scholarly journals Clusters of cause specific neonatal mortality and its association with per capita gross domestic product: A structured spatial analytical approach

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255882
Author(s):  
Daniela Testoni Costa-Nobre ◽  
Mandira Daripa Kawakami ◽  
Kelsy Catherina Nema Areco ◽  
Adriana Sanudo ◽  
Rita Cassia Xavier Balda ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Analytical Approach ◽  
Moving Average ◽  
Order Effects ◽  
Capita Gross Domestic Product ◽  
Per Capita Gdp ◽  
Neonatal Deaths ◽  
Live Births ◽  
Per Capita ◽  
Spatial Moving Average

Background Infant mortality rate is a measure of population health and neonatal mortality account for great proportion of these deaths. Underdevelopment might be associated to higher neonatal mortality risk due to assistant related factors. Spatial and temporal distribution of mortality help identifying and developing strategies for interventions. Objective To investigate the cluster areas of asphyxia-associated neonatal mortality and to explore its association with per capita gross domestic product (GDP) in São Paulo State (SP), Brazil. Methods Ecological study including live births residents in SP from 2004–2013. Neonatal deaths (0–27 days) with perinatal asphyxia were defined as intrauterine hypoxia, birth asphyxia or meconium aspiration syndrome written in any line of the Death Certificate. Geoprocessing analytical approach included detection of first order effects through quintiles and spatial moving average maps, followed by second order effects by global and local spatial autocorrelation (Moran and LISA, respectively) before and after smoothing with local Bayesian estimates. Finally, Spearman correlation was applied between asphyxia-associated neonatal mortality and mean per capita GDP rates for the municipalities with significant LISA. Results There were 6,713 asphyxia-associated neonatal deaths among 5,949,267 live births (rate: 1.13/1000) in SP. Spatial moving average maps showed a non-random distribution among municipalities, with presence of clusters (I = 0.048; p = 0.023). LISA map identified clusters of asphyxia-associated neonatal mortality in the south, southeast and northwest. After applying local Bayes estimates, clusters were more pronounced (I = 0.589; p = 0.001). There was a partial overlap of the areas of higher asphyxia-associated neonatal mortality and lower mean per capita GDP. Conclusions Spatial analysis identified cluster areas of high asphyxia-associated neonatal mortality and low per capita GDP rates, with a significant negative correlation. This optimized, structured, and hierarchical approach to identify high-risk areas of cause-specific neonatal mortality may be helpful for guiding public health efforts to decrease neonatal mortality.

scholarly journals Secular trend, seasonality and effects of a community-based intervention on neonatal mortality: follow-up of a cluster-randomised trial in Quang Ninh province, Vietnam

2018 ◽  
Vol 72 (9) ◽  
pp. 776-782
Author(s):  
Leif Eriksson ◽  
Nguyen T Nga ◽  
Dinh T Phuong Hoa ◽  
Duong M Duc ◽  
Anna Bergström ◽  
...  
Keyword(s):  
Time Series ◽  
Neonatal Mortality ◽  
Secular Trend ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Neonatal Deaths ◽  
Live Births ◽  
Cluster Randomised ◽  
Quang Ninh

BackgroundLittle is know about whether the effects of community engagement interventions for child survival in low-income and middle-income settings are sustained. Seasonal variation and secular trend may blur the data. Neonatal mortality was reduced in a cluster-randomised trial in Vietnam where laywomen facilitated groups composed of local stakeholders employing a problem-solving approach for 3 years. In this analysis, we aim at disentangling the secular trend, the seasonal variation and the effect of the intervention on neonatal mortality during and after the trial.MethodsIn Quang Ninh province, 44 communes were allocated to intervention and 46 to control. Births and neonatal deaths were assessed in a baseline survey in 2005, monitored during the trial in 2008–2011 and followed up by a survey in 2014. Time series analyses were performed on monthly neonatal mortality data.ResultsThere were 30 187 live births and 480 neonatal deaths. The intervention reduced the neonatal mortality from 19.1 to 11.6 per 1000 live births. The reduction was sustained 3 years after the trial. The control areas reached a similar level at the time of follow-up. Time series decomposition analysis revealed a downward trend in the intervention areas during the trial that was not found in the control areas. Neonatal mortality peaked in the hot and wet summers.ConclusionsA community engagement intervention resulted in a lower neonatal mortality rate that was sustained but not further reduced after the end of the trial. When decomposing time series of neonatal mortality, a clear downward trend was demonstrated in intervention but not in control areas.Trial registration numberISRCTN44599712, Post-results.

Retrospective analysis of neonatal deaths secondary to infections in England and Wales, 2013–2015

2020 ◽  
pp. fetalneonatal-2020-319093
Author(s):  
Godwin Oligbu ◽  
Leila Ahmed ◽  
Laura Ferraras-Antolin ◽  
Shamez Ladhani
Keyword(s):  
Mortality Rate ◽  
Retrospective Analysis ◽  
Neonatal Mortality ◽  
Mortality Rates ◽  
Neonatal Mortality Rate ◽  
England And Wales ◽  
Neonatal Deaths ◽  
Live Births ◽  
Extremely Preterm ◽  
Related Mortality

ObjectiveTo estimate the overall and infection-related neonatal mortality rate and the pathogens responsible using electronic death registrations.DesignRetrospective analysis of national electronic death registrations data.SettingEngland and Wales.PatientsNeonates aged <28 days.Main outcome measuresOverall and infection-related mortality rate per 1000 live births in term, preterm (28–36 weeks) and extremely preterm (<28 weeks) neonates; the contribution of infections and specific pathogens; comparison with mortality rates in 2003–2005.ResultsThe neonatal mortality rate during 2013–2015 (2.4/1000 live births; 5095 deaths) was 31% lower than in 2003–2005 (3.5/1000; 6700 deaths). Infection-related neonatal mortality rate in 2013–2015 (0.32/1000; n=669) was 20% lower compared with 2003–2015 (0.40/1000; n=768), respectively. Infections were responsible for 13.1% (669/5095) of neonatal deaths during 2013–2015 and 11.5% (768/6700) during 2003–2005. Of the infection-related deaths, 44.2% (296/669) were in term, 19.9% (133/669) preterm and 35.9% (240/669) extremely preterm neonates. Compared with term infants (0.15/1000 live births), infection-related mortality rate was 5.9-fold (95% CI 4.7 to 7.2) higher in preterm (0.90/1000) and 188-fold (95% CI 157 to 223) higher in extremely preterm infants (28.7/1000) during 2013–2015. A pathogen was recorded in 448 (67%) registrations: 400 (89.3%) were bacterial, 37 (8.3%) viral and 11 (2.4%) fungal. Group B streptococcus (GBS) was reported in 30.4% (49/161) of records that specified a bacterial infection and 7.3% (49/669) of infection-related deaths.ConclusionsOverall and infection-related neonatal mortality rates have declined, but the contribution of infection and of specific pathogens has not changed. Further preventive measures, including antenatal GBS vaccine may be required to prevent the single most common cause of infection-related deaths in neonates.

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 ◽  
...  
Keyword(s):  
Birth Weight ◽  
Neonatal Mortality ◽  
Ecological Study ◽  
Population Based ◽  
Cross Sectional ◽  
Neonatal Deaths ◽  
Live Births ◽  
Taipei City ◽  
The Impact ◽  
The City

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.

scholarly journals Neonatal mortality and leading causes of deaths: a descriptive study in China, 2014–2018

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042654
Author(s):  
Yuxi Liu ◽  
Leni Kang ◽  
Chunhua He ◽  
Lei Miao ◽  
Xiaoqiong Qiu ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Middle Income ◽  
Government Interventions ◽  
Neonatal Deaths ◽  
Live Births ◽  
Urban And Rural Areas

ObjectiveThe present study estimated the national and urban–rural levels and causes of neonatal deaths in China annually between 2014 and 2018 to provide data support for the further end of preventable neonatal deaths for China and other low-income and middle-income countries.MethodsThe study was based on data from the National Maternal and Child Health Surveillance System. All neonates of surveillance districts (gestational week: ≥28 weeks) who died after delivery have been involved in the study. The mortality rate and the leading causes of death for neonates were analysed.ResultsThe neonatal mortality rate (NMR) of China has steadily decreased from 5.9 deaths per 1000 live births in 2014 to 3.9 deaths per 1000 live births in 2018. The NMR in 2018 of urban and rural areas was 2.2 deaths per 1000 live births and 4.7 deaths per 1000 live births, respectively. The leading preventable causes of neonatal deaths are the same in the urban and rural areas were same, which were preterm birth, intrapartum complications and pneumonia. Mortality rates of these three causes fell significantly between 2014 and 2018 but contributed to a higher proportion of deaths in rural areas than urban areas. The proportion of preventable deaths accounted for 74.6% in 2018.ConclusionsThe NMR of China has decreased steadily from 2014 to 2018. However, the inequality between urban and rural areas still exists. The goal of government interventions should be to reduce the health inequality of neonates and further take targeted measures to eliminate preventable neonatal death.

scholarly journals Is There Cross-Country Income Convergence Among the BRICS Nations? An Examination

2019 ◽  
Vol 11 (1-2) ◽  
pp. 121-135
Author(s):  
Ramesh Chandra Das
Keyword(s):  
Steady State ◽  
Direct Investment ◽  
Poor Country ◽  
Jel Classification ◽  
Income Convergence ◽  
Working Population ◽  
Capita Gross Domestic Product ◽  
Per Capita Gdp ◽  
Per Capita ◽  
Cross Country

Narrowing the developmental gaps of a relatively poor country with a relatively rich one is one of the priorities to the policymakers of the former. One way to reduce the developmental gaps is making different countries in a group to converge to a single steady-state value. Under this background, this study aims to examine whether the BRICS nations are converging in per capita GDP for the period 1990–2016. Applying the neoclassical methodology of β convergence and σ convergence, the study observes that the countries are not unconditionally β converging but converging in conditional terms with the variables such as foreign direct investment (FDI) flow and working population acting as the deciding factor. Furthermore, the study shows that the countries are converging in σ definition meaning the cross-country dispersion in per capita gross domestic product (GDP) has fallen significantly. Hence, formation of BRICS has made the countries relatively better off compared to pre-BRICS phase. JEL Classification: E01, O4, J21

scholarly journals Evaluation of a two-way SMS messaging strategy to reduce neonatal mortality: rationale, design and methods of the Mobile WACh NEO randomised controlled trial in Kenya

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e056062
Author(s):  
Keshet Ronen ◽  
Esther M Choo ◽  
Brenda Wandika ◽  
Jenna I Udren ◽  
Lusi Osborn ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Neonatal Mortality ◽  
Maternal Mental Health ◽  
Post Partum ◽  
Controlled Trial ◽  
Care Seeking ◽  
Essential Newborn Care ◽  
Neonatal Deaths ◽  
Live Births ◽  
Randomised Controlled

IntroductionGlobally, approximately half of the estimated 6.3 million under-5 deaths occur in the neonatal period (within the first 28 days of life). Kenya ranks among countries with the highest number of neonatal deaths, at 20 per 1000 live births. Improved identification and management of neonates with potentially life-threatening illness is critical to meet the WHO’s target of ≤12 neonatal deaths per 1000 live births by 2035. We developed an interactive (two-way) short messaging service (SMS) communication intervention, Mobile Solutions for Neonatal Health (Mobile women’s and children’s health (WACh) NEO), focused on the perinatal period. Mobile WACh NEO sends automated tailored SMS messages to mothers during pregnancy and up to 6 weeks post partum. Messages employ the Information-Motivation-Behaviour Skills framework to promote (1) maternal implementation of essential newborn care (ENC, including early, exclusive breast feeding, cord care and thermal care), (2) maternal identification of neonatal danger signs and care-seeking, and (3) maternal social support and self-efficacy. Participants can also send SMS to the study nurse, enabling on-demand remote support.Methods and analysisWe describe a two-arm unblinded randomised controlled trial of the Mobile WACh NEO intervention. We will enrol 5000 pregnant women in the third trimester of pregnancy at 4 facilities in Kenya and randomise them 1:1 to receive interactive SMS or no SMS (control), and conduct follow-up visits at 2 and 6 weeks post partum. Neonatal mortality will be compared between arms as the primary outcome. Secondary outcomes include care-seeking, practice of ENC and psychosocial health. Exploratory analysis will investigate associations between maternal mental health, practice of ENC, care-seeking and SMS engagement.Ethics and disseminationThis study received ethical approval from the University of Washington (STUDY00006395), Women and Infants Hospital (1755292-1) and Kenyatta National Hospital/University of Nairobi (P310/04/2019). All participants will provide written informed consent. Findings will be published in peer-reviewed journals and international conferences.Trial registration numberNCT04598165

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

Reduction in Perinatal Mortality after Implementation of HBB Training at a District Hospital in Mali

2019 ◽  
Vol 66 (3) ◽  
pp. 315-321
Author(s):  
M Innerdal ◽  
I Simaga ◽  
H Diall ◽  
M Eielsen ◽  
S Niermeyer ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Perinatal Mortality ◽  
District Hospital ◽  
Neonatal Mortality Rate ◽  
Neonatal Deaths ◽  
Live Births ◽  
Early Neonatal Mortality ◽  
Helping Babies Breathe ◽  
Before And After

Abstract Background Mali has a high neonatal mortality rate of 38/1000 live births; in addition the fresh stillbirth rate (FSR) is 23/1000 births and of these one-third are caused by intrapartum events. Objectives The aims are to evaluate the effect of helping babies breathe (HBB) on mortality rate at a district hospital in Kati district, Mali. Methods HBB first edition was implemented in April 2016. One year later the birth attendants were trained in HBB second edition and started frequent repetition training. This is a before and after study comparing the perinatal mortality during the period before HBB training with the period after HBB training, the period after HBB first edition and the period after HBB second edition. Perinatal mortality is defined as FSR plus neonatal deaths in the first 24 h of life. Results There was a significant reduction in perinatal mortality rate (PMR) between the period before and after HBB training, from 21.7/1000 births to 6.0/1000 live births; RR 0.27, (95% CI 0.19–0.41; p &lt; 0.0001). Very early neonatal mortality rate (24 h) decreased significantly from 6.3/1000 to 0.8/1000 live births; RR 0.12 (95% CI 0.05–0.33; p = 0.0006). FSR decreased from 15.7/1000 to 5.3/1000, RR 0.33 (95% CI 0.22–0.52; p &lt; 0.0001). No further reduction occurred after introducing the HBB second edition. Conclusion HBB may be effective in a local first-level referral hospital in Mali.

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 Effect of Parity on Neonatal Mortality in Indonesia

2021 ◽  
Vol 12 (3) ◽  
pp. 250-262
Author(s):  
Arianty Siahaan ◽  
Iwan Ariawan
Keyword(s):  
Neonatal Mortality ◽  
Neonatal Death ◽  
P Value ◽  
Cross Sectional ◽  
Place Of Delivery ◽  
Neonatal Deaths ◽  
Live Births ◽  
Number Of Children ◽  
Logistic Regressions ◽  
Cross Sectional Design

The neonatal mortality rate in Indonesia is still relatively high (15 per 1,000 live births). The number of children born to a woman (parity) is also still high. The Total Fertility Rate (TFR) is 2.4 per woman. This study aims to determine the effect of parity on neonatal deaths in Indonesia. We used 2017 IDHS data with a cross-sectional design includes 14,827 live births in the 2012-2017 period. Data were analyzed using the multiple logistic regressions method. The results showed that primipara had a statistically insignificant relationship (p-value > 0.05) compared with multipara. While parity≥4 had a risk of 1.90 times experienced on neonatal mortality compared with multipara (95% CI:1,00-3,63) after being controlled by the maternal age, birth attendant, and place of delivery and statistically significant (p-value≤0,05). Thus, parity ≥4 was significantly associated with neonatal mortality. The more children born to mothers, the higher the risk of neonatal death. While parity 1 did not have a significant relationship with neonatal mortality. It is recommended that family planning programs be increased to reduce parity to avoid the risk of neonatal death. The BKKBN program should be improved in reducing TFR.

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