scholarly journals Timing and causes of neonatal mortality in Tamale Teaching Hospital, Ghana: A retrospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245065
Author(s):  
Alhassan Abdul-Mumin ◽  
Cesia Cotache-Condor ◽  
Sheila Agyeiwaa Owusu ◽  
Haruna Mahama ◽  
Emily R. Smith
Keyword(s):  
Retrospective Study ◽  
Preterm Birth ◽  
Neonatal Mortality ◽  
Teaching Hospital ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
Sub Saharan Africa ◽  
Neonatal Deaths ◽  
Birth Complications ◽  
Tamale Teaching Hospital

Neonatal deaths now account for more than two-thirds of all deaths in the first year of life and for about half of all deaths in children under-five years. Sub-Saharan Africa accounts up to 41% of the total burden of neonatal deaths worldwide. Our study aims to describe causes of neonatal mortality and to evaluate predictors of timing of neonatal death at Tamale Teaching Hospital (TTH), Ghana. This retrospective study was conducted at TTH located in Northern Ghana. All neonates who died in the Neonatal Intensive Care Unit (NICU) from 2013 to 2017 were included and data was obtained from admission and discharge books and mortality records. Bivariate and multivariate logistic regression were used to assess predictors of timing of neonatal death. Out of the 8,377 neonates that were admitted at the NICU during the 5-year study period, 1,126 died, representing a mortality rate of 13.4%. Of those that died, 74.3% died within 6 days. There was an overall downward trend in neonatal mortality over the course of the 5-year study period (18.2% in 2013; 14.3% in 2017). Preterm birth complications (49.6%) and birth asphyxia (21.7%) were the top causes of mortality. Predictors of early death included being born within TTH, birth weight, and having a diagnosis of preterm birth complication or birth asphyxia. Our retrospective study found that almost 3/4 of neonatal deaths were within the first week and these deaths were more likely to be associated with preterm birth complications or birth asphyxia. Most of the deaths occurred in babies born within health facilities, presenting an opportunity to reduce our mortality by improving on quality of care provided during the perinatal period.

scholarly journals Trends, patterns and cause-specific neonatal mortality in Tanzania: a hospital-based retrospective survey

2020 ◽  
Author(s):  
Chacha D Mangu ◽  
Susan F Rumisha ◽  
Emanuel P Lyimo ◽  
Irene R Mremi ◽  
Isolide S Massawe ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
International Classification Of Diseases ◽  
Mortality Rates ◽  
Data Availability ◽  
Mortality Data ◽  
Neonatal Deaths ◽  
Over Time

Abstract Background Globally, large numbers of children die shortly after birth and many of them within the first 4 wk of life. This study aimed to determine the trends, patterns and causes of neonatal mortality in hospitals in Tanzania during 2006–2015. Methods This retrospective study involved 35 hospitals. Mortality data were extracted from inpatient registers, death registers and International Classification of Diseases-10 report forms. Annual specific hospital-based neonatal mortality rates were calculated and discussed. Two periods of 2006–2010 and 2011–2015 were assessed separately to account for data availability and interventions. Results A total of 235 689 deaths were recorded and neonatal deaths accounted for 11.3% (n=26 630) of the deaths. The majority of neonatal deaths (87.5%) occurred in the first week of life. Overall hospital-based neonatal mortality rates increased from 2.6 in 2006 to 10.4 deaths per 1000 live births in 2015, with the early neonates contributing 90% to this rate constantly over time. The neonatal mortality rate was 3.7/1000 during 2006–2010 and 10.4/1000 during 2011–2015, both periods indicating a stagnant trend in the years between. The leading causes of early neonatal death were birth asphyxia (22.3%) and respiratory distress (20.8%), while those of late neonatal death were sepsis (29.1%) and respiratory distress (20.0%). Conclusion The majority of neonatal deaths in Tanzania occur among the early newborns and the trend over time indicates a slow improvement. Most neonatal deaths are preventable, hence there are opportunities to reduce mortality rates with improvements in service delivery during the first 7 d and maternal care.

Neonatal Mortality Rate in Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital in Missan Province From 2011 to 2014

2016 ◽  
Vol 12 (27) ◽  
pp. 55
Author(s):  
Esraa Abd Al-Muhsen Ali
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Teaching Hospital ◽  
Causes Of Death ◽  
Neonatal Period ◽  
Birth Asphyxia ◽  
Neonatal Care ◽  
Neonatal Mortality Rate ◽  
Neonatal Deaths ◽  
Neonatal Care Unit

Background: The neonatal mortality rate is a key outcome indicator for newborn care and directly reflects prenatal, natal, and postnatal care. Early neonatal deaths are more closely associated with pregnancy-related factors and maternal health, whereas late neonatal deaths are associated more with factors in the newborn‘s environment. Objectives: To estimate the neonatal mortality rate in Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital in Missan Province during period (2011-2014). To determine the most common causes of death in the neonatal period. Patients and methods: A hospital-based study was done depending on data collected from records of the Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital in Missan Province to calculate the number of deaths within the neonatal period (0-28 days) that was conducted from 2011 to 2014. The other line of data was collected from Obstetrical Ward by calculating number of live births for the same period. Then Neonatal Mortality Rate is calculated and conducted for each year according to the method recommended by WHO. Results: The neonatal mortality rates were 12.15, 13.51, 16.37 and16.11 in 2011 to 2014 respectively in which there was an increment in mortality rate. The main causes of death were respiratory distress syndrome, birth asphyxia and congenital anomalies. Conclusion: Neonatal mortality rate was high in the Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital, but it was less than the previous period in Iraq since 1990. These results suggest, that to decrease neonatal mortality, improved health service quality is crucial.

scholarly journals A Study of Early Neonatal Deaths at Kathmandu Medical College Teaching Hospital

1970 ◽  
Vol 27 (2) ◽  
pp. 79-82
Author(s):  
M Shrestha ◽  
BL Bajracharya ◽  
DS Manandhar
Keyword(s):  
Birth Weight ◽  
Neonatal Mortality ◽  
Death Rate ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
Early Neonatal Death ◽  
Extreme Prematurity ◽  
Neonatal Deaths ◽  
Live Births ◽  
Early Neonatal Deaths

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

scholarly journals A study of early neonatal mortality in a tertiary hospital of Maharashtra, India

2018 ◽  
Vol 5 (5) ◽  
pp. 1869
Author(s):  
Nitin Mehkarkar ◽  
Vijay Baburao Sonawane
Keyword(s):  
Neonatal Mortality ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
Tertiary Hospital ◽  
Premature Delivery ◽  
Early Neonatal Death ◽  
Neonatal Deaths ◽  
Live Births ◽  
Early Neonatal Mortality ◽  
Early Neonatal Deaths

Background: India has a high Neonatal Mortality Rate (NMR) of 31 per 1000 live births and rural being 34 whereas urban being 17 (2011). Two thirds of the newborn deaths usually occur in the first week of life. Newborn survival has become an important issue to improve the overall health care goals. This study is carried out to identify primary causes of early neonatal deaths and to ascertain the factors affecting early neonatal mortality.Methods: This is a prospective study of all the early neonatal deaths in tertiary hospital of Maharashtra over two years. Details of each early neonatal death were filled in the standard perinatal death proforma.Results: Out of the 2073 total births, there were 75 early neonatal deaths (END) which is nearly 36.18 per 1000 live births. The important causes of END were severe birth asphyxia, respiratory distress syndrome and septicemia. About 50% of deaths were observed in mothers with age < 20 years, 25% deaths observed in mothers of age group 20-29 years, and similar percentage is with age >30 years. Most of the early neonatal deaths were due to Birth asphyxia and RDS was the second most important cause of early neonatal deaths. 70% of ENDs 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.Conclusions: Early Neonatal Mortality (ENM) at Tertiary Hospital is fairly high. In present study, early neonatal death rate of 36.18 per 1000 live births is observed which significantly higher than reported in literature.

scholarly journals Assessment of neonatal mortality major factors

2019 ◽  
pp. 124-130
Author(s):  
Rasmiya Lafta ◽  
Husam Habeeb
Keyword(s):  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Congenital Anomalies ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
Health Resources ◽  
Neonatal Care ◽  
Hemorrhagic Disease ◽  
Neonatal Deaths ◽  
Major Factors

Background: Neonatal mortality accounts for nearly half of the deaths of children under the age of five, the main leading causes for which are respiratory distress, infection, and congenital anomalies. Action plans, which call for the elimination of preventable deaths of newborn babies, set specific targets to reduce neonatal mortality. This retrospective descriptive study was conducted in the Basra Teaching Hospital for maternity and childhood from January 2019 to February 2020, including all the neonates who were admitted in the first and second neonatal care units of the hospital. Aim: This study aims to study the main causes of neonatal deaths in newborn babies in the neonatal care units at the main maternity and pediatric hospital of the Basra government. Patients and methods: A total of 716 neonatal deaths were registered along with days of life before death and the cause of death; the cases were classified as early (1–6) days death and late (7–28) days death. Results: In this study, we found that the main causes of early neonatal death were respiratory distress syndrome (68.4%), congenital anomalies (11.4%), infection (10.9%), birth asphyxia (7.2%), and other neonatal conditions (inborn error of metabolism, hemorrhagic disease of newborn, severe anemia, and unspecified causes) (2.1%), while for late neonatal death, respiratory distress (27.2%), congenital problems (17.7%), infection (45.6%), birth asphyxia (6.1%), and other conditions (3.4%) were cited. Conclusions: It is important to direct the health resources towards preventable causes of neonatal deaths both before, during and after the delivery of a baby when the higher risk factors are preventable (prematurity, birth problems, and sepsis). Using all available resources to decrease preterm labors and mother education toward pregnancy and to improve the facilities and quality of neonatal care at the delivery room and neonatal care units. Keywords: neonate, prematurity, congenital problems, birth asphyxia

scholarly journals Neonatal mortality contributors using the three delays audit: a study from Albuluk paediatrics teaching hospital in Sudan

2017 ◽  
Vol 5 (12) ◽  
pp. 5139 ◽  
Author(s):  
Fikria Abdalwhab Salih ◽  
Ebtihal Elameen Eltyeb
Keyword(s):  
Neonatal Mortality ◽  
Teaching Hospital ◽  
Birth Asphyxia ◽  
Care Facility ◽  
Health Care Facility ◽  
Healthcare Facility ◽  
Maternal Knowledge ◽  
Neonatal Deaths ◽  
Danger Signs ◽  
Three Delays

 Background: In certain developing countries neonatal mortality rates still showed a slower decline. Many factors were attributed to neonatal mortality that varies from one country to another. This study investigated factors attributed to neonatal mortality in Sudan.Methods: Data was collected from 72 neonatal deaths records at Albuluk pediatrics' teaching hospital, and then it was analyzed using a modified three delays model to determine contributing delays.Results: 31.9% of neonatal mortality occurred on the first day after birth and 86.1% thereafter. Newborn characteristics showed that more than half of dead newborn were male and more than 80% admitted in the age of more than 2 days although there was 26% of involved newborn were preterm. About two third of deliveries were home deliveries and only 52% of the mothers were in regular antenatal care. The leading causes of death were sepsis and pneumonia in 83% followed by birth asphyxia in 11% of total neonatal mortality. Regarding the three delays audit; delay in decision making were present in 54.2% and that was due to inability of the mothers to recognize danger signs, delay in reaching the health care facility was present in 9.8% of the neonatal mortality, while delay in initiation of treatment in the healthcare facility was present in only 6.9%.Conclusions: Maternal knowledge of neonatal danger signs and decision to seek medical care is a major contributor for neonatal mortality in this study. Further efforts should be exerting to raise knowledge of the mothers about danger signs of neonatal illness.

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 A profile on the spectrum of neonatal mortality and morbidity pattern of extramural neonates in the Specialised Neonatal Care Unit (SNCU) in a tertiary care hospital

2018 ◽  
Vol 5 (2) ◽  
pp. 427 ◽  
Author(s):  
Anuradha D. ◽  
Rajesh Kumar S. ◽  
Aravind M. A. ◽  
Jayakumar M. ◽  
J. Ganesh J.
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Low Birthweight ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Care Hospital ◽  
Neonatal Deaths

Background: Every year, nearly four million newborn babies die in the first month of life. India carries the single largest share (around 25-30%) of neonatal deaths in the world. Neonatal deaths constitute two thirds of infant deaths in India. 45% of the deaths occur within the first two days of life. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively at the appropriate time. It was further estimated that health facility-based interventions can reduce neonatal mortality by 23-50% in different settings. Facility-based newborn care, thus, has a significant potential for improving the survival of newborns in India. This research has been planned with an aim to study the profile of pattern of admissions in a SNCU and their outcomes following admission and management in the unit.Methods: All babies referred for neonatal problems (less than 28 days) and admitted in NICU will be included. Both term and preterm babies will be considered. The criteria for admission includes various causes like low birth weight, preterm, birth asphyxia, respiratory distress, hyperbilirubinemia, congenital anomalies, risk factors (maternal, neonatal, prenatal), infections and outcome will be analysed.Results: Among the 2927 admissions term babies and boys outnumbered. The common causes for admission were birth asphyxia, respiratory distress, low birthweight and preterm. Most babies had an uncomplicated stay. The mortality in the extramural neonates was due to neonatal sepsis, extreme preterm and congenital malformations.Conclusions: Intensive and interventional management, along with good neonatal monitoring and care can reduce the mortality and improve the survival of low birth weight babies and other treatable problems. Thus, a combined effort of management by pediatricians, nursing care, neonatal intensive care unit can improve the survival rates of neonates.

scholarly journals Impact of antenatal care on neonatal mortality among neonates in Ethiopia: a systematic review and meta-analysis

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Tadesse Tolossa ◽  
Ginenus Fekadu ◽  
Belayneh Mengist ◽  
Diriba Mulisa ◽  
Getahun Fetensa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antenatal Care ◽  
Neonatal Mortality ◽  
Neonatal Death ◽  
Statistical Tests ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
The Impact

Abstract Background As compared to other regions of the world, Sub Saharan Africa (SSA) is the region with the highest neonatal mortality and is the region showing the least progress in the reduction of newborn death. Despite better progress made in reducing neonatal mortality, Ethiopia contributes the highest rate of neonatal death in Africa. In Ethiopia, findings from few studies were inconsistent and there is a need to systematically pool existing data to determine the impact of antenatal care on neonatal mortality among mother-neonate pairs in Ethiopia. Methods Published articles from various electronic databases such as Medline, Hinari, Pub Med, Cochrane library, the Web of Science, and Google Scholar were accessed. Also, unpublished studies from library catalogs were identified. All observational studies that were conducted on the association between antenatal care follow-up and neonatal mortality among neonates in Ethiopia were included. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled estimate with a 95% confidence interval (CI). Forest plots were used to visualize the presence of heterogeneity and estimate the pooled impact on antenatal care on neonatal mortality. The presence of publication bias was assessed by funnel plots and Egger’s statistical tests. Results Initially, a total of 345 studies were accessed. Finally, 28 full-text studies were reviewed and fourteen studies fulfilled inclusion criteria and included in the final meta-analysis. The overall pooled estimate indicates the odds of neonatal death among neonates from women with antenatal care were 65% lower than those neonates from women who had no antenatal care follow-up (OR: 0.35, 95% CI: 0.24, 0.51). Conclusions In this systematic review and meta-analysis, lack of ANC follow-up increase the probability of neonatal mortality as compared to having ANC follow-up. Thus, we will recommend for more coverages of appropriate antenatal care where risk groups can best be identified and managed.

scholarly journals The causes of early neonatal death in Sulaimani Intensive Care Unite at Maternity Teaching Hospital between Jan 2016 - Feb 2017

2017 ◽  
Vol 2 (2) ◽  
pp. 121-127
Author(s):  
Pary M. Azize ◽  
Layla A. Muhammad ◽  
Nasren A. Kareem
Keyword(s):  
Intensive Care ◽  
Teaching Hospital ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
P Value ◽  
Early Neonatal Death ◽  
Factors Affecting ◽  
Neonatal Deaths ◽  
The Mean

Early neonatal death refers to all deaths of liveborn infants occurring on or before the first seven days of life. There is a shortage of research on the specific causes of early neonatal death. This study has been conducted in order to assess causes of early neonatal death in Sulaimani's Neonatal Intensive Care Unit at Maternity Teaching Hospital. Information was obtained retrospectively from the patients’ medical records, including (Mother and neonate socio-demographic, Maternal, Fetal and labor causes of death). Generally, this study found that in 2016 out of total 18.573 recorded delivery, 168 early neonatal deaths were analyzed from January 2016 to February 2017. However, this number was declined in comparison to the data of 2015, which estimated around 244 early deaths out of 21.142 total births. The mean age of mothers was ranged (28.22 ±7.69), 73.2% of neonate mothers were multi gravid with 67.3% of them delivered through normal vaginal, The majority of early neonate death was happening in the mean expected date delivery of (28.64 ± 2.90) weeks, with  mostly weighing  700- 1.10 gm.  Regarding the maternal causes, more than a quarter of the mother had Preeclamptic toxemia followed by (25% antepartum hemorrhage, 22.6% diabetes, respectively), In terms of the fetal causes, more than three-quarter of neonate  were dead because of prematurity and the majority 85.2% were deceased because of the respiratory distress syndrome. Almost no labor causes. The study also found that there is a significant association between gravidity, mode of delivery and maternal cause in p value < 0.05. However, that relationship was not found to fetal cause. Moreover, there is also no significant relationship between fetal cause and (Age of mother, Expected date delivery and fetal weight) in p-value > 0.05 accept the gender of the neonate. In conclusion, some factors affecting early neonatal death have been identified in this study special care is essential for these children in order to reduce their mortality rates.

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