scholarly journals Comparing regional neonatal mortality rates: the influence of registration of births as live born for birth weight <500 g in Taiwan

2019 ◽  
Vol 3 (1) ◽  
pp. e000526
Author(s):  
Liang-Yi Wang ◽  
Yu-Shan Chang ◽  
Fu-Wen Liang ◽  
Yung-Chieh Lin ◽  
Yuh-Jyh Lin ◽  
...  

ObjectiveTo investigate regional variation in the registration of births (still+live) as live born for birth weight <500 g and the impact on the city/county ranking of neonatal mortality rate (NMR) in Taiwan.DesignPopulation-based cross-sectional ecological study.Setting20 cities/counties in Taiwan.ParticipantsRegistered births for birth weight <500 g and neonatal deaths in 2015–2016.Main outcome measuresCity/county percentage of births <500 g registered as live born and ranking of city/county NMR (deaths per 1000 live births) including and excluding live births <500 g.ResultsThe percentage of births <500 g registered as live born ranged from 0% in Keelung City (0/26) and Penghu County (0/4) to 20% in Taipei City (112/558), 24% in Hsinchu County (5/21) and 28% in Hualien County (9/32). The change in city/county ranking of NMR from including to excluding live births <500 g was most prominent in Taipei City (from the 15th to the 1st) followed by Kaohsiung City (from the 18th to the 14th).ConclusionsThe city/county NMR in Taiwan is influenced by variation in the registration of live born for births with uncertain viability. We recommend presenting city/county NMR using both criteria (with or without minimum threshold of gestation period or birth weight) for better interpretation of the findings of comparisons of city/county NMR.

2014 ◽  
Vol 48 (5) ◽  
pp. 778-786 ◽  
Author(s):  
Maria Aparecida Munhoz Gaiva ◽  
Elizabeth Fujimori ◽  
Ana Paula Sayuri Sato

Objective To evaluate the factors associated with neonatal mortality in infant born with low birth weight. Method Cross-sectional study that analyzed data from 771 live births with low birth weight (<2500 g) in the city of Cuiabá, MT, in 2010, of whom 54 died in the neonatal period. We obtained data from the Information System on Live Births and Mortality, by integrated linkage. Results In multiple logistic regression, neonatal mortality was associated with: number of prenatal visits less than 7 (OR=3.80;CI:1,66-8,70); gestational age less than 37 weeks (OR=4.77;CI:1.48-15.38), Apgar score less than 7 at the 1st minute (OR=4.25;CI:1.84-9.81) and the 5th minute (OR=5.72,CI:2.24-14.60) and presence of congenital anomaly (OR=14.39;IC:2.72-76.09). Conclusion Neonatal mortality in infants with low birth weight is associated with avoidable factors through adequate attention to prenatal care, childbirth and infants.



2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Duah Dwomoh

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.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250373
Author(s):  
Serena Donati ◽  
Marta Buoncristiano ◽  
Ilaria Lega ◽  
Paola D’Aloja ◽  
Alice Maraschini ◽  
...  

In this before and after cross-sectional analysis, the authors aim to assess the impact of the bundle of research and training initiatives implemented between 2013 and 2018, and coordinated by the Italian Obstetric Surveillance System (ItOSS) to reduce obstetric haemorrhagic emergencies in five selected Italian Regions. To this purpose, the haemorrhagic Maternal Mortality Ratios (MMR) per 100,000 live births were estimated before and after implementing the bundle, through the ItOSS’s vital statistic linkage procedures and incident reporting and Confidential Enquiries. The research and training bundle was offered to all health professionals involved in pregnancy and birth care in the selected regions, representing 40% of national live births, and participating in the ItOSS audit cycle since its institution. The haemorrhagic MMR significantly decreased from 2.49/100,000 live births [95% CI 1.75 to 3.43] in the years 2007–2013 prior to the bundle implementation, to 0.77/100,000 live births [95% CI 0.31 to 1.58] in the years 2014–2018 after its implementation. According to the study results, the bundle of population-based initiatives might have contributed to reducing the haemorrhagic MMR in the participating regions, thus improving the quality of care of the major obstetric haemorrhage.


2017 ◽  
Vol 17 (3) ◽  
pp. 527-537 ◽  
Author(s):  
Franciele Mattei ◽  
Ioná Carreno

Abstract Objectives: to analyze the factors associated to maternal and child's health from the Live Births Information System (Sinasc) in Rio Grande do Sul, 2012. Methods: a cross-sectional ecological study with analysis on Sinasc variables from 19 Regional Health Coordinations in Rio Grande do Sul. The variables occurrence frequencies were calculated and analyzed by Spearman correlation. Results: we observed that a higher maternal level of education, the presence of a partner and the adequate number of prenatal consultations reduced the frequency of vaginal delivery, as for the proportion of cesarean section, it was 62%. The frequency of low schooling was associated to prematurity (rho = 0.521, p=0.022) and low birth weight (rho = 0.542, p=0.016). The low prenatal coverage correlated positively with the Apgar score ≤ 7 in the 5th minute (rho = 0.467; p=0.044) and negatively with adequate birth weight (rho = -0.500; p=0.029). Conclusions: this study allows to identify factors associated to maternal and child's health contributing information to the development of actions that qualifies pregnant women's healthcare.


Author(s):  
Silvalia Rahma Pratiwi ◽  
◽  
Hanung Prasetya ◽  
Bhisma Murti ◽  
◽  
...  

ABSTRACT Background: Low birth weight (LBW) has been used as an important public health indicator. LBW is one of the key drivers and indirect causes of neonatal death. It contributes to 60% to 80% of all neonatal deaths, annually. This study aimed to examine association between LBW and neonatal mortality using meta analysis. Subjects and Methods: This was meta-analysis and systematic review. Published articles in 2010-2020 were collected from Google Scholar, PubMed, Springer Link, Hindawi, Clinical Key, ProQuest databases. Keywords used “low birth weight” AND “mortality” OR “birth weight mortality” OR “neonatal death” AND “cross sectional” AND “adjusted odd ratio”. The inclusion criteria were full text, using cross-sectional study design, and reporting adjusted ratio. The data were analyzed by PRISMA flow chart and Revman 5.3. Results: 6 studies were met criteria. This study showed that low birth weight increased the risk of neonatal mortality (aOR= 2.23; 95% CI= 1.12 to 4.44; p= 0.02). Conclusion: Low birth weight increases the risk of neonatal mortality. Keywords: low birth weight, mortality, neonatal death Correspondence: Silvalia Rahma Pratiwi. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 082324820288. DOI: https://doi.org/10.26911/the7thicph.03.113


2016 ◽  
Vol 25 (4) ◽  
Author(s):  
Maria Aparecida Munhoz Gaiva ◽  
Elizabeth Fujimori ◽  
Ana Paula Sayuri Sato

ABSTRACT This was a cross-sectional study that investigated maternal and child factors associated with neonatal mortality. Data was obtained from the Live Births and Mortality Information Systems integrated by linkage. A total of 9,349 live births and 78 deaths in the neonatal period, which occurred in 2010 in Cuiabá-MT were analyzed. Univariate and multivariate analyzes were performed. In the multiple logistic regression, neonatal mortality was associated with: maternal age less than 20 years; prematurity; low birth weight; Apgar score less than seven at 1 and 5 minutes; and presence of congenital anomaly. The results highlight the need to improve the quality of prenatal care in order to prevent low birth weight and prematurity. The association between neonatal death and low Apgar score at 1 and 5 minutes indicates the importance of investments in delivery care.


1970 ◽  
Vol 27 (2) ◽  
pp. 79-82
Author(s):  
M Shrestha ◽  
BL Bajracharya ◽  
DS Manandhar

Over 9 million deaths occur each year in the perinatal and neonatal periods globally. 98% of these deaths take place in the developing world. Nepal has a high neonatal mortality rate (NMR) of 38.6 per 1000 live births (2001). Two thirds of the newborn deaths usually occur in the first week of life (early neonatal death). Newborn survival has become an important issue to improve the overall health status and for achieving the millennium developmental goals of a developing country like Nepal. Aims and Objectives: This study was carried out to determine the causes of early neonatal deaths (ENND) at KMCTH in the two-year period from November 2003 to October2005 (Kartik 2060 B.S. to Ashoj 2062). Methodology: This is a prospective study of all the early neonatal deaths in KMCTH during the two-year study period. Details of each early neonatal death were filled in the standard perinatal death audit forms of the Department. Results: Out of the 1517 total births in the two-year period, there were 10 early neonatal deaths (ENND). Early neonatal death rate during the study period was 6.7 per 1000 live births and early neonatal death rate (excluding less than 1 kg) was 6.1 per 1000 live births The important causes of early neonatal deaths were extreme prematurity, birth asphyxia, congenital anomalies and septicaemia. During the study period, there was no survival of babies with a birth weight of less than 1 kg. Among the maternal characteristics, 80% of the mothers of early neonatal deaths were aged between 20-35 years. 50% of the mothers were primigravida. 50% of the mothers of ENNDs had delivered their babies by caesarean section.Discussion: Most of the early neonatal deaths were due to extreme prematurity. Birth asphyxia was the second most important cause of early neonatal deaths. 70% of ENNDs were among LBW babies. Prevention of premature delivery, proper management of very low birth weight babies and early detection and appropriate management of perinatal hypoxia have become important interventional strategies in reducing early neonatal deaths in KMCTH.Conclusion: Early neonatal mortality at KMCTH is fairly low. Good care during pregnancy, labour and after the birth of the baby has helped to achieve these results. Low cost locally made equipments were used to manage the sick newborns. Reduction of early neonatal deaths require more intensive care including use of ventilators, surfactant and parenteral nutrition and prevention of preterm births Key words: Early neonatal death (ENND), neonatal mortality   doi:10.3126/jnps.v27i2.1584 J. Nepal Paediatr. Soc. Vol 27(2), p.79-82


2020 ◽  
Vol 17 (S2) ◽  
Author(s):  
Sangappa M. Dhaded ◽  
Manjunath S. Somannavar ◽  
Janet L. Moore ◽  
Elizabeth M. McClure ◽  
Sunil S. Vernekar ◽  
...  

Abstract Background Neonatal mortality causes a substantial proportion of the under-5 mortality in low and middle-income countries (LMIC). Methods We undertook a prospective, population-based research study of pregnant women residing in defined geographic areas in the Karnataka State of India, a research site of the Global Network for Women’s and Children’s Health Research. Study staff collected demographic and health care characteristics on eligible women enrolled with neonatal outcomes obtained at delivery and day 28. Cause of neonatal mortality at day 28 was assigned by algorithm using prospectively defined variables. Results From 2014 to 2018, the neonatal mortality rate was 24.5 per 1,000 live births. The cause of the 28-day neonatal deaths was attributed to prematurity (27.9%), birth asphyxia (25.1%), infection (23.7%) and congenital anomalies (18.4%). Four or more antenatal care (ANC) visits was associated with a lower risk of neonatal death compared to fewer ANC visits. In the adjusted model, compared to liveborn infants ≥ 2500 g, infants born weighing < 1000 g RR for mortality was 25.6 (95%CI 18.3, 36.0), for 1000-1499 g infants the RR was 19.8 (95% CI 14.2, 27.5) and for 1500–2499 g infants the RR was 3.1 (95% CI 2.7, 3.6). However, more than one-third (36.8%) of the deaths occurred among infants with a birthweight ≥ 2500 g. Infants born preterm (< 37 weeks) were also at higher risk for 28-day mortality (RR 7.9, 95% CI 6.9, 9.0) compared to infants ≥ 37 weeks. A one-week decrease in gestational age at delivery was associated with a higher risk of mortality with a RR of 1.3 (95% CI 1.3, 1.3). More than 70% of all the deliveries occurred at a hospital. Among infants who died, 50.3% of the infants had received bag/mask ventilation, 47.3% received antibiotics, and 55.6% received oxygen. Conclusions Consistent with prior research, the study found that infants who were preterm and low-birth weight remained at highest risk for 28-day neonatal mortality in India. Although most of births now occur within health facilities, a substantial proportion are not receiving basic life-saving interventions. Further efforts to understand the impact of care on infant outcomes are needed. Study registration The trial is registered at clinicaltrials.gov. ClinicalTrial.gov Trial Registration: NCT01073475


2020 ◽  
Vol 23 (16) ◽  
pp. 2973-2982 ◽  
Author(s):  
Binyan Zhang ◽  
Suhang Shang ◽  
Shanshan Li ◽  
Baibing Mi ◽  
Minmin Li ◽  
...  

AbstractObjective:To investigate the association of folic acid (FA) supplementation with birth weight, the risk of small for gestational age (SGA) and low birth weight (LBW) in singleton and twin pregnancy.Design:A population-based cross-sectional survey.Setting:Twenty counties and ten districts in Shaanxi Province of northwestern China, 2013.Participants:28 174 pregnant women with their infants, covering 27 818 single live births and 356 twin live births.Results:The prevalence of FA supplementation in singletons and twins was 63·9 and 66·3 %. The mean birth weight was 3267 (sd 459·1) g, 2525 (sd 534·0) g and 2494 (sd 539·5) g; the prevalence of SGA was 14·3, 51·4 and 53·4 %; the prevalence of LBW was 3·4, 42·4 and 46·6 % among singleton, twin A and twin B, respectively. Compared with non-users, women with FA supplementation were (β 17·3, 95 % CI 6·1, 28·4; β 166·3, 95 % CI 69·1, 263·5) associated with increased birth weight, lower risk of SGA (OR 0·85, 95 % CI 0·80, 0·92; OR 0·45, 95 % CI 0·30, 0·68) and LBW (OR 0·82, 95 % CI 0·71, 0·95; OR 0·50, 95 % CI 0·33, 0·75) in singletons and twins, and more prominent effects in twins. Moreover, there were significant interactions between FA supplementation and plurality on birth weight, SGA and LBW.Conclusions:The present study suggests the association of periconceptional 0·4 mg/d FA supplementation with increased birth weight and reduced risk of SGA and LBW in both singletons and twins, and this association may be more prominent in twins.


2015 ◽  
Vol 12 (4) ◽  
pp. 477-482 ◽  
Author(s):  
Ariane Bélanger-Gravel ◽  
Lise Gauvin ◽  
Daniel Fuller ◽  
Louis Drouin

Background:Favorable public opinion and support for policies are essential to favor the sustainability of environmental interventions. This study examined public perceptions and support for active living policies associated with implementing a public bicycle share program (PBSP).Methods:Two cross-sectional population-based telephone surveys were conducted in 2009 and 2010 among 5011 adults in Montréal, Canada. Difference-in-differences analyses tested the impact of the PBSP on negative perceptions of the impact of the PBSP on the image of the city, road safety, ease of traveling, active transportation, health, and resistance to policies.Results:People living closer to docking stations were less likely to have negative perceptions of the effect of the PBSP on the image of the city (OR = 0.5; 95% CI, 0.4−0.8) and to be resistant to policies (OR = 0.8; 95% CI, 0.6−1.0). The likelihood of perceiving negative effects on road safety increased across time (OR = 1.4; 95% CI, 1.2−1.8). Significant interactions were observed for perceptions of ease of traveling (OR = 0.5; 95% CI, 0.4−0.8), active transportation (OR = 0.6; 95% CI, 0.4−1.0), and health (OR = 0.6; 95% CI, 0.4−0.8): likelihood of negative perceptions decreased across time among people exposed.Conclusion:Findings indicate that negative perceptions were more likely to abate among those living closer to the PBSP.


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