{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T03:29:32Z","timestamp":1793762972688,"version":"4.6.1"},"reference-count":32,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T00:00:00Z","timestamp":1625529600000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,6,2]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The paucity of specialised care in the peripheral areas of developing countries necessitates the referral of sick neonates to higher centres. Organised interhospital transport services provided by a skilled and well-equipped team can significantly improve the outcome. The present study evaluated the transport characteristics and predictors of mortality among neonates referred to a tertiary care centre in North India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings<\/jats:title>\n                    <jats:p>Tertiary care teaching hospital in North India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>1013 neonates referred from peripheral health units.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Mortality among referred neonates on admission to our centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 1013 enrolled neonates, 83% were transferred through national ambulance services, 13.7% through private hospital ambulances and 3.3% through personal vehicles. Major transfer indications were prematurity (35%), requirement for ventilation (32%), birth asphyxia (28%) and hyperbilirubinaemia (19%). Hypothermia (32.5%, 330 of 1013), shock (19%, 192 of 1013) and requirement for immediate cardiorespiratory support (ICRS) (10.4%, 106 of 1013) on arrival were the major complications observed during transfer. A total of 305 (30.1%, N=1013) deaths occurred. Of these, 52% (n=160) died within 24\u2009hours of arrival. On multivariate logistic analysis, unsupervised pregnancy (&lt;4 antenatal visits; p=0.037), antenatal complications (p&lt;0.001), prematurity \u226430 weeks (p=0.005), shock (p=0.001), hypothermia (p&lt;0.001), requirement for ICRS on arrival (p&lt;0.001), birth asphyxia (p=0.004), travel time &gt;2\u2009hours (p=0.005) and absence of trained staff during transfer (p&lt;0.001) were found to be significant predictors of mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The present study depicts high mortality among infants referred to our centre. Adequate training of peripheral health personnel and availability of pre-referral stabilisation and dedicated interhospital transport teams for sick neonate transfers may prove valuable interventions for improved outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-044625","type":"journal-article","created":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T12:26:37Z","timestamp":1625574397000},"page":"e044625","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Transport characteristics and predictors of mortality among neonates referred to a tertiary care centre in North India: a prospective observational study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7721-5614","authenticated-orcid":false,"given":"Jasbir","family":"Singh","sequence":"first","affiliation":[{"name":"Pediatrics, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India"},{"name":"Pediatrics, Pt BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poonam","family":"Dalal","sequence":"additional","affiliation":[{"name":"Pediatrics, Pt BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geeta","family":"Gathwala","sequence":"additional","affiliation":[{"name":"Pediatrics, Pt BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Rohilla","sequence":"additional","affiliation":[{"name":"Community Medicine, Government Medical College and Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,6]]},"reference":[{"key":"2025121401383055000_11.7.e044625.1","unstructured":"Neonatal Mortality Rate . 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