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

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 36(6/7) 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.