scholarly journals Neonatal mortality and associated factors in the specialized neonatal care unit Asmara, Eritrea

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Amanuel Kidane Andegiorgish ◽  
Mihreteab Andemariam ◽  
Sabela Temesghen ◽  
Liya Ogbai ◽  
Zemichael Ogbe ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Neonatal Mortality ◽  
Associated Factors ◽  
Distress Syndrome ◽  
Congenital Abnormalities ◽  
Very Low Birth Weight ◽  
Neonatal Care ◽  
Neonatal Care Unit

Abstract Background Limited knowledge on the magnitude of neonatal mortality and associated factors is hampering early intervention in African countries. Objective: To determine neonatal mortality and associated factors in the Specialized Neonatal Care Unit Asmara, Eritrea. Methods Medical records of all neonates admitted to the Specialized Neonatal Care Unit in 2016 were reviewed using a cross-sectional study. The most important causes of admission and mortality were analyzed. Univariate and multivariate logistic regression analysis was used to evaluate the strength of risk factors associated with neonatal mortality. Variables significant at P < 0.20 level in the univariate analysis were retained in the multivariate model. Model fit was evaluated using Hosmer and Lemeshow test (Chi-square = 12.89, df = 8; P = 0.116), implies the model’s estimates fit the data at an acceptable level. Collinearity was assessed using variance inflation factor (VIF) < 4. P-value < 0.05 was considered statistically significant. Results Of the 1204 (59.9% boys and 40.1% girls) neonates admitted in 2016, 79 (65.6/1000 live births) died. The major causes of admission were sepsis (35.5%), respiratory distress syndrome (15.4%) and perinatal asphyxia (10%). Major causes of death were respiratory distress syndrome (48.1%); extremely low birth weight (40.9%) and very low birth weight (30.5%). After adjustment, low birth weight (Adjusted odds ratio (AOR) = 4.55, 95% CI,1.97–10.50), very low birth weight (AOR = 19.24, 95% CI, 5.80–63.78), late admission (24 h after diagnosis) (AOR = 2.96, 95% CI, 1.34–6.52), apgar score (in 1 min AOR = 2.28, 95% CI, 1.09–4.76, in 5 min AOR = 2.07, 95% CI, 1.02–4.22), and congenital abnormalities (AOR = 3.95, 95% CI, 1.59–9.85) were significantly associated with neonatal mortality. Neonates that stayed > 24 h in the Specialized Neonatal Care Unit (AOR = 0.23, 95% CI, 0.11–0.46) had a lower likelihood of death. Overall 95.8% of mothers of neonates attended antenatal care and 96.6% were facility delivered. None of the maternal conditions were associated with neonatal mortality in this study. Conclusions Low birth weight, late admission, low apgar scores and congenital abnormalities were significantly associated with neonatal mortality in the Specialized Neonatal Care Unit. Early management of low birth weight, preterm births, and neonatal complications should be the priority issues for controlling local neonatal deaths.

Passage of the First Stool in Very Low Birth Weight Infants

PEDIATRICS ◽  
1987 ◽  
Vol 79 (6) ◽  
pp. 1005-1007
Author(s):  
Meenakshi K. Jhaveri ◽  
Savitri P. Kumar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Very Low Birth Weight ◽  
Gut Hormones ◽  
Low Birth Weight Infants ◽  
Severe Respiratory Distress ◽  
Severe Respiratory Distress Syndrome

Times of first stool passage were studied in 171 infants who weighed less than 1,500 g at birth. Delayed passage (greater than 48 hours) was noted in 20.4% of this group. Significant differences were noted between the delayed and nondelayed groups for gestational age, presence of severe respiratory distress syndrome, and the time of the first enteral feeding. In very low birth weight infants, delay in the passage of the first stool is a common occurrence. This delay is probably due to physiologic immaturity of the motor mechanisms of the gut, lack of triggering effect of enteral feeds on gut hormones, and the presence of severe respiratory distress syndrome, which may singly or in concert adversely affect gastrointestinal motility.

scholarly journals Trends in Neonatal Mortality at a Tertiary Level Teaching Hospital

2013 ◽  
Vol 33 (3) ◽  
pp. 213-217
Author(s):  
Srijana Basnet ◽  
Laxman Shrestha
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Teaching Hospital ◽  
Distress Syndrome ◽  
Linear Trend ◽  
Perinatal Asphyxia ◽  
Live Births

Introduction: Neonatal services at Tribhuvan University Teaching hospital (TUTH) was essentially up to level II till year 2008 and upgraded to level III care in later years. A 4 years retrospective study was carried out at TUTH, Kathmandu, Nepal to determine any change in the trend of neonatal mortality after the improvement in its services. Materials and Methods: Labor room record book, neonatal record book, perinatal audit data and neonatal record charts were used to collect the data. Results: During the study period, there were total of 15063 live births. The neonatal mortality ranges from 9.46 to 14.88 per 1000 live births per year. There was no significant fall in trend of neonatal mortality (x2 for linear trend=1.40, p=0.23). There was also no significant fall in trend in perinatal mortality rates over this period (x2 for linear trend=1.92, p=0.16).The number of neonates referred to other hospitals has been significantly reduced by 61%.(x2 for linear trend=33.18, p<0.001). Majority of the neonatal deaths (72%) occurred within first 7 days of life and more than a third (39%) died within the first 24 hours of life. Respiratory distress syndrome, perinatal asphyxia and neonatal sepsis were three major causes of death. Deaths due to respiratory distress and perinatal asphyxia has not changed significantly over the years (p=0.4 and 0.25 respectively). Incidence of low birth weight ranges from 10.8 – 16.1% of total live births. 63% of neonatal mortality occurred in low birth weight babies. This trend has not changed in over the years (x2=1.03, p=0.31). Conclusion: With the improvement in the services, though neonatal mortality remained unchanged, referral rates and mortality due to respiratory distress syndrome of prematurity has decreased. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8957   J. Nepal Paediatr. Soc. 2013;33(3):213-217

scholarly journals Infection remains a leading cause of neonatal mortality among infants delivered at a tertiary hospital in Karachi, Pakistan

2014 ◽  
Vol 8 (11) ◽  
pp. 1470-1475 ◽  
Author(s):  
Muhammad Ayaz Mustufa ◽  
Razia Korejo ◽  
Anjum Shahid ◽  
Sadia Nasim
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Distress Syndrome ◽  
Very Low Birth Weight ◽  
Neonatal Period ◽  
Healthcare Facility ◽  
Normal Birth Weight ◽  
Neonatal Deaths ◽  
Normal Birth

Introduction: The current cohort study was conducted to determine the frequency and compare the mortality rate with associated characteristics among low birth weight and normal birth weight infants during the neonatal period at a tertiary healthcare facility, Karachi. Methodology: Close-ended structured questionnaires were used to collect information from the parents of 500 registered neonates at the time of birth. Follow-ups by phone on the 28th day of life were done to determine the mortality among low birth weight and normal birth weight babies during the neonatal period. Results: The neonatal mortality rate ranged from as low as 2.4% in the normal birth weight and 16.4% in the low birth weight categories to as high as 96% in the very low birth weight category. Respiratory distress syndrome (24.2%) and sepsis (18.2%) were reported as the leading causes of neonatal deaths. The babies’ lengths of stay ranged from 2 to 24 hours, and around 90% of neonatal deaths were reported in the first seven days of life. More than 6% of neonates died at home, and 7.6% of the deceased babies did not visit any healthcare facility or doctor before their death. In the 12–15 hours before their deaths, 13.6% of the deceased babies had been unattended. Around 90% of the deceased babies were referred from a doctor or healthcare facility. Conclusions: The present estimates of neonatal mortality are very high among low birth weight and very low birth weight categories. Infectious diseases, including respiratory distress syndrome (24.2%) and sepsis (18.2%), were leading causes of neonatal deaths.

scholarly journals Causes of Preterm and Low Birth Weight Neonatal Mortality in a Rural Community in Kenya: Evidence From Verbal and Social Autopsy

2020 ◽  
Author(s):  
Beatrice Olack ◽  
Nicole Santos ◽  
Mary Inziani ◽  
Vincent Moshi ◽  
Polycarp Oyoo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Distress Syndrome ◽  
Neonatal Period ◽  
Preterm Neonates ◽  
Neonatal Deaths ◽  
Social Autopsy

Abstract BackgroundUnder-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. We aimed to establish causes of neonatal LBW and preterm mortality in Migori County, among participants of the PTBI-K (Preterm Birth Initiative-Kenya) study.MethodsThis was a cross sectional study whereby Verbal and social autopsy (VASA) interviews were conducted with caregivers of deceased LBW and preterm neonates delivered within selected 17 health facilities in Migori County, Kenya. The probable cause of death was assigned using the WHO International Classification of Diseases (ICD-10). ResultsBetween January 2017 to December 2018, 3175 babies were born preterm or LBW, and 162 (5.1%) died in the first 28 days of life in 17 participating health facilities in the PTBI-K project. VASA was conducted among 88 (53.7%) neonatal deaths. Almost half (38, 43.2%) of the deaths occurred within the first 24 hours of life. Birth asphyxia (45.5%), neonatal sepsis (26.1%), respiratory distress syndrome (12.5%) and hypothermia (11.0%) were the leading causes of death. In the early neonatal period, majority (54.3%) of the neonates succumbed to asphyxia while in the late neonatal period majority (66.7%) succumbed to sepsis. Delay in seeking medical care was reported for 4 (5.8%) of the neonatal deaths. ConclusionDeaths among LBW and preterm neonates occur early in life due to preventable causes. This calls for enhanced intrapartum and immediate postpartum care interventions targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia.

A Controlled Trial of Dexamethasone to Prevent Bronchopulmonary Dysplasia in Surfactant-treated Infants

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 204-210 ◽  
Author(s):  
Alok Rastogi ◽  
Subuola M. Akintorin ◽  
Michelle L. Bez ◽  
Pablo Morales ◽  
Rosita S. Pildes
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Bronchopulmonary Dysplasia ◽  
Distress Syndrome ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Low Birth Weight Infants ◽  
Dexamethasone Therapy

Background. Surfactant therapy now has a well-established role in the treatment of neonates with respiratory distress syndrome but has failed to reduce the incidence of bronchopulmonary dysplasia (BPD). We conducted a double-blind, placebo-controlled trial to test the hypothesis that dexamethasone therapy given during the first 12 days of life to very low birth weight infants would be synergistic to surfactant in preventing BPD. Methods. Seventy surfactant-pretreated infants (700-1500 g) who had severe respiratory distress syndrome (a/A ratio, 0.18 ± 0.10; mean airway pressure, 11.1 ± 1.9 cm H2O; fraction of inspired oxygen, 0.81 ± 0.22) were enrolled to receive a 12-day course of dexamethasone (n = 36) or saline placebo (n = 34) starting within the first 12 hours after birth. The starting dose of dexamethasone was 0.5 mg/kg per day, and it was tapered progressively. Results. Ventilator variables at 5 to 14 days were significantly improved in those infants who received dexamethasone compared with those who received the placebo. The effect seem to be more marked in infants weighing less than 1250 g at birth. Significantly more infants could be extubated by 14 days of age in the dexamethasone group (26 of 32 vs 14 of 32). Dexamethasone therapy reduced the incidence of BPD at 28 days (odds ratio, 0.1; 95% confidence interval, 0.03 to 0.3) and eliminated BPD at 36 weeks' postconceptional age. Dexamethasone-treated infants had greater weight loss at 14 days (12.9 ± 6.4% vs 3.7 ± 8.6%, respectively) and higher blood pressures from days 3 to 10. However, no differences were seen in time to regain birth weight, hypertension (1 infant in each group), or incidence of intraventricular hemorrhage. Conclusions. We found an additive effect between dexamethasone and surfactant in improving pulmonary status and reducing the incidence of BPD. Compared with the placebo, dexamethasone therapy was more effective in reducing the incidence of BPD in surfactantpretreated very low birth weight infants.

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