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Predictors of Mortality in Neonatal Pneumonia: An INCLEN Childhood Pneumonia Study

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Abstract

Background

Neonatal pneumonia contributes significantly to mortality due to pneumonia in the under-five age group, but the predictors of mortality are largely unknown.

Objective

To evaluate the clinical and microbiological characteristics and other risk factors that predict mortality in neonates admitted with pneumonia in tertiary care centres.

Study design

Prospective observational cohort study.

Participants

Term and preterm (32 weeks to 366/7 weeks) neonates (<28 days of life) admitted with clinical and radiological features suggestive of pneumonia.

Intervention

Baseline sociodemographic data, clinical details, blood culture and nasopharyngeal swabs for virologic assay (RT PCR for RSV, Influenza) were collected at admission and the neonates were observed throughout their hospital stay.

Outcome

The primary outcome was predictors of mortality in neonatal pneumonia.

Results

Five hundred neonates were enrolled in the study. Out of 476 neonates with known outcomes, 39 (8.2%) died. On multivariate analysis, blood culture positive sepsis was independently associated with mortality (adjusted OR 2.51, 95% CI1.23 to 5.11; P-0.01).

Conclusion

Neonates with blood culture positive pneumonia positive are at a higher risk of death.

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Acknowledgements

Technical advisory group constituting Prof Dr Lalitha Krishnan, Prof Dr Siddharth Ramji and Prof Dr Ramesh Agarwal for their critical appraisal of the project and for providing technical guidance. INCLEN, especially Dr Manoj K Das, for providing continuous technical and logistic support for the study. Dr Murali Reddy and his team from Beyond P value for providing statistical assistance. We also thank the project coordinator Mrs. Pavani Soujanya for supervising and coordinating the project, and also analyzing the viral isolates.

Funding

Funding: This work was supported by Bill and Melinda Gates Foundation through The INCLEN Trust International (Grant number: OPP1084307). The funding source had no contribution in study design, implementation, collection and interpretation of data and report writing. Competing interests: None stated.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Institute of Child Health, Niloufer Hospital, Osmania Medical College, Hyderabad, Telangana, India

    C. Suresh Kumar

  2. Department of Pediatrics, Gandhi Hospital and Medical College, Hyderabad, Telangana, India

    J. V. Rao & Srikanth Bhat

  3. Department of Neonatology, Paramitha and NeoBBC Children Hospital, Hyderabad, Telangana, India

    Sreeram Subramanian

  4. Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India

    Srinivas Murki

  5. Department of Neonatology, Niloufer Hospital and Osmania Medical College, Hyderabad, Telangana, India

    Himabindu Singh, Alimelu Madireddy, Swapna Lingaldinna & Bharadwaj Namala

  6. Department of Microbiology, Osmania Medical College and SRRIT&CD, Hyderabad, Telangana, India

    Meera Bai & Sarguna Penagaram

  7. Department of Microbiology, Fernandez Hospital, Hyderabad, Telangana, India

    Nirupama Padmaja Bondili

Authors
  1. C. Suresh Kumar
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  2. Sreeram Subramanian
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  3. Srinivas Murki
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  4. J. V. Rao
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  5. Meera Bai
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  7. Himabindu Singh
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  8. Nirupama Padmaja Bondili
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  9. Alimelu Madireddy
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  10. Swapna Lingaldinna
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  11. Srikanth Bhat
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  12. Bharadwaj Namala
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Contributions

SK, SS, SM, JVR, MB: involved in the concep-tion, design of the project; SK,SS,SM were also involved in data analysis, drafting of manuscript; MB, SP, NPB: designed and conducted the microbiological aspects of the study; HS, AM, SL, SB, BN: involved in case enrolment and supervision. All the authors were involved in critical appraisal and have reviewed and approved the manuscript.

Corresponding author

Correspondence to Sreeram Subramanian.

Ethics declarations

(i) Ethics committee of Osmania medical college, Hyderabad; Reg No ECR/300/Inst/AP/2013 Date of approval June 23, 2015; (ii) Ethics committee of Gandhi Medical college, Hyderabad, ECR/180/Inst/AP/2013- October 13, 2015; and (iii) Ethics committee of Fernandez hospital, Hyderabad; ECR/933/Inst/TG/2017 — December 09, 2015.

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Kumar, C.S., Subramanian, S., Murki, S. et al. Predictors of Mortality in Neonatal Pneumonia: An INCLEN Childhood Pneumonia Study. Indian Pediatr 58, 1040–1045 (2021). https://doi.org/10.1007/s13312-021-2370-8

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  • DOI: https://doi.org/10.1007/s13312-021-2370-8

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