Changes in Infant Morbidity Associated with Decreases in Neonatal Mortality

PEDIATRICS ◽  
1983 ◽  
Vol 72 (3) ◽  
pp. 408-415
Author(s):  
Sam Shapiro ◽  
Marie C. McCormick ◽  
Barbara H. Starfield ◽  
Barbara Crawley
Keyword(s):  
Birth Weight ◽  
Developmental Delay ◽  
Neonatal Mortality ◽  
High Mortality ◽  
Congenital Anomalies ◽  
Mortality And Morbidity ◽  
Random Samples ◽  
Infant Morbidity

Neonatal mortality and morbidity among infants surviving to 1 year of age in eight geographic areas have been compared to determine whether recent decreases in mortality have affected the risk of infants having congenital anomalies or developmental delay. Mortality was obtained from birth and death records in 1976 and either 1978 or 1979; morbidity through home interviews with mothers of random samples of infants and developmental observations on the children. It is concluded that the decrease in mortality was not offset by increases in children with defects. Neonatal mortality decreased by 18% in this 2- to 3-year period; risk of congenital anomalies or developmental delay (all types combined) declined by 16% among the surviving infants. The reduction in risk was concentrated in the minor congenital anomalies or developmental delay category; the proportion of children with severe or moderate congenital anomalies or developmental delay did not change. Decreases occurred at every birth weight including the very low birth weights of 1,500 g or less, a subgroup with especially high mortality and morbidity resulting from perinatal events.

Pneumopericardium in the Neonate

2017 ◽  
Vol 36 (6) ◽  
pp. 368-373
Author(s):  
Tiffany L. Walker ◽  
Dorothy A. Shannon
Keyword(s):  
Mechanical Ventilation ◽  
Birth Weight ◽  
Respiratory Distress ◽  
Premature Infants ◽  
High Mortality ◽  
Neonatal Care ◽  
Mortality And Morbidity ◽  
Surfactant Replacement ◽  
Antenatal Steroids ◽  
History Of

AbstractPneumopericardium occurs when air accumulates in the pericardial sac surrounding the heart and is one of the rarest forms of air leaks in neonates. Because of various advances in neonatal care, including gentler modes of ventilation, surfactant replacement, and antenatal steroids, the incidence of pneumopericardium has decreased. Despite the decrease in incidence of pneumopericardium, most cases arise in premature infants with a history of respiratory distress and mechanical ventilation. Evidence has shown that the incidence is inversely related to birth weight and that pneumopericardium has high mortality and morbidity rates.

scholarly journals Neonatal Mortality and Morbidity in a Tertiary Care Hospital of Coastal South India

2018 ◽  
Vol 37 (3) ◽  
pp. 232-237
Author(s):  
Raja Kannan ◽  
Suchetha Rao ◽  
Prasanna Mithra ◽  
SM Rajesh ◽  
Bhaskaran Unnikrishnan ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Congenital Malformations ◽  
Distress Syndrome ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
New Born

Correction: On 13th June, Prasanna Mithra was added as an author of this paper.Introduction: Progress in new-born survival has been slow. There is a variation in neonatal death rates across states and geographical region of a country. Understanding the pattern of mortality is essential in improving new-born survival. This study was conducted to study the mortality and morbidity profile in Neonatal Intensive Care Unit (NICU) of a university teaching hospital.Material and Methods: This was a retrospective descriptive study including records of all neonates admitted in NICU from January 2015 to December 2016.Results 3623 neonates were admitted during the study period. Majority were preterm and low birth weight babies. Neonatal jaundice (41.4%) was the leading cause of admission. Major cause of morbidity was sepsis (26.2%). Average duration of stay were higher in out borns (8.4 days) compared to inborn (6.5 days) neonates. Among mortality a higher male predominance was seen. Neonatal sepsis (36.3%) was the single most common cause of mortality followed by respiratory distress syndrome (27.4%) and congenital malformations (18.6%). Out born neonates which were self-transported had higher mortality rate than transported by ambulance.Conclusion This study identifies sepsis, prematurity and low birth weight as the major causes of morbidity. Sepsis, respiratory distress syndrome and congenital malformations were the leading causes of mortality Understanding causes of neonatal mortality may help to implement interventions to promote new-born survival.  

scholarly journals Neonatal mortality and morbidity in vertex–vertex second twins according to mode of delivery and birth weight

2005 ◽  
Vol 26 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Q Yang ◽  
S W Wen ◽  
Y Chen ◽  
D Krewski ◽  
K Fung Kee Fung ◽  
...  
Keyword(s):  
Birth Weight ◽  
Neonatal Mortality ◽  
Mode Of Delivery ◽  
Mortality And Morbidity

CAUSES OF NEONATAL MORTALITY IN SPAIN (1975–98): INFLUENCE OF SEX, RURAL–URBAN RESIDENCE AND AGE AT DEATH

2005 ◽  
Vol 38 (4) ◽  
pp. 537-551 ◽  
Author(s):  
VERÓNICA ALONSO ◽  
VICENTE FUSTER ◽  
FRANCISCO LUNA
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Congenital Anomalies ◽  
Urban Areas ◽  
Age At Death ◽  
Male Mortality ◽  
Respiratory Problems ◽  
Early Neonatal Mortality ◽  
Preterm Born

Neonatal mortality during the first week of life, corresponding to the years 1975–1998, was studied in Spain. The first week of life is the time in which the highest number of deaths occur. The temporal decrease of the neonatal mortality rate (NMR) was modelled according to log10(NMR+1)= 2·784−0·023 per year. This decline cannot be explained by an increase in the mean birth weight (MBW=23440·835−10·107 g per year). From the most frequent of the causes of death to the least were: congenital anomalies, preterm born or low birth weight, respiratory problems, pregnancy difficulties, hypoxaemia/asphyxia, delivery difficulties and infectious diseases. This sequence changed when the specific age at death was considered. The NMR descended evenly for both sexes for the causes indicated above, except for preterm born or low birth weight, in which the male mortality decrease was greater since its rate was more elevated at the beginning of the period studied. For all the causes listed, NMR was more elevated both in urban areas and for males. Early neonatal mortality (first 24 hours) was higher for pregnancy difficulties, preterm born or low birth weight, congenital anomalies and hypoxaemia/asphyxia.

scholarly journals Neonatal mortality of sick newborns admitted in a tertiary care teaching hospital in Tamil Nadu, South India

2017 ◽  
Vol 4 (2) ◽  
pp. 399
Author(s):  
Sathya Jeganathan ◽  
Rsavikmar S. A. ◽  
Tamilmani A. ◽  
Parameshwari P. P. ◽  
Asvatha Valarmathi Chinnarajalu ◽  
...  
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Tamil Nadu ◽  
South India ◽  
Birth Asphyxia ◽  
Mortality And Morbidity ◽  
Medical College

Background: Neonatal period is an important period in the life where most of the deaths are preventable. In India every year 1 million babies die, which contributes to 25% of the world neonatal mortality. Perinatal death is very high in developing countries including India.Methods: A record based retrospective study was conducted in the Neonatal Intensive care unit(NICU) of Department of Pediatrics, Chengalpattu Medical College in Tamil Nadu, South India. The records were collected for the period of one year from January 2016 to December 2016. All the neonates admitted in the NICU during this period were included in the study. Results: The number of total deliveries in Chengalpattu Medical College for the year 2016 was 9339. Total number of live births was 9170 of which 21.88% were low birth weight and 15.96% were preterm delivery. Mortality rate in males is 3.2% (54/1689) and mortality rate in female is 3.98% (55/1383). The difference in mortality rate among male and female neonates was not significant. Respiratory distress syndrome and prematurity related illness contributed to 45% of the total neonatal deaths (39/110). Birth asphyxia and meconium aspiration contributed to 23.6 % (24/110). Rest of the mortality was contributed by ELBW 11.8% (13/110), major congenital malformation 6.4% (7/110), sepsis 1.8% (2/110) and others.Conclusions: Prematurity related problems and respiratory distress are the leading causes of neonatal mortality and morbidity followed by birth asphyxia in CMCH. Proper identification and management of pre-eclampsia, prevention of preterm and low birth weight deliveries are the need of the hour to reduce the mortality and morbidity among neonates.  

scholarly journals Neonatal mortality in intensive care units of Central Brazil

2005 ◽  
Vol 39 (5) ◽  
pp. 775-781 ◽  
Author(s):  
Claci F Weirich ◽  
Ana Lucia S S Andrade ◽  
Marilia Dalva Turchi ◽  
Simonne A Silva ◽  
Otaliba L Morais-Neto ◽  
...  
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
High Mortality ◽  
Apgar Score ◽  
Neonatal Death ◽  
Mortality Rates ◽  
Death Certificates ◽  
Central Brazil

OBJECTIVE: To identify potential prognostic factors for neonatal mortality among newborns referred to intensive care units. METHODS: A live-birth cohort study was carried out in Goiânia, Central Brazil, from November 1999 to October 2000. Linked birth and infant death certificates were used to ascertain the cohort of live born infants. An additional active surveillance system of neonatal-based mortality was implemented. Exposure variables were collected from birth and death certificates. The outcome was survivors (n=713) and deaths (n=162) in all intensive care units in the study period. Cox's proportional hazards model was applied and a Receiver Operating Characteristic curve was used to compare the performance of statistically significant variables in the multivariable model. Adjusted mortality rates by birth weight and 5-min Apgar score were calculated for each intensive care unit. RESULTS: Low birth weight and 5-min Apgar score remained independently associated to death. Birth weight equal to 2,500g had 0.71 accuracy (95% CI: 0.65-0.77) for predicting neonatal death (sensitivity =72.2%). A wide variation in the mortality rates was found among intensive care units (9.5-48.1%) and two of them remained with significant high mortality rates even after adjusting for birth weight and 5-min Apgar score. CONCLUSIONS: This study corroborates birth weight as a sensitive screening variable in surveillance programs for neonatal death and also to target intensive care units with high mortality rates for implementing preventive actions and interventions during the delivery period.

Discrepancy Analysis between Clinical Versus Ultrasound Estimated Fetal Weight and Actual Birth Weight at 3rd Trimester

2019 ◽  
Vol 11 (1) ◽  
pp. 32-38
Author(s):  
Naznin Rashid Shewly ◽  
Menoka Ferdous ◽  
Hasina Begum ◽  
Shahadat Hossain Khan ◽  
Sheema Rani Debee ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Fetal Weight ◽  
P Value ◽  
Weight Estimation ◽  
Third Trimester ◽  
Mortality And Morbidity ◽  
Fetal Weight Estimation ◽  
Obstetric Management ◽  
Estimated Fetal Weight

Background: In obstetric management fetal weight estimation is an important consideration when planning the mode of delivery in our day to day practice. In Bangladesh low birth weight is a major public health problem & incidence is 38% - 58%. Neonatal mortality and morbidity also yet high. So accurate antenatal estimation of fetal weight is a good way to detect macrosomia or small for date baby. Thus to improve the pregnancy outcome and neonatal outcome decreasing various chance of neonatal mortality and morbidity antenatal fetal weight prediction is an invaluable parameter in some situation where to identify the at risk pregnancy for low birth weight become necessary. Reliable method for prenatal estimation of fetal weight two modalities have got popularity - Clinical estimation and another one is ultrasonic estimation. This study was designed to determine the accuracy of clinical versus ultrasound estimated fetal weight detecting the discrepancy with actual birth weight at third trimester. So that we can verify more reliable and accurate method. Objectives: To find out more accurate and reliable modality of fetal weight estimation in antenatal period during obstetric management planning. To compare clinical versus ultrasound estimated fetal weight & to determine discrepancy of both variable with actual birth weight. Method: This prospective, cross sectional analytical study was carried out in Dhaka Medical College Hospital from January 2006 to December 2006. By purposive sampling 100 pregnant women fulfilling inclusion criteria were included in my study in third trimester (29wks-40wks). In clinical weight estimation procedure SFH (Symphysio Fundal Height) was measured in centimeter. On pervaginal finding whether vertex below or above the ischial spine was determined. By Johnson’s formula fetal weight in grams was estimated. Then by ultrasound scan different biometric measurements were taken and finally by Hadlock’s formula fetal weight was estimated. Eventually actual birth weight was taken after birth by Globe Brand weighing machine. Accuracy of both modalities were compared and which one was more reliable predictor was determined by statistical analysis. Results: After data collection were analyzed by computer based software (SPSS). There was gradual and positive relationship between symphysiofundal height and estimated birth weight. Discrepancy between clinical and actual birth weight at third trimester was statistically significant – Paired Student’s ‘t’ test was done where p value was <0.001. Whereas discrepancy between sonographically estimated fetal weight with actual birth weight was not statistically significant (by paired ‘t’ test where p value was >0.05). That implies discrepancy between ultrasound estimated fetal weight and actual birth weight was significantly less than that of clinically estimated fetal weight. 14% clinically and 46% sonographically estimated fetal weight were observed within £ 5% of actual birth weight. 31% clinical and 42% sonographically estimates observed within 6% to 10% of actual birth weight and 55% clinical and 12% sonographically estimate were >10% of actual birth weight. That is about 88% sonographical versus 45% clinical estimates were within 10% of actual birth weight. Conclusion: There is no doubt about importance of fetal weight in many obstetric situations. Clinical decisions at times depends on fetal weight. Whether to use oxytocin, to use forceps or vacuum for delivery or extend of trial or ended by Caesarian section immediately or no scope of trial to be largely depend on fetal size and weight. So more accurate modality for antenatal fetal weight estimation has paramount importance. In my study sonographically estimated weight have more accuracy than that of clinical estimate in predicting actual birth weight. Sonographically estimated fetal weight is more reliable, accurate and reproducible rather than other modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 32-38

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