Identification of important and potentially avoidable risk factors in a prospective audit study of neonatal deaths in a paediatric hospital in Vietnam

2013 ◽  
Vol 103 (2) ◽  
pp. 139-144 ◽  
Author(s):  
Alexandra Y Kruse ◽  
Cam N Phuong ◽  
Binh TT Ho ◽  
Lone G Stensballe ◽  
Freddy K Pedersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Audit ◽  
Paediatric Hospital ◽  
Neonatal Deaths ◽  
Avoidable Risk

Studying the Birth Outcome in Tikrit Teaching Hospital

2018 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Areej Noaman
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Teaching Hospital ◽  
Birth Outcome ◽  
Morbidity And Mortality ◽  
Healthy Baby ◽  
Factors Affecting ◽  
Neonatal Deaths ◽  
Healthy Mother

  Background : A successful birth outcome is defined as the birth of a healthy baby to a healthy mother. While relatively low in industrialized world, maternal and fetal morbidity and mortality and neonatal deaths occur disproportionately in developing countries. Aim of the Study: To assess birth outcome and identify some risk factors affecting it for achieving favorable birth outcome in Tikrit Teaching Hospital

Prevention of Preterm Birth

2018 ◽  
Vol 11 (2) ◽  
pp. 95-104
Author(s):  
Ivan D. Ivanov ◽  
Stefan A. Buzalov ◽  
Nadezhda H. Hinkova
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
High Risk ◽  
Medical Science ◽  
Secondary Prophylaxis ◽  
High Risk Group ◽  
Screening Methods ◽  
Perinatal Complications ◽  
Social Significance ◽  
Neonatal Deaths

Summary Preterm birth (PTB) is a worldwide problem with great social significance because it is a leading cause of perinatal complications and perinatal mortality. PTB is responsible for more than a half of neonatal deaths. The rate of preterm delivery varies between 5-18% worldwide and has not decreased in recent years, regardless of the development of medical science. One of the leading causes for that is the failure to identify the high-risk group in prenatal care. PTB is a heterogeneous syndrome in which many different factors interfere at different levels of the pathogenesis of the initiation of delivery, finally resulting in delivery before 37 weeks of gestation (wg). The various specificities of risk factors and the unclear mechanism of initiation of labour make it difficult to elaborate standard, unified and effective screening to diagnose pregnant women at high-risk for PTB correctly. Furthermore, they make primary and secondary prophylaxis less effective and render diagnostic and therapeutic measures ineffective and inappropriate. Reliable and accessible screening methods are necessary for antenatal care, and risk factors for PTB should be studied and clarified in search of useful tools to solve issues of risk pregnancies to decrease PTB rates and associated complications.

scholarly journals Neonatal mortality rates, characteristics, and risk factors for neonatal deaths in Ghana: analyses of data from two health and demographic surveillance systems

2021 ◽  
Vol 14 (1) ◽  
pp. 1938871
Author(s):  
Shadrach Dare ◽  
Abraham R. Oduro ◽  
Seth Owusu-Agyei ◽  
Daniel F. Mackay ◽  
Laurence Gruer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Neonatal Mortality ◽  
Mortality Rates ◽  
Surveillance Systems ◽  
Neonatal Deaths ◽  
Demographic Surveillance Systems

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.

scholarly journals No Take Home Baby After Caesarian Birth for Foetal Distress in Women with Risk

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Risk Factors ◽  
Neonatal Outcome ◽  
Meta Analysis ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Cord Compression ◽  
High Rate ◽  
Neonatal Deaths ◽  
Fetal Ecg ◽  
Foetal Asphyxia

Sometimes interventions are done for the baby in women with risks but it turns out to be unnecessary caesarian section (CS). However it may be delayed decision and / or delayed execution of intervention, CS too, with no take home baby. While lack of adverse outcome reflected that the decision was not for a compromised foetus, still birth or asphyxiated baby at birth meant delayed decision and / or execution. Recent studies revealed an estimated 9.04 million perinatal deaths related to birth asphyxia. Of them 1.02 million were intrapartum deaths leading to still births, many after CB for foetal concern. Birth asphyxia is a significant global health problem, responsible for around 1.2 million neonatal deaths each year worldwide [1-3]. Those who survive often suffer from a range of disorders. Chauhan et al. conducted, a meta analysis comprising of 169 articles and 37 reports and concluded that the overall risk of prompt CB for fetal concern was 3.1 % (43,340 of 13,98,9740 cases) [4,5]. From time to time several hospital based studies have proved the role of various antepartum or intrapartum maternal & foetal risk factors which lead to foetal asphyxia. It is known that some disorders which could cause foetal asphyxia are obvious during pregnancy, some are labour related, be it mother or baby. Kaye reported association of primiparity, anaemia, hypertensive disorders of pregnancy, foetal growth restriction, malpresentation, antepartum haemorrhage, premature rupture of membranes, prematurity, fever, oxytocin augmentation of labour, umbilical cord prolapse, as risk factors ,with complex interplay between factors which predispose foetuses to poor outcome, due to decreased oxygenation, ACOG reported that foetal hypoxemia which if not compensated or corrected in time progressed to birth asphyxia and even death, either in utero or immediately after birth [6,7]. Gaffineet and James have reported, intrapartum hypoxia complicating around 1% of labours, resulting in foetal / neonatal deaths in 0.5/1000 pregnancies and cerebral palsy in 1 in 1000 cases diagnosed after swift delivery for clinically diagnosed “fetal distress’’ [8]. Earlier Murphy et al had suggested that reduced uterine perfusion uteroplacental vascular disease, low fetal reserve foetal asphyxia, foetal sepsis and cord compression with other gestational and antepartum factors could affect the fetal response which needed to be known. However diagnosis of FD also has to be correct and timely [9]. Cardiotocography (CTG) has been criticized for unnecessary high rate of operative delivery [10-12]. In the study by Roy, non-reassuring fetal heart rate (FHR) detected by CTG did not correlate well with neonatal outcome [13]. In the era of defensive practices, ‘play safe’ attitude results in high CS rate for non-reassuring FHR. The concept of detecting fetal acidosis, using fetal scalp blood appeared attractive, but practical difficulties in carrying it out restricted its use [14,15]. Roy et al suggested that since non-reassuring FHR detected by CTG did not correlate well with adverse neonatal outcome and resulted in unnecessary CS, fetal ECG needed to be introduced in addition to conventional CTG, wherever possible [13]. There are many such issues about timely appropriate authentic diagnosis and action.

scholarly journals The burden of disease preventable by risk factor reduction in Serbia

2013 ◽  
Vol 70 (5) ◽  
pp. 445-451 ◽  
Author(s):  
Sandra Sipetic ◽  
Vesna Bjegovic-Mikanovic ◽  
Hristina Vlajinac ◽  
Jelena Marinkovic ◽  
Slavenka Jankovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Alcohol Consumption ◽  
Cigarette Smoking ◽  
Physical Inactivity ◽  
Fruit And Vegetables ◽  
Blood Cholesterol ◽  
Years Of Life Lost ◽  
High Blood Cholesterol ◽  
Avoidable Risk

Background/Aim. Reliable and comparable analysis of health risks is an important component of evidence-based and preventive programs. The aim of this study was to analyze the impact of the most relevant avoidable risk factors on the burden of the selected conditions in Serbia. Methods. Attributable fractions were calculated from the survey information on the prevalence of a risk factor and the relative risk of dying if exposed to a risk factor. The population-attributable risks were applied to deaths, years of life lost due to premature mortality (YLL), years of life with disability (YLD) and disability adjusted life years (DALY). Results. More than 40% of all deaths and of the total YLL are attributable to cigarette smoking, overweight, physical inactivity, inadequate intake of fruit and vegetables, hypertension and high blood cholesterol. Alcohol consumption has in total a beneficial effect. According to the percent of DALY for the selected conditions attributable to the observed risk factors, their most harmful effects are as follows: alcohol consumption on road traffic accidents; cigarette smoking on lung cancer; physical inactivity on cerebrovascular disease (CVD), ischemic heart disease (IHD) and colorectal cancer; overweight on type 2 diabetes; hypertension on renal failure and CVD; inadequate intake of fruit and vegetables on IHD and CVD, and high blood cholesterol on IHD. Conclusions. This study shows that a high percentage of disease and injury burden in Serbia is attributable to avoidable risk factors, which emphasizes the need for improvement of relevant preventive strategies and programs at both individual and population levels. Social preferences should be determined for a comprehensive set of conditions and cost effectiveness analyses of potential interventions should be carried out. Furthermore, positive measures, derived from health, disability and quality of life surveys, should be included.

scholarly journals Trends and risk factors of stillbirths and neonatal deaths in Eastern Uganda (1982-2011): a cross-sectional, population-based study

2016 ◽  
Vol 22 (1) ◽  
pp. 63-73 ◽  
Author(s):  
Sanni Kujala ◽  
Peter Waiswa ◽  
Daniel Kadobera ◽  
Joseph Akuze ◽  
George Pariyo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Population Based ◽  
Cross Sectional ◽  
Population Based Study ◽  
Neonatal Deaths ◽  
Eastern Uganda

scholarly journals Identifying the risk factors for catheter-associated urinary tract infections: a large cross-sectional study of six hospitals

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e022137 ◽  
Author(s):  
Allison S Letica-Kriegel ◽  
Hojjat Salmasian ◽  
David K Vawdrey ◽  
Brett E Youngerman ◽  
Robert A Green ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Large Data ◽  
Time Range ◽  
Healthcare Associated Infection ◽  
Cross Sectional ◽  
Data Set ◽  
Paediatric Hospital ◽  
Tract Infections

MotivationCatheter-associated urinary tract infections (CAUTI) are a common and serious healthcare-associated infection. Despite many efforts to reduce the occurrence of CAUTI, there remains a gap in the literature about CAUTI risk factors, especially pertaining to the effect of catheter dwell-time on CAUTI development and patient comorbidities.ObjectiveTo examine how the risk for CAUTI changes over time. Additionally, to assess whether time from catheter insertion to CAUTI event varied according to risk factors such as age, sex, patient type (surgical vs medical) and comorbidities.DesignRetrospective cohort study of all patients who were catheterised from 2012 to 2016, including those who did and did not develop CAUTIs. Both paediatric and adult patients were included. Indwelling urinary catheterisation is the exposure variable. The variable is interval, as all participants were exposed but for different lengths of time.SettingUrban academic health system of over 2500 beds. The system encompasses two large academic medical centres, two community hospitals and a paediatric hospital.ResultsThe study population was 47 926 patients who had 61 047 catheterisations, of which 861 (1.41%) resulted in a CAUTI. CAUTI rates were found to increase non-linearly for each additional day of catheterisation; CAUTI-free survival was 97.3% (CI: 97.1 to 97.6) at 10 days, 88.2% (CI: 86.9 to 89.5) at 30 days and 71.8% (CI: 66.3 to 77.8) at 60 days. This translated to an instantaneous HR of. 49%–1.65% in the 10–60 day time range. Paraplegia, cerebrovascular disease and female sex were found to statistically increase the chances of a CAUTI.ConclusionsUsing a very large data set, we demonstrated the incremental risk of CAUTI associated with each additional day of catheterisation, as well as the risk factors that increase the hazard for CAUTI. Special attention should be given to patients carrying these risk factors, for example, females or those with mobility issues.

scholarly journals A Significant Reduction in Paediatric Post-Tonsillectomy Vomiting through Audit

2008 ◽  
Vol 90 (3) ◽  
pp. 226-230 ◽  
Author(s):  
AMD Bennett ◽  
PJ Emery
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Gold Standard ◽  
Postoperative Vomiting ◽  
Prospective Audit ◽  
The Subject ◽  
Audit Cycle

INTRODUCTION Postoperative vomiting occurs more frequently after tonsillectomy than any other commonly performed paediatric operation. Postoperative vomiting is also the commonest cause of morbidity and re-admission following tonsillectomy. We present a successful completed audit cycle and literature review on the subject. PATIENTS AND METHODS Data on the risk factors for postoperative vomiting, whether the patient vomited and details of the patient's vomitus were collected prospectively on consecutive patients and compared with a gold standard. Changes in practice were agreed and a second cycle performed. RESULTS Two cycles and a total of 107 patients were included in the audit. A significant reduction in vomiting from 27% to 11% was achieved following the introduction of routine use of intravenous dexamethasone during surgery. CONCLUSIONS This simple prospective audit of paediatric post-tonsillectomy vomiting has resulted in a statistically significant reduction in vomiting which would appear to be due to use of intra-operative steroids.

Sign in / Sign up

Export Citation Format

Share Document