Risk factors associated with increased mortality in neonatal jaundice:
(1) age on admission < 10 days
(2) symptoms for < 5 days on admission
(3) presence of risus sardonicus
(4) fever (level not defined)
Symptoms associated with neonatal tetanus (diagnosis based on >=3 of the following):
(1) failure to suck
(2) spasticity
(3) twitching
(4) trismus
(5) opisthotonus
(6) risus sardonicus
All patients received intensive care, anti-tetanus serum, antibiotics and removal of infected cord stumps.
Neonatal tetanus can be reduced by:
(1) immunizing women who may become pregnant with tetanus toxoid
(2) good hygiene and asepsis during delivery
Limitations:
• Access to health care services may affect when a family brings in a neonate. In the United States a family will often bring in a child within hours of onset, while in a developing country the family may try to care for the child several days before coming to a hospital.
• Diagnosis required 3 or more symptoms. In theory neonatal tetanus could occur with fewer symptoms, but this would probably indicate milder disease.
• Data analysis involved simple risk analysis. Multivariate analysis is not described.
• How the cumulative number of risk factors relates to mortality is not described.
