Association of Family Income with the Clinical Profile and Health Outcomes of Neonates Admitted to the Neonatal Intensive Care Units in Galle, Sri Lanka

Abstract

Background: Socio-economic factors, especially family income significantly impacts on neonatal health outcomes worldwide. Low-income families face barriers to receive quality neonatal care, leading to disparities in their health outcomes. In Sri Lanka, relationship between family income and neonatal care or health outcomes remains inadequately studied, highlighting the need for more focused studies in this area. Objective: To determine the association of family income with the clinical profile and health outcomes of neonates admitted to the Neonatal Intensive Care Unit (NICU)s of selected hospitals in Galle, Sri Lanka Methods: A cross-sectional study was conducted among conveniently selected 104 neonates admitted to selected NICUs in Galle, using a data collection guide. Data on family income (low, middle, high), clinical profile (gestational age, mode of delivery, intrauterine growth restriction, NICU stay, antibiotic usage), and health outcomes (feeding status, developmental milestones) were collected through hospital records. Descriptive statistics and Chi-square test were used for data analysis. Results: The majority were preterm (67.3%), with a mean±SD gestational age of 34±3.7 weeks, and 75% were delivered via cesarean section. Among the neonates, 41.3% belonged to low, 48.1% to middle and 10.6% to high levels of family income. The majority of neonates (51.9%) had a NICU stay of less than seven days and 90.4% received antibiotics. At discharge, most neonates were breastfed (97.1%), sucked orally (63.5%) and most achieved development milestones: cognitive (92.3%), motor (95.2%), psychosocial (94.2%), and communication (91.4%). No significant associations were found between family income, and gestational age (p=0.621), mode of delivery (p=0.298), intrauterine growth restriction (p=0.392), NICU stay (p=0.806), antibiotic usage (p=0.829), feeding type (p=0.607), developmental milestones: cognitive (p=0.153), motor (p=0.524), psychosocial (p=0.846), communication (p=0.465) at discharge. Conclusion: There is no significant association between family income and clinical profile or health outcomes of neonates. The findings indicate that neonatal critical healthcare in the studied NICUs in Sri Lanka is equitably accessible, irrespective of family income.