Perinatal vs. Neonatal Mortality

PEDIATRICS ◽  
1973 ◽  
Vol 52 (2) ◽  
pp. 311-311
Author(s):  
Peter W. Houck
Keyword(s):  
Neonatal Mortality ◽  
Death Rate ◽  
Hospital Care ◽  
Perinatal Death ◽  
Newborn Infants ◽  
Vital Statistics ◽  
Neonatal Deaths ◽  
Perinatal Death Rate ◽  
International Comparability

The annual summary of vital statistics for 1971 was noted in the December 1972 issue. I am confused as to the method of reporting newborn deaths. The recently revised Standards and Recommendations, Hospital Care of Newborn Infants handbook recommends reporting a perinatal death rate for international comparability. Stillbirths after 28 weeks and neonatal deaths under seven days* are used as a more relative means of assessing conditions surrounding birth. The following formula is used to calculate the perinatal death rate:

Epidemiology of congenital malformations of the central nervous system in (a) Aberdeen and (b) Scotland

1974 ◽  
Vol 6 (2) ◽  
pp. 113-137 ◽  
Author(s):  
Dugald Baird
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Death Rate ◽  
Perinatal Death ◽  
Social Classes ◽  
Stillbirth Rate ◽  
Sequence Of Events ◽  
Perinatal Death Rate ◽  
The Central Nervous System ◽  
Cns Malformations

SummaryThe incidence of anencephalus and other malformations of the central nervous system (CNS) is much higher in the United Kingdom than in other countries of Western Europe which were not industrialized to the same extent. In the UK the incidence is highest in the unskilled manual occupational group, especially in the large cities of the North of England, Scotland and Northern Ireland. Standards of living have been low in these areas for many years and deteriorated sharply at the time of the worldwide industrial depression from 1928 to 1934. The population tended to be stunted in stature and to show other signs of chronic malnutrition.The cohort of women born in these years had an unusually high stillbirth rate from anencephalus (and from all other CNS malformations) from about 1946 onwards. It was highest in the early 1960s when these women were at the peak of their reproductive activity. This suggests that the severe malnutrition to which they were subjected before and soon after birth resulted in severe damage, which reduced their reproductive efficiency as demonstrated by the unusually high perinatal death rate from all CNS malformations. Not surprisingly the death rate rose sooner, lasted longer and reached a higher level in social classes IV and V than in social classes I and II. Other evidence of damage was an increase in the incidence of low birth weight babies with a corresponding increase in the perinatal death rate from this cause.In Scotland the stillbirth rate from anencephalus was approximately 2·1 per 1000 in 1948–49, 3·4 at its highest point between 1961 and 1963 and 2·1 in 1968, by which time the women born in the years of the depression had completed their childbearing. A teratogen acting during a particular period of time could not provide a satisfactory explanation for this sequence of events.

Study of obstetric factors in perinatal morbidity and mortality at a tertiary centre

2017 ◽  
Vol 7 (1) ◽  
pp. 198
Author(s):  
Sanjaykumar G. Tambe ◽  
Yogesh A. Thawal ◽  
Tania Anand ◽  
Dipak Suresh Kolate
Keyword(s):  
Perinatal Mortality ◽  
Health Care Providers ◽  
Perinatal Death ◽  
Golden Rule ◽  
Vital Statistics ◽  
Safe Motherhood ◽  
Care Providers ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Tertiary Center

Background: Safe motherhood and child survival have always been a concern for the policymakers but perinatal mortality, especially stillbirths, have not received due attention. There are 5.9 million perinatal deaths worldwide, almost all of which occur in developing countries. Stillbirths account for over half of all perinatal deaths. This study was aimed to determine perinatal mortality rate and related obstetrics risk factors. Perinatal mortality is only a tip of the iceberg, morbidity being much higher. Vital statistics obtained through this study may serve an important source of information to guide the public health policy makers and health care providers in future.Methods: Present observational study was undertaken in a tertiary center to look into various maternal factors and possible cause of perinatal death. All perinatal deaths including stillbirths (SBs) and early neonatal deaths (ENNDs) within 0-7 days of birth after 28 weeks of gestation were analysed. The data was collected through a pre-designed proforma.Results: Perinatal mortality is 66.27/1000 births in our centre, where 37% were intrauterine deaths, 34% were neonatal deaths and 29% were still births. Preterm, pregnancy induced hypertension; abruptio placentae remain the most important factors for perinatal loss.Conclusions: One of the reasons for high perinatal mortality in tertiary centres is because of poor antenatal care at peripheral centres and late referrals. Early detection of obstetric complications and aggressive treatment is one of golden rule to reduce perinatal loss.

Stillbirth and Neonatal mortality in Jordan: Findings from Jordan Stillbirths and Neonatal Deaths Surveillance System (Preprint)

2021 ◽  
Author(s):  
Yousef Khader ◽  
Nihaya Al-Sheyab ◽  
Mohammad Alyahya ◽  
Ziad El-Khatib ◽  
Khulood Shattnawi ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Low Income ◽  
Surveillance System ◽  
Death Rate ◽  
Congenital Malformations ◽  
Low Birthweight ◽  
Chromosomal Abnormalities ◽  
Mortality Rates ◽  
Low Income Countries ◽  
Neonatal Deaths

BACKGROUND Stillbirth and neonatal mortality declined significantly in high- and some middle- income countries because of the significant improvements in obstetric and neonatal care. Yet, stillbirth and neonatal mortality rates remain high in low-income countries. The main reason for low progress in reducing such stillbirths and neonatal deaths in Jordan is the scarcity of data on causes and contributing factors leading to these deaths. OBJECTIVE This study aimed to determine the rates, causes and risk factors of stillbirth and neonatal mortality in Jordan. METHODS An electronic stillbirth and neonatal deaths surveillance system was established in five large hospitals in Jordan. Data on all births, stillbirths and neonatal deaths and their causes during the period May 2019 – December 2020 were exported from the system and analyzed. RESULTS A total of 29,592 women gave birth to 31,106 babies during a period of 20 months in the selected hospitals. The stillbirth rate was 10.5 per 1,000 total births, the neonatal death rate was 14.2 per 1,000 live births, and the perinatal death rate was 21.4 per 1,000 total births. Of all neonatal deaths, 29.4% died within the first day of life and 77.8% died during the first week of life. For neonatal deaths occurred pre-discharge, the leading causes of death were respiratory and cardiovascular disorders (35.0%), low birth weight and prematurity (32.7%), and congenital malformations, deformations and chromosomal abnormalities (19.5%). Almost one third of stillbirths had unspecified cause of death (33.3% of antepartum stillbirths and 28.9% of intrapartum stillbirths). Acute antepartum event was responsible of 27.4% of antepartum stillbirths and acute intrapartum event was responsible for 13.2% of intrapartum stillbirths. Congenital malformations, deformations and chromosomal abnormalities contributed to 18.1% of antepartum stillbirths and 34.2% of intrapartum stillbirths. CONCLUSIONS There is a relative stability of stillbirth and neonatal mortality rates in Jordan. Several identified maternal and/or fetal conditions that contributed to stillbirths and/or neonatal deaths in Jordan are preventable. Focused care needs to be directed high-risk pregnant women and to neonates with low birthweight and respiratory problems.

Perinatal Death Rate

BMJ ◽  
1954 ◽  
Vol 2 (4899) ◽  
pp. 1278-1279 ◽  
Keyword(s):  
Death Rate ◽  
Perinatal Death ◽  
Perinatal Death Rate

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 Analysis of causes of early neonatal mortality during covid-19 pandemic in 2020 in Russia

2021 ◽  
Author(s):  
UN Tumanova ◽  
AI Schegolev ◽  
AA Chausov ◽  
MP Shuvalova
Keyword(s):  
Neonatal Mortality ◽  
Neonatal Death ◽  
Respiratory Diseases ◽  
Perinatal Death ◽  
Absolute Number ◽  
World Health ◽  
Neonatal Deaths ◽  
Early Neonatal Mortality ◽  
Federal Districts ◽  
Health Organization

In March 2020, the World Health Organization declared a COVID-19 pandemic. The aim of this study was to compare the causes of and statistics on neonatal mortality in Russia in the years 2020 and 2019 using the Rosstat A-5 forms that aggregate data from perinatal death certificates. In 2020, there was a 7.6% reduction in the absolute number of live births relative to 2019. In 2020, the early neonatal death rate (1.59‰) fell by 4.4% relative to 2019 (1.67‰). But neonatal death rates in the Southern and Far Eastern Federal Districts rose by 20.5% and 6.1%, respectively. Respiratory diseases were the most common cause of early neonatal mortality across Russia (37.3% and 40.2% relative to the total number of neonatal deaths in 2019 and 2020, respectively). Congenital sepsis accounted for 43.6% and 46.6% of neonatal deaths from infectious diseases and for 7.3% and 7.9% of all neonatal deaths reported in 2019 and 2020, respectively. There was an increase in the proportion of respiratory diseases among neonates, including congenital pneumonia and other respiratory conditions, and infections, including congenital sepsis, which reflects the direct and indirect effects of SARS-CoV-2 infection in pregnant women and neonates.

scholarly journals A compelling symmetry: The extended fetuses-at-risk perspective on modal, optimal and relative birthweight and gestational age

2020 ◽  
Author(s):  
K.S. Joseph
Keyword(s):  
At Risk ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Death Rate ◽  
Perinatal Death ◽  
The United States ◽  
Rate Of Change ◽  
Death Rates ◽  
First Derivative ◽  
Perinatal Death Rate

AbstractBackgroundThe relationship between several intriguing perinatal phenomena, namely, modal, optimal, and relative birthweight and gestational age, remains poorly understood, especially the mechanism by which relative birthweight and gestational age resolve the paradox of intersecting perinatal mortality curves.MethodsBirthweight and gestational age distributions and birthweight- and gestational age-specific perinatal death rates of low- and high-risk cohorts in the United States, 2004-2015, were estimated using births-based and extended fetuses-at-risk formulations. The relationships between these births-based distributions and rates, and the first derivatives of fetuses-at-risk birth and perinatal death rates were examined in order to assess how the rate of change in fetuses-at-risk rates affects gestational age distributions and births-based perinatal death rate patterns.ResultsModal gestational age typically exceeded optimal gestational age because both were influenced by the peak in the first derivative of the birth rate, while optimal gestational age was additionally influenced by the point at which the first derivative of the fetuses-at-risk perinatal death rate showed a sharp increase in late gestation. The clustering and correlation between modal and optimal gestational age within cohorts, the higher perinatal death rate at optimal gestational age among higher-risk cohorts, and the symmetric left-shift in births-based gestational age-specific perinatal death rates in higher-risk cohorts explained how relative gestational age resolved the paradox of intersecting perinatal mortality curves.ConclusionsChanges in the first derivative the fetuses-at-risk birth and perinatal death rates underlie several births-based perinatal phenomena and this explanation further unifies the fetuses-at-risk and births-based models of perinatal death.

scholarly journals A compelling symmetry: The extended fetuses-at-risk perspective on modal, optimal and relative birthweight and gestational age

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0238673
Author(s):  
K. S. Joseph
Keyword(s):  
At Risk ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Death Rate ◽  
Perinatal Death ◽  
The United States ◽  
Rate Of Change ◽  
Death Rates ◽  
First Derivative ◽  
Perinatal Death Rate

Background The relationship between several intriguing perinatal phenomena, namely, modal, optimal, and relative birthweight and gestational age, remains poorly understood, especially the mechanism by which relative birthweight and gestational age resolve the paradox of intersecting perinatal mortality curves. Methods Birthweight and gestational age distributions and birthweight- and gestational age-specific perinatal death rates of low- and high-risk cohorts in the United States, 2004–2015, were estimated using births-based and extended fetuses-at-risk formulations. The relationships between these births-based distributions and rates, and the first derivatives of fetuses-at-risk birth and perinatal death rates were examined in order to assess how the rate of change in fetuses-at-risk rates affects gestational age distributions and births-based perinatal death rate patterns. Results Modal gestational age typically exceeded optimal gestational age because both were influenced by the peak in the first derivative of the birth rate, while optimal gestational age was additionally influenced by the point at which the first derivative of the fetuses-at-risk perinatal death rate showed a sharp increase in late gestation. The clustering and correlation between modal and optimal gestational age within cohorts, the higher perinatal death rate at optimal gestational age among higher-risk cohorts, and the symmetric left-shift in births-based gestational age-specific perinatal death rates in higher-risk cohorts explained how relative gestational age resolved the paradox of intersecting perinatal mortality curves. Conclusions Changes in the first derivative of the fetuses-at-risk birth and perinatal death rates underlie several births-based perinatal phenomena and this explanation further unifies the fetuses-at-risk and births-based models of perinatal death.

scholarly journals Prospective study to explore changes in quality of care and perinatal outcomes after implementation of perinatal death audit in Uganda

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e027504
Author(s):  
Victoria Nakibuuka Kirabira ◽  
Mamuda Aminu ◽  
Juan Emmanuel Dewez ◽  
Romano Byaruhanga ◽  
Pius Okong ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Perinatal Mortality ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Stillbirth Rate ◽  
Neonatal Mortality Rate ◽  
Neonatal Deaths ◽  
Early Neonatal Mortality ◽  
Early Neonatal Mortality Rate

ObjectiveTo assess the effects of perinatal death (PND) audit on perinatal outcomes in a tertiary hospital in Kampala.DesignInterrupted time series (ITS) analysis.SettingNsambya Hospital, Uganda.ParticipantsLive births and stillbirths.InterventionsPND audit.Primary and secondary outcome measuresPrimary outcomes: perinatal mortality rate, stillbirth rate, early neonatal mortality rate. Secondary outcomes: case fatality rates (CFR) for asphyxia, complications of prematurity and neonatal sepsis.Results526 PNDs were audited: 142 (27.0%) fresh stillbirths, 125 (23.8%) macerated stillbirths and 259 (49.2%) early neonatal deaths. The ITS analysis showed a decrease in perinatal death (PND) rates without the introduction of PND audits (incidence risk ratio (IRR) (95% CI) for time=0.94, p<0.001), but an increase in PND (IRR (95% CI)=1.17 (1.0 to –1.34), p=0.0021) following the intervention. However, when overdispersion was included in the model, there were no statistically significant differences in PND with or without the intervention (p=0.06 and p=0.44, respectively). Stillbirth rates exhibited a similar pattern. By contrast, early neonatal death rates showed an overall upward trend without the intervention (IRR (95% CI)=1.09 (1.01 to 1.17), p=0.01), but a decrease following the introduction of the PND audits (IRR (95% CI)=0.35 (0.22 to 0.56), p<0.001), when overdispersion was included. The CFR for prematurity showed a downward trend over time (IRR (95% CI)=0.94 (0.88 to 0.99), p=0.04) but not for the intervention. With regards CFRs for intrapartum-related hypoxia or infection, no statistically significant effect was detected for either time or the intervention.ConclusionThe introduction of PND audit showed no statistically significant effect on perinatal mortality or stillbirth rate, but a significant decrease in early neonatal mortality rate. No effect was detected on CFRs for prematurity, intrapartum-related hypoxia or infections. These findings should encourage more research to assess the effectiveness of PND reviews on perinatal deaths in general, but also on stillbirths and neonatal deaths in particular, in low-resource settings.

Letters to the Editor

PEDIATRICS ◽  
1973 ◽  
Vol 52 (2) ◽  
pp. 311-311
Author(s):  
Myron E. Wegman
Keyword(s):  
International Comparison ◽  
Live Birth ◽  
Death Rate ◽  
Perinatal Death ◽  
Letters To The Editor ◽  
Newborn Mortality ◽  
Perinatal Death Rate ◽  
Uniform Definition ◽  
Definition Of ◽  
Period Of Gestation

Dr. Houck is quite correct that the perinatal death rate is very useful as a method of studying newborn mortality; many deaths just before birth have the same causes as those which occur immediately after a live birth. The major problem in using such a rate for international comparison relates to reliability of reporting and definition of the period of gestation. It is easy to give a precise and uniform definition of a live birth and the age period after birth may also be determined with exactitude.

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