Relationship Between Time and Day of Birth and Neonatal Mortality in Hospitalized Infants in Neonatal Intensive Care Unit in Fatemieh Hospital, Hamadan, Iran
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Background: The neonatal mortality rate is one of the most important indicators of health promotion. However, undoubtedly, the first step to decreasing this indicator is to identify the factors affecting neonatal mortality. Objectives: This study was designed and implemented in order to identify other factors, such as time and day of birth, personnel shift, and work experience, and their relationship with neonatal mortality. Patients and Methods: In this retrospective, cross-sectional study, the medical records of all deceased neonates hospitalized in Fatemieh hospital of Hamadan, during a 5-year period (2006 – 2011) were extracted. A questionnaire including sex, weight, gestational age, time of birth, delivery mode, maternal disease, and leading cause of death was filled out. The information was then analyzed using SPSS 19. Results: In this study, 974 neonatal deaths were registered, among which 57.2% were male. The mean birth weight of neonates was 1.548 g (ranging from 300 – 4.800), and the mean gestational age was 31.2 weeks. The leading causes of death were respiratory distress syndrome (49.6%), septicemia (26.2%), and disseminated intravascular coagulation (4.9%). In terms of the time of death, 63.1% had died during night shifts. The mean length of stay from birth to death was 3.1 and 2.3 days for morning and night shifts, respectively. In terms of the average work experience, the morning shift nursing personnel (seven individuals/shift) had 8.3 years of experience, while the night shift nursing personnel had 4.1 years of experience (five individuals/shift). Conclusions: The mortality rate is higher in neonates born during night shifts and weekends. This is because, in addition to known factors affecting the mortality rate, human factors, such as taking advantage of fewer personnel with less work experience during night shifts, can increase the neonatal mortality rate.