THE MORBIDITY AND MORTALITY PATTERNS OF PRETERM INFANTS AT A TERTIARY CARE HOSPITAL IN PESHAWAR: A MEDICAL RECORD REVIEW
Introduction: The numbers of premature deliveries in developing countries are still a great problem despite of advancement
in medical field including advancement in prenatal and neonatal care. The preterm babies are at high risk
of mortality and morbidity mainly due to various factors, which varies from region to region and country to countries.
Although government have given due emphasis on maternal and child health however little is known about mortality
and morbidity of preterm children in tertiary care hospitals especially in Peshawar. This study aims to mortality and
morbidity spectrum among preterm neonate presented in Khyber Teaching Hospital, Peshawar, Pakistan during five
months in 2014-2015.
Methods: The cross-sectional study is based on retrospective data collection (hospital records) carried out at Khyber
Teaching Hospital (KTH) between recruited data of September 2014 to February 2015. Data for all premature infants,
admitted to the unit during this period, was included, reviewed and recorded in the check list. Data were analyzed using
SPSS version 20 and appropriate statistical measure were applied accordingly
Results: A total of 2103 neonates were admitted to the unit during the period, of which 605 (28.8%) were premature,
with a male to female ratio of 1.9:1. Most (41%) of admissions were with prematurity / low birth weight (no specific diagnosis
established), followed by neonatal sepsis (28%), neonatal jaundice (11.6%) and Respiratory distress syndrome
(9.3%). Only 45% of the admitted babies were those born at KTH rest were brought from home or other hospitals (public
or private). The mean stay in the unit was 3.5 days while the mortality rate was 29%, with a higher rate amongst those
babies who were born at home compared to health care centers including KTH. The mortality rate among those with
birth weight of less than 1000g was high (69.6%) compared to neonate with birth weight of 1000-1499g (40.3%) while
it was 24.5% for those between 1500-2499g. Regarding case specific it was high (41%) amongst babies with highest
for Respiratory Distress Syndrome, followed by 32.4% for Neonatal sepsis, 31.2% for prematurity/ low birth weight,
18.2% for hypoxic ischemic encephalopathy.
Conclusion: Preterm mortality and morbidity in KTH was alarming, mainly due to Respiratory Distress Syndrome,
infections (neonatal sepsis) and complications of prematurity. The study highlights the need for formulation of comprehensive
strategy and more research specially focusing on the care of preterm infants with very low birth and extremely
low birth weights, respiratory distress syndrome and neonatal sepsis.
Keywords: Preterm infants, Premature, Respiratory Distress syndrome, Mortality, Outcomes, Morbidity, low birth weight,