Maternal, social and health factors influencing admission of newborns to the special newborn care unit at Kakinada, India

Suhasini Vasireddy, G. Krishna Babu, Jhansi Nadipena, Thej Kiran Reddy Dalli, Krishna Kishore Aligina, R. Mahalakshmi, K. Babji


Background: Substantial progress has been made in reducing under five mortality, infant mortality in the last two decades. We need to focus our attention in reducing neonatal mortality.

Methods: Setting and design was observational study in SNCU of Government General Hospital, Kakinada. Data collected using semi-structured questionnaire and Hospital Records of mother and newborn. Analysis was done using MS EXCEL2007 and SPSS 20 software. Sample size and time period was a convenient sample of 300 mothers were interviewed from Jan- June, 2018.

Results: The mean age of the mothers in the study is 23.39±3.195 years and age at marriage is 19.12±2.29 years. 79% of study population belong to lower social classes. Maternal risk factors-35.6 % are pre-obese or obese and 9.3% underweight, 11.3% had <4 antenatal visits, 87.33% (262) had anemia, 18.33% (55) had PIH. The mean birth weight of newborns was 2601±0.93 grams. 58.3% are preterm and 38.3% (115) low birth weight. 46.33% (139) of newborn admissions were due to birth asphyxia, 27.33% (82) jaundice 9.66% (29) convulsions, 6.66% (20) congenital anomalies, 4% (12) sepsis.

Conclusions: Low income, low literacy and less no of antenatal visits showed an association with maternal anemia and LBW (statistically not significant). Upon regression analysis age of mother and gestational period were the only factors with statistical significance.


Maternal factors, Newborn morbidity, Social factors, Special newborn care unit

Full Text:



UNICEF Data: Monitoring the situation of children and women- Neonatal Mortality – March 2018. Available at: child-survival/neonatal-mortality/. Accessed 10 January 2020.

Levels and Trends in Child Mortality Report 2018, Estimates developed by the UN Inter-agency Group for Child Mortality Estimation (UN-IGME - Press Release- UN department of Economic and Social affairs, Population division -

The Situation of Children in India A Profile, United Nations Children’s Fund (UNICEF) May 2011. Available at; Accessed May 2011.

India Newborn Action Plan Ministry of health and family welfare, Government of India, September 2014. Available at: Accessed September 2014.

Partnership for Maternal, Newborn and Child health - WHO Newborn Death and Illness. Available at: Accessed 10 January 2020.

Luo ZC, Wilkins R, Kramer MS. Effect of neighbourhood income and maternal education on birth outcomes: a population-based study. CMAJ. 2006;174(10):1415-20.

Saleem SM. Modified Kuppuswamy socioeconomic scale updated for the year 2019. Ind J Forensic Commun Med. 2019;6(1):1-3.

United Nations. Provisional Guidelines on Standard International Age Classifications. Available at: Accessed 10 January 2020.

Quinn JA, Munoz FM, The Brighton Collaboration Preterm Birth Working Group Preterm Birth: Case definition and guidelines for data collection, analysis, and presentation of immunisation safety data. Vaccine. 2016;34(49):6047-56.

Indian Council of Medical Research. Evaluation of the National Nutritional Anaemia Prophylaxis Programme. Task Force Study: New Delhi: ICMR; 1989. Available at: pubmed/2246014. Accessed on 27 January 2020.

Rakholia R, Rawat V, Bano M, Singh G. Neonatal morbidity and mortality of sick newborns admitted in a teaching hospital of Uttarakhand. Chrism J Health Res. 2014;1(4):228.

Saini N, Chhabra S, Chhabra S, Garg L, Garg N. Pattern of neonatal morbidity and mortality: A prospective study in a District Hospital in Urban India. J Clin Neonatol. 2016;5(3):183.

Radhakrishnan T, Thankappan KR, Vasan RS, Sarma PS. Socioeconomic and demographic factors associated with birth weight: A community-based study in Kerala. Ind Pediatr. 2000;37(8):872-5.

Martinson ML, Reichman NE. Socioeconomic inequalities in low birth weight in the United States, the United Kingdom, Canada, and Australia. Am J Public Health. 2016;106(4):748-54.

Masalin S, Laine MK, Kautiainen H, Gissler M, Raina M, Pennanen P, et al. Impact of maternal height and gestational diabetes mellitus on offspring birthweight. Diabe Res Clin Prac. 2019;148:110-8.

Robinson HE, O’Connell CM, Joseph KS, McLeod NL. Maternal outcomes in pregnancies complicated by obesity. Obstetr Gynecol. 2005;106(6):1357-64.

Tomar GS, Singhal S, Shukla A. Anaemia in pregnancy and its determinants Inter J Medi Health Res. 2017;3(1);5-9.

Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW. Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2013;346:F3443

Bhagat B, Jha D. Maternal hemoglobin concentration in relation to neonatal birth weight. IAIM. 2017;4(7):67-73.

Levy A, Fraser D, Katz M, Mazor M, Sheiner E. Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. Eur J Obstetr Gynecol Reprod Biol. 2005;122(2):182-6.

Anitha CJ, Nair MK, Rajamohanan K, Nair SM, Shenoy KT, Narendranathan M. Predictors of birthweight-a cross sectional study. Ind Pediatr. 2009;46:59-62.

Garcia R, Ali N, Guppy A, Griffiths M, Randhawa G. Differences in the pregnancy gestation period and mean birth weights in infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK: a retrospective analysis of routinely collected data. BMJ Open. 2017 Aug 1;7(8):e017139.

Fischer C, Rybakowski C, Ferdynus C, Sagot P, Gouyon JB. A population-based study of meconium aspiration syndrome in neonates born between 37 and 43 weeks of gestation. Inter J Pediatr. 2011;2012.

Kalteren WS, ter Horst HJ, den Heijer AE, de Vetten L, Kooi EM, Bos AF. Perinatal anemia is associated with neonatal and neurodevelopmental outcomes in infants with moderate to severe perinatal asphyxia. Neonatol. 2018;114(4):315-22.