Evaluation of neonatal mortality in the Last 5 Years in Cukurova University Faculty of Medicine Balcalı Hospital Neonatal Intensive Care Units

Objective: In this study, it is aimed to determine the plans to reduce the mortality rate by examining the causes of mortality of newborns who died in the Neonatal Intensive Care Units of our hospital in 2016-2020. Methods: Infants who were hospitalized between 2016-2020 and died in Çukurova University Faculty of Medicine, Department of Pediatrics, Neonatology Department, Neonatal Intensive Care Units were included in this study. Hospitalization files and epicrisis of infants in the hospital information management system were reviewed retrospectively. Maternal age, consanguinity, sibling death history, premature birth in the mother's previous pregnancies, premature rupture of the membrane, prolonged rupture of the membrane, urinary tract infection, diabetes mellitus, preeclampsia in the mother of the patients, baby's gender, gestational age, mode of delivery, APGAR, SNAPPE II scores, birth weight, presence of resuscitation at birth, meconium aspiration, respiratory distress syndrome, surfactant administration, transient tachypnea of the newborn, central catheter and umbilical catheter presence, intraventricular hemorrhage, presence of oxygen therapy, hypoglycemia, presence of jaundice, nutrition intolerance, time to first feeding, time of total parenteral nutrition, pneumonia, early onset sepsis, presence of hospital care-associated sepsis, blood blood stream infection, ventilator-associated pneumonia, clinical sepsis evaluation, presence of menengitis, presence of hypoxic ischemic encephalopathy, presence of congenital heart disease, presence of metabolic disease, pneumothorax, pulmonary hemorrhage, retinopathy, presence of bronchopulmonary dysplasia presence of patient records detected. Results: Between 2016 and 2020, 282 of 4659 newborns hospitalized in neonatal intensive care units died. The mortality rate during the study period was 6%. Of the infants who died, 164 (58.4%) were male and 118 (41.6%) were female. 230 (81.6%) of the newborns were born by cesarean section and 52 (18.4%) were born by normal vaginal birth. Of the newborns who lost their lives, 239 (84.8%) were born in Balcalı Hospital, and 43 (15.2%) were referred to our hospital from other centers. The mean gestational age of the newborns was 33±6 weeks (21 – 43 weeks); 58.5% (n=165) of the newborns who died were premature. .24.8% (n=70) of newborns were under 28 weeks, 16.3% (n=46) were between 28-316/7 weeks, 6% (n=17) were between 32-336/7 weeks, % 11.3 (n=32) of them were born between 34-366/7 weeks. 41.4% (n=117) of the babies had a gestational week of 37 and above. The mean birth weight of the was 2020±1148 grams (390 - 5370 gr). Of the infants who died, 14 (5%) were less than 500 grams, 74 (26%) were between 500-1000 grams, 29 (10%) were between 1000-1500 grams, 49 (17%) were between 1500-2500 grams, 108 (38.2%) babies were born between 2500-4000 grams, 8 (2.8%) babies were born over 4000 grams. 100 newborns (35.4%) were lost due to prematurity and its complications. Of the newborns in the study, 96 (34%) had congenital heart disease and 47 (16%) had congenital anomalies. 26 (9.2%) had early or nosocomial sepsis, 10 (3.2%) had a history of metabolic disease, 22 (7.8%) had hydrops, 5 (1.7%) had a history of hypoxic ischemic encephalopathy. Conclusion: Neonatal period is a period in which an infant adapts to the outside world. During this period, the problems that the baby may encounter should be defined and treated. For this, well-equipped neonatal intensive care units and experienced and trained personnel to work there are needed. Retrospective analyzes and forward-looking improvements should be continued in terms of innovations and current approaches on unavoidable causes of mortality.