Clinical audit of newborn infants admitted in neonatal intensive care unit of a teaching hospital: A retrospective study

Understanding the causes of neonatal intensive care unit admission and their association with the neonatal outcome may help organising better patient care services. The objective was to investigate the causes and outcome of the newborn infants admitted in the neonatal intensive care unit. This was a retrospective study that analysed demographic and clinical data on newborns infants and their mothers obtained from medical records of all the neonatal intensive care unit admissions from 2018-2020. As a result, out of 400 neonatal admissions, majority (61.7%) of the newborn infants were aged <72 hours with male preponderance (63%) and presented with respiratory distress (59%) and jaundice (75%). Almost all outborn infants were found hypothermic on admission. Proportion of the patients presenting at the age of 4 days or more was significantly higher in the infants delivered inborn. Majority of mothers were aged 18-35 years (91.5%), multigravida (55.5%), and had >4 antenatal care visits (57.5%). Overall, a total of 252 (63%) infants recovered, 44 (11%) died and 104 (26%) left against the medical advice. The recovery rate was significantly higher (81.8%) in the inborn infants. Respiratory distress and jaundice in the newborn infants were the common clinical conditions on admission. High rate of left against the medical advice was a cause of concern and needed further studies to find out the actual reasons. The study highlighted the need for early risk identification, improved neonatal transport, targeted maternal care, strategies to reduce cases of leaving against medical advice, and enhanced in-hospital delivery services to improve neonatal outcomes and optimise neonatal intensive care unit