal centre. J Paediatr Child Health. 2012;48(7):596-9. https://doi.org/10.1111/j.1440-1754.2012.02425.x
Simpson CD, Ye XY, Hellmann J, Tomlinson C. Trends in cause-specific mortality at a Canadian outborn NICU. Pediatrics. 2010;126(6):e1538-44. https://doi.org/10.1542/peds.2010-1167
Eventov-Friedman S, Kanevsky H, Bar-Oz B. Neonatal end-of-life care: a single-center NICU experience in Israel over a decade. Pediatrics. 2013;131(6):e1889-96. https://doi.org/10.1542/peds.2012-0981
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, Iran during (2014-2016). Int J Pediatr. 2018;6(5):7641-9. https://doi.org/10.22038/IJP.2017.28212.2441
Javanmardi Z, Marjan Beigi M, Nouhpisheh E. Investigating about the causes of neonates' death in the hospitals of Isfahan Province. Iran J Forensic Med. 2010;15(4):229-33.
Aref Nejad M, Jaberi N, Khalili Pour E, Parveneh I. Survey of neonatal mortality in NICU in Amiralmomenin Hospital of Zabol University of Medical Sciences in 2014: a short report. J Rafsanjan Univ Med Sci Health Serv. 2016;15(1):91-8.
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(3):e26965. https://doi.org/10.17795/compreped-26965
Hoseini BL, Sadati ZM, Rakhshani MH. Assessment of neonatal mortality in the neonatal intensive care unit in Sabzevar City for the period of 2006-2013. Electron Physician. 2015;7(7):1494-9. https://doi.org/10.19082/1494
Fallahi M, Joudaki N, Mohseni Bandpey H. Evaluation of causes of neonatal mortality in Shohadaye Tajrish Hospital, during years 2004-2007. Pajoohande. 2009;14(1):43-6.
Mirzarahimi M, Abedi A, Shahnazi F, Saadati H, Enteshari A. Causes and rate of mortality among the newborns in NICU and newborns unit at Imam Khomeini and Alavi Hospitals in Ardabil from September 2006 to September 2007. J Ardabil Univ Med Sci. 2008;8(4):424-30.
Lee SK, McMillan DD, Ohlsson A, Pendray M, Synnes A, Whyte R, et al. Variations in practice and outcomes in the Canadian NICU network: 1996-1997. Pediatrics. 2000;106(5):1070-9. https://doi.org/10.1542/peds.106.5.1070
Horbar JD, Badger GJ, Lewit EM, Rogowski J, Shiono PH. Hospital and patient characteristics associated with variation in 28-day mortality rates for very low birth weight infants. Vermont Oxford Network. Pediatrics. 1997;99(2):149-56. https://doi.org/10.1542/peds.99.2.149
Kharaghani R, Cheraghi Z, Okhovat Esfahani B, Mohammadian Z, Nooreldinc RS. Prevalence of preeclampsia and eclampsia in Iran. Arch Iran Med. 2016;19(1):64-71. https://doi.org/10.5812/ircmj.40856
Vakilian K, Ranjbaran M, Khorsandi M, Sharafkhani N, Khodadost M. Prevalence of preterm labor in Iran: a systematic review and meta-analysis. Int J Reprod Biomed (Yazd). 2015;13(12):743-8. https://doi.org/10.29252/ijrm.13.12.743
Rahmati S, Azami M, Badfar G, Parizad N, Sayehmiri K. The relationship between maternal anemia during pregnancy with preterm birth: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2019;1-11. https://doi.org/10.1080/14767058.2018.1555811
Rahmati S, Delpishe A, Azami M, Hafezi Ahmadi MR, Sayehmiri K. Maternal anemia during pregnancy and infant low birth weight: a systematic review and meta-analysis. Int J Reprod Biomed (Yazd). 2017;15(3):125-34. https://doi.org/10.29252/ijrm.15.3.125
Parizad Nasirkandy M, Badfar G, Shohani M, Rahmati S, YektaKooshali MH, Abbasalizadeh S, et al. The relation of maternal hypothyroidism and hypothyroxinemia during pregnancy on preterm birth: an updated systematic review and meta-analysis. Int J Reprod Biomed (Yazd). 2017;15(9):543-52. https://doi.org/10.29252/ijrm.15.9.543
Fallahzadeh H, Farajpour Z, Emam Z. Duration and determinants of birth interval in Yazd, Iran: a population study. Int J Reprod Med. 2013;11(5):379-84.
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