NEONATAL MORTALITY AND NEURODEVELOPMENTAL OUTCOME OF VERY LOW BIRTH WEIGHT (VLBW) NEWBORNS ATTENDING A RURAL TERTIARY CARE HOSPITAL, PREDICTED BY CLINICAL RISK INDEX FOR BABIES SCORE II (CRIBS II)
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 19
Abstract
BACKGROUND Mortality and various neuro-developmental sequelae among very low birth weight babies (VLBW) are a common problem in Indian scenario. Most of them are delayed diagnosed and there is no enough research work available regarding magnitude and pattern of disability in Indian scenario. Data which is available from developed countries is not reflecting the real picture of developing countries. In contrast to western population, our hands are bound by various problems including poor nutrition of mother during antenatal period, anaemia, poor hygiene, infection, unhealthy environment and inadequate health-care infrastructure. Several studies have reported high incidence of growth failure and poor neurological outcome during infancy and childhood. There have been a few studies from India, reporting growth and neurodevelopment of low birth weight infants. We wanted to assess the efficacy of CRIBS II as a tool for assessing the mortality and long-term neuro-developmental outcome of VLBW babies. METHODS This prospective cohort study included 143 VLBW babies admitted in Sick New Born Care Unit (SNCU) of North Bengal Medical College & Hospital, Darjeeling, West Bengal from June 2016 to August 2017 and discharged babies were followed up. RESULTS A total of 143 neonates were studied at SNCU. Among them, 82 (57.3%) were male and 61(42.7%) were female. Birth weight ranged from 500 to 1500 grams with a mean of 1199.6 ±244.14 and the median was 1240 gm. CRIB II score ranged from 1-18 with mean of 8.021±3.883, and median of 7.73.4 %. 105 out of 143 were discharged alive. Significant positive correlations were found among birth weight, gestational age, temperature, excess base, and progressive increase in mortality with increasing CRIB II score (p<0.001). Adverse neonatal outcome associated with CRIB II score ≥ 10. Cut off value of CRIB II score (>10) at which maximum sensitivity of 97.5% and specificity of 50% is 9.5 for predicting mortality of VLBW babies. The value under the ROC curve was 0.986 (95 % CI: 0.000 – 1.000) with a standard error of 0.0029. CONCLUSIONS CRIB II score was found to be a very good tool for VLBW babies with regard to mortality and neuro-developmental assessment. It is easily applicable and can replace the traditional models as a predictor of neonatal outcome.
Authors and Affiliations
Kausik Patra, Balai Chandra Karmakar
Keywords
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- EP ID EP617251
- DOI 10.14260/jemds/2019/338
- Views 89
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