scholarly journals Neonatal death in India: Birth order in a context of maternal undernutrition

2021 ◽  
Author(s):  
Diane Coffey ◽  
Dean Spears
Keyword(s):  
Developing Countries ◽  
Birth Order ◽  
Neonatal Mortality ◽  
Body Mass ◽  
Neonatal Death ◽  
Mass Range ◽  
High Rate ◽  
Maternal Undernutrition ◽  
High Prevalence ◽  
Indian Mothers

Abstract We document a novel fact about neonatal death, or death in the first month of life. Globally, neonatal mortality is disproportionately concentrated in India. We identify a large effect of birth order on neonatal mortality that is unique to India: later-born siblings have a steep survival advantage relative to the birth order gradient in other developing countries. We show that India’s high prevalence of maternal undernutrition and its correlation with age and childbearing can explain this pattern. We find that Indian mothers exit the underweight body mass range at an internationally comparatively high rate as they progress through childbearing careers.

scholarly journals Determinants of neonatal mortality in the largest international border of Brazil: a case-control study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Suzana de Souza ◽  
Etienne Duim ◽  
Fernando Kenji Nampo
Keyword(s):  
Neonatal Mortality ◽  
Neonatal Death ◽  
Case Control Study ◽  
Case Control ◽  
High Rate ◽  
Mortality Data ◽  
Sociodemographic Characteristics ◽  
Factors Associated ◽  
International Border ◽  
Control Study

Abstract Background Foz do Iguassu is a Brazilian municipality located in the most populous international border of the country and provides medical care to foreigners. Neonatal mortality in the city is higher than Brazil’s average and corresponds to 61% of all deaths in children under five. The current study aimed to identify the determinants of neonatal mortality in Foz do Iguassu. Methods In this case-control study, we analyzed all neonatal deaths occurred in Foz do Iguassu from 2012 to 2016. Birth and mortality data were extracted from two national governmental databases (SINASC and SIM). We extracted data on (i) maternal sociodemographic characteristics, (ii) pregnancy care, and (iii) newborn characteristics. Multiple logistic regression with the conceptual framework was applied to examine the factors associated with neonatal mortality. Results Most of the deaths occurred in the early neonatal period (65.9%). The factors associated with neonatal death were fetal congenital anomaly (OR 22.49; CI 95% 7.44–67.95; p = < 0.001); low birth weight (OR 17.15; CI 95% 8.56–34.37; p = < 0.001), first minute Apgar score under 7 (OR 15.60; CI 95% 8.23–29.67; p = < 0.001); zero to 3 prenatal appointments (OR 3.34; CI 95% 1.28–8.73; p = 0.014) and prematurity (OR 3.60; CI 95% 1.87–7.11; p = < 0.001). Conclusion The high rate of neonatal death in Foz do Iguassu is strongly associated with newborn characteristics and not associated with maternal sociodemographic characteristics. Thus, the health services in the Brazilian side of this international borders should be aware of the quality of the prenatal care and childbirth attention provided.

scholarly journals Determinants Of Neonatal Mortality In The Largest International Border Of Brazil: A Case-Control Study

2019 ◽  
Author(s):  
Suzana de Souza ◽  
Etienne Larissa Duim ◽  
Fernando Kenji Nampo
Keyword(s):  
Neonatal Mortality ◽  
Neonatal Death ◽  
Case Control Study ◽  
Case Control ◽  
High Rate ◽  
Mortality Data ◽  
Sociodemographic Characteristics ◽  
Factors Associated ◽  
International Border ◽  
Control Study

Abstract BACKGROUND: Foz do Iguassu is a Brazilian municipality located in the most populous international border of the country and provides medical care to foreigners. Neonatal mortality in the city is higher than Brazil’s average and corresponds to 61% of all deaths in children under five. The current study aimed to identify the determinants of neonatal mortality in Foz do Iguassu. METHODS: In this case-control study, we analyzed all neonatal deaths occurred in Foz do Iguassu from 2012 to 2016. Birth and mortality data were extracted from two national governmental databases (SINASC and SIM). We extracted data on (i) maternal sociodemographic characteristics, (ii) pregnancy care, and (iii) newborn characteristics. Multiple logistic regression with the conceptual framework was applied to examine the factors associated with neonatal mortality. RESULTS : Most of the deaths occurred in the early neonatal period (65.9%). The factors associated with neonatal death were fetal congenital anomaly (OR 22.49; CI 95% 7.44-67.95; p = <0.001); low birth weight (OR 17.15; CI 95% 8.56-34.37; p = <0.001), first minute Apgar score under 7 (OR 15.60; CI 95% 8.23- 29.67; p = <0.001); zero to 3 prenatal appointments (OR 3.34; CI 95% 1.28-8.73; p = 0.014) and prematurity (OR 3.60; CI 95% 1.87‑7.11; p = <0.001). CONCLUSION : The high rate of neonatal death in Foz do Iguassu is strongly associated with newborn characteristics and not associated with maternal sociodemographic characteristics. Thus, the health services in the Brazilian side of this international borders should be aware of the quality of the prenatal care and childbirth attention provided.

scholarly journals Survival analysis of neonatal mortality in Ghana using three population-based surveys

2022 ◽  
Vol 80 (1) ◽  
Author(s):  
David Teye Doku
Keyword(s):  
Risk Factors ◽  
Birth Order ◽  
Neonatal Mortality ◽  
Neonatal Death ◽  
Neonatal Period ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Geographical Regions ◽  
Demographic Risk ◽  
Demographic Risk Factors

Abstract Background Neonatal mortality in many low-and middle-income countries (LMICs) remains high despite global efforts at addressing this challenge. Tackling neonatal death in LMICs is further complicated by lack of reliable data from individual countries in the region to inform effective context specific interventions. This study investigates the probability of neonatal survival and socio-demographic risk factors of neonatal mortality in Ghana. Methods Pooled data from three population-based surveys (N = 12,148) were analysed using multivariable Cox Proportional Hazards regression models. Results The risk of dying within the first 28 days of life was highest in the first week of life (early neonatal period), it then decreases sharply around the middle of the second week of life and remains low over the late neonatal period. Adjusted hazard ratios (HRs) showed that: rural residency (HR = 1.80, 95% CI: 1.15-2.75); birth order 2-3 (HR = 1.63, 95% CI: 1.10-2.42); birth order ≥7 (HR = 1.89, 95% CI: 1.07-3.33) increased the risk of neonatal death. Additionally, children born to women who were obese had higher risk of neonatal death (HR = 1.69, CI: 1.12-2.56) compared with those of women with optimal weight. Disparities in the risk of neonatal death by geographical regions were also found. Conclusion The risk of neonatal mortality is highest during the first week of life and it is socio-demographically patterned. The findings emphasise the need to tackle socio-demographic risk factors of neonatal mortality in order to achieve the Sustainable Development Goal 3, which is aimed at reducing neonatal mortality to 12 per 1000 live births by the year 2030.

scholarly journals Determinants Of Neonatal Mortality In The Largest International Border Of Brazil: A Case-Control Study

2019 ◽  
Author(s):  
Suzana de Souza ◽  
Etienne Larissa Duim ◽  
Fernando Kenji Nampo
Keyword(s):  
Neonatal Mortality ◽  
Neonatal Death ◽  
Case Control Study ◽  
Case Control ◽  
High Rate ◽  
Mortality Data ◽  
Sociodemographic Characteristics ◽  
Factors Associated ◽  
International Border ◽  
Control Study

Abstract BACKGROUND: Foz do Iguassu is a Brazilian municipality located in the most populous international border of the country and provides medical care to foreigners. Neonatal mortality in the city is higher than Brazil’s average and corresponds to 61% of all deaths in children under five. The current study aimed to identify the determinants of neonatal mortality in Foz do Iguassu. METHODS: In this case-control study, we analyzed all neonatal deaths occurred in Foz do Iguassu from 2012 to 2016. Birth and mortality data were extracted from two national governmental databases (SINASC and SIM). We extracted data on (i) maternal sociodemographic characteristics, (ii) pregnancy care, and (iii) newborn characteristics. Multiple logistic regression with the conceptual framework was applied to examine the factors associated with neonatal mortality. RESULTS : Most of the deaths occurred in the early neonatal period (65.9%). The factors associated with neonatal death were fetal congenital anomaly (OR 22.49; CI 95% 7.44-67.95; p = <0.001); low birth weight (OR 17.15; CI 95% 8.56-34.37; p = <0.001), first minute Apgar score under 7 (OR 15.60; CI 95% 8.23- 29.67; p = <0.001); zero to 3 prenatal appointments (OR 3.34; CI 95% 1.28-8.73; p = 0.014) and prematurity (OR 3.60; CI 95% 1.87‑7.11; p = <0.001). CONCLUSION : The high rate of neonatal death in Foz do Iguassu is strongly associated with newborn characteristics and not associated with maternal sociodemographic characteristics. Thus, the health services in the Brazilian side of this international borders should be aware of the quality of the prenatal care and childbirth attention provided.

scholarly journals Geospatial analysis of determinants of neonatal mortality in Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Duah Dwomoh
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Neonatal Death ◽  
Reproductive Age ◽  
Multiple Births ◽  
Demographic And Health Surveys ◽  
Neonatal Deaths ◽  
The Impact

Abstract Background Ghana did not meet the Millennium Development Goal 4 of reducing child mortality by two-thirds and may not meet SDG (2030). There is a need to direct scarce resources to mitigate the impact of the most important risk factors influencing high neonatal deaths. This study applied both spatial and non-spatial regression models to explore the differential impact of environmental, maternal, and child associated risk factors on neonatal deaths in Ghana. Methods The study relied on data from the Ghana Demographic and Health Surveys (GDHS) and the Ghana Maternal Health Survey (GMHS) conducted between 1998 and 2017 among 49,908 women of reproductive age and 31,367 children under five (GDHS-1998 = 3298, GDHS-2003 = 3844, GDHS-2008 = 2992, GDHS-2014 = 5884, GMHS-2017 = 15,349). Spatial Autoregressive Models that account for spatial autocorrelation in the data at the cluster-level and non-spatial statistical models with appropriate sampling weight adjustment were used to study factors associated with neonatal deaths, and a p-value less than 0.05 was considered statistically significant. Results Population density, multiple births, smaller household sizes, high parity, and low birth weight significantly increased the risk of neonatal deaths over the years. Among mothers who had multiple births, the risk of having neonatal deaths was approximately four times as high as the risk of neonatal deaths among mothers who had only single birth [aRR = 3.42, 95% CI: 1.63–7.17, p < 0.05]. Neonates who were perceived by their mothers to be small were at a higher risk of neonatal death compared to very large neonates [aRR = 2.08, 95% CI: 1.19–3.63, p < 0.05]. A unit increase in the number of children born to a woman of reproductive age was associated with a 49% increased risk in neonatal deaths [aRR = 1.49, 95% CI: 1.30–1.69, p < 0.05]. Conclusion Neonatal mortality in Ghana remains relatively high, and the factors that predisposed children to neonatal death were birth size that were perceived to be small, low birth weight, higher parity, and multiple births. Improving pregnant women’s nutritional patterns and providing special support to women who have multiple deliveries will reduce neonatal mortality in Ghana.

Association between parental and offspring’s body mass index: results from EPACI Portugal 2012

2021 ◽  
pp. 1-25
Author(s):  
Margarida Nazareth ◽  
Elisabete Pinto ◽  
Milton Severo ◽  
Carla Lopes ◽  
Carla Rêgo
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Mixed Models ◽  
Portuguese Population ◽  
Transgenerational Transmission ◽  
Gestational Weight ◽  
Effective Interventions ◽  
Random Intercept ◽  
High Prevalence ◽  
Longitudinal Association

Abstract Objective: To assess the longitudinal association between parental body mass index (BMI) and offspring´s BMI, in EPACI Portugal 2012. Design: Longitudinal study with retrospective collection of children’s anthropometry data since birth. Children’s anthropometric data were gathered from individual child health bulletins and parents’ anthropometrics were self-reported. Children’s and parents’ BMI were classified according to WHO cut-offs. Linear mixed models with random intercept and slope for age were applied to quantify the association between parental BMI and children BMI Z-score (zBMI). Setting: EPACI Portugal 2012. Participants: Representative sample from the Portuguese population (n 2230) aged from 12 to 36 months. Results: 58.9% of the fathers and 35.6% of the mothers were overweight (OW) or obese. Prevalence of infants who were, at least, at risk of OW increased from 17.0% to 30.3% since birth to 12 months. About half of the mothers with pre-pregnancy OW and obesity (OB) gained gestational weight above the recommendations. The children from mothers with gestational weight gain (GWG) below the recommendations showed a -0.15 SD lower zBMI (95% confidence interval (CI): -0.23;-0.06) in early life, comparing with mothers within GWG recommendations. Children of obese mothers were more likely to present a higher zBMI (0.24 SD, 95%CI: 0.13;0.35) throughout the first months of life. Conclusion: A high prevalence of OW and OB was observed in Portuguese young adults and toddlers. Mothers’ pre-pregnancy BMI and insufficient GWG had a direct effect on offspring BMI. Early effective interventions are needed in order to prevent the transgenerational transmission of OB.

scholarly journals Prevalence of Thinness among Santal Preschool Children Using New Body Mass Index Cut-Off Points

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Subal Das ◽  
Kaushik Bose
Keyword(s):  
Body Mass Index ◽  
Preschool Children ◽  
Nutritional Status ◽  
Body Mass ◽  
Cross Sectional Study ◽  
High Rate ◽  
Tribal Community ◽  
Community Based ◽  
Cross Sectional ◽  
Purulia District

A community-based cross-sectional study was undertaken to determine the prevalence of undernutrition using body mass index (BMI) among 2–6-year Santal preschool children of Purulia District, West Bengal, India. A total of 251 (116 boys and 135 girls) children from 12 villages were measured. Commonly used indicators, that is, weight, height, and BMI, were used to evaluate the nutritional status. More boys (59.5%) than girls (53.3%), based on BMI, were undernourished. Significant age differences in weight (F=44.29∗∗∗; df=3), height (F=58.48∗∗∗; df=3), and BMI (F=3.52∗∗∗; df=3) among boys were observed. Similarly, significant differences between ages in mean weight (F=56.27∗∗∗; df=3), height (F=64.76∗∗∗; df=3), and BMI (F=2.62∗∗∗; df=3) were observed among the girls. The present study revealed that the nutritional status of the preschool children of Santal tribal community of these villages was poor with very high rate of thinness in boys and girls (59.5% and 53.3%, resp.).

scholarly journals First Environmental Investigation of Toxigenic Clostridium difficile at a Large Hospital in Bangladesh

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S406-S406
Author(s):  
M Jahangir Alam ◽  
Khurshida Begum ◽  
Tasnuva Rashid ◽  
Irtiza Hasan ◽  
Jacob McPherson ◽  
...  
Keyword(s):  
Developing Countries ◽  
Clostridium Difficile ◽  
Enrichment Culture ◽  
Large Hospital ◽  
Environmental Investigation ◽  
Fluorescent Pcr ◽  
High Prevalence ◽  
Pcr Ribotyping ◽  
Developed World ◽  
Culture Positive

Abstract Background Toxigenic Clostridium difficile is the most common cause of infectious diarrhea in hospitalized patients in the developed world and an emerging pathogen in developing countries due to increased use of broad-spectrum antibiotics. Although likely ubiquitous worldwide, the prevalence of toxigenic C. difficile spores in the hospital environs of developing countries is poorly understood. The objectives of the study are to isolate and characterize C. difficile from the hospital environs of a large hospitals in Dhaka, Bangladesh. Methods As part of our environmental surveillance effort, we collected 330 shoe-bottom swab samples from hospital employees, patients, and visitors inside of a large hospital in Dhaka, Bangladesh. Samples were analyzed for C. difficile using anaerobic enrichment culture and molecular methods. Suspected colonies from cycloserine cefoxitin fructose agar (CCFA) plates were identified by PCR (tcdA, tcdB, cdtA, cdtB and tpi genes) and strain typed using fluorescent PCR ribotyping, and MLVA methods. Results A total 149 of 333 (44.7%) shoe-bottom swab samples were culture positive for C. difficile of which 19.8% samples were toxigenic (tcdA and tcdB) C. difficile. A total of 11 distinct ribotypes were identified from 58 toxigenic C. difficile isolates tested. Predominant ribotypes were F053-163 (24.1%), F017 (20.7%), F106 (19.0%), F014-020 (17.2%). Other ribotypes were R001, F005, F010, F018, F054, F216, and FP407. No R027 and R078 C. difficile isolated. A broad MLVA diversity has been seen among the tested strains. Conclusion We identified a high prevalence of toxigenic C. difficile with diverse ribotypes from hospital environmental shoe-bottom swabs in Bangladesh. This is the first hospital environmental report of C. difficile from Bangladesh. Disclosures All authors: No reported disclosures.

scholarly journals Midwives and Maternal Mortality Evidence from a Midwifery Policy Experiment in 19th Century Sweden

2021 ◽  
Author(s):  
Louise Lorentzon ◽  
Per Pettersson-Lidbom
Keyword(s):  
Developing Countries ◽  
Infant Mortality ◽  
Maternal Mortality ◽  
19Th Century ◽  
Causal Effect ◽  
High Rate ◽  
Current Debate ◽  
Effective Strategy ◽  
Policy Experiment ◽  
Exogenous Source

Abstract This paper estimates the causal effect of a historical midwifery policy experiment on maternal mortality, infant mortality, and stillbirth during the period of 1830–1894 in Sweden. Exploiting sharp changes or “discontinuities” across time and place in the availability of trained and licensed midwives as an exogenous source of variation, we find that a doubling of trained midwives led to a 20%–40% reduction in maternal mortality and a 20% increase in the uptake of midwife-assisted homebirths. The results thus suggest that a 1% increase in the share of midwife-assisted homebirths decreased maternal mortality by as much as 2%, which is a remarkable finding given that midwife training was only 6–12 months at that time. The results of this study contribute to the current debate about the most effective strategy to reduce the unacceptably high rate of maternal mortality in many developing countries, especially in low-resource settings.

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