scholarly journals Risk factors for perinatal mortality in an urban area of Southern Brazil, 1993

1998 ◽  
Vol 32 (3) ◽  
pp. 209-216 ◽  
Author(s):  
Ana M. B. Menezes ◽  
Fernando C. Barros ◽  
Cesar G. Victora ◽  
Elaine Tomasi ◽  
Ricardo Halpern ◽  
...  

INTRODUCTION: Although there was a considerable reduction in infant mortality in Pelotas, Rio Grande do Sul in the last decade, its perinatal causes were reduced only by 28%. The associated factors of these causes were analised. MATERIAL AND METHOD: All hospital births and perinatal deaths were assessed by daily visits to all the maternity hospitals in the city, throughout 1993 and including the first week of 1994. RESULTS: The perinatal mortality rate was 22.1 per thousand births. The multivariate analysis showed the following risk factors: low socioeconomic level, male sex and maternal age above 35 years . Among multigravidae women, the fetal mortality rate was significantly increased for mothers with a previously low birthweight and a previous stillbirth. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight. CONCLUSIONS: Main risk factors for perinatal mortality: low socioeconomic level, maternal age above 35 years and male sex. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight.

2018 ◽  
Vol 35 (3-4) ◽  
pp. 94-100
Author(s):  
S. M. Salendu W. ◽  
Sutomo Raharjo ◽  
Immanuel Mustadjab ◽  
Nan Warouw

The risk factors of low birthweight infants were assessed in a retrospective study covering 3607 singleton livebirth infants at Manado Hospital from January until December 1993. The analysis confirmed that patterns of risk birthweight hypertension in pregnancy (P<0.01), maternal education (P<0.01), maternal age (P<0.05), and parity (P<0.01), marital status (P<0.01), history of abortion (P<0.05), and parity (P<0.01). Anemia in pregnancy was also associated with birthweight in low birth weight (P<0.05). Asymetric intrauterine growth retardation (Ponderal Index below 2.32) was found both in premature and term infants.


Author(s):  
Mayadevi Brahmanandan ◽  
Lekshmi Murukesan ◽  
Bindu Nambisan ◽  
Shaila Salmabeevi

Background: The greatest risks to life are in its very beginning. Although a good start in life begins well before birth, it is just before, during, and in the very first hours and days after birth that life is most at risk. This prospective case control study was designed on maternal risk factors for perinatal mortality.Methods: This was a case control study conducted in the Department of Obstetrics and Gynecology and Department of Paediatrics, Medical College Trivandrum for one year period in 2004-2005. The cases were all the fresh and macerated still births and early neonatal death cases during the study period. The controls were chosen as the next delivery entry in the OR register.Results: During this period, the total number of deliveries was 14,796 and there were 431 perinatal deaths. The perinatal mortality rate was 29.12. This was much higher compared to Kerala’s perinatal mortality rate of 10, the reason being that the study is conducted in a tertiary referral hospital with one of the best new born care nurseries and a large number of referrals. The most significant risk factors for perinatal mortality were low socio-economic status, referrals, late registration, prematurity, low birth weight, intra-uterine growth restriction, maternal diseases like gestational hypertension and gestational diabetes and intrapartum complications like abruption.Conclusions: Perinatal mortality rate serves as the most sensitive index of maternal and neonatal care. Good antenatal care and prevention of preterm birth may play a key role in further reduction of PMR.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yi Xie ◽  
Jing Han ◽  
Weili Yu ◽  
Junping Wu ◽  
Xue Li ◽  
...  

Identify the treatment effects and risk factors for mortality in patients with pulmonary tuberculosis receiving antituberculosis treatment under the Directly Observed Treatment Short-Course (DOTS) program to reduce the mortality rate of tuberculosis. A retrospective cohort analysis was conducted on the outcomes of antituberculosis treatment of 7,032 patients with tuberculosis in the DOTS program, in the Tuberculosis Management Information System from 2014 to 2017 in Tianjin, China. The Kaplan–Meier method and multifactor Cox proportional risk regression model were used to analyze the risk factors for mortality during antituberculosis treatment under DOTS. The success rate of antituberculosis treatment was 90.24% and the mortality rate was 4.56% among 7,032 cases of tuberculosis in Tianjin. Cox regression analysis showed that advanced age, male sex, human immunodeficiency virus (HIV) positivity, first sputum positivity, retreated tuberculosis, and a delayed visit (≥14 days) were risk factors for mortality in patients with pulmonary tuberculosis receiving antituberculosis treatment under DOTS. The treatment effects in patients with pulmonary tuberculosis during antituberculosis treatment under DOTS were positive in Tianjin. Advanced age, male sex, HIV positivity, first sputum positivity, retreated tuberculosis, and a delayed visit (≥14 days) increased the risk for mortality during antituberculosis treatment.


2010 ◽  
Vol 13 (5) ◽  
pp. 490-494 ◽  
Author(s):  
Ruoyan Gai Tobe ◽  
Rintaro Mori ◽  
Norio Shinozuka ◽  
Takahiko Kubo ◽  
Kazuo Itabashi

Our aims were to assess the incidence of birthweight discordance of twins, to explore risk factors and its impact on perinatal mortality, and to quantify the risks at different severity of birthweight discordance in Japan, by using a nationwide obstetric database. There were 10,828 pairs of twins, born from 2001 to 2005 recorded in the database of the national Perinatal Health Care Project, fully enrolled. The overall incidence of birthweight discordance was 47.34%. The incidence of mild, severe and extremely severe discordance was 19.26%, 10.21% and 17.87%, respectively. The incidence of birthweight discordance in Japan is much higher than that in other countries, particularly at higher severity level. By linear regression model, our study added independent factors of primiparity (p < .001), sex composition (p < .001), chorionicity (p < .001), gestational age (p < .001), and delivery mode (p < .001) in determining birthweight discordance percentage. Maternal age and application of assisted reproduction technologies (ART) didn't significantly influence the birthweight discordance. The birthweight discordance is closely associated with gestational age and affected discharge mortality. From 25% of birthweight discordance, risk to discharge mortality tended to significantly increase, suggesting it should be added as a reference for clinical practices.


2016 ◽  
Vol 48 (5) ◽  
pp. 306
Author(s):  
Made Lndah Nastiti Utami Budha ◽  
Wayan Retayasa ◽  
Made Kardana

Background The first week of life of a neonate is a critical period.In Asia, early neonatal mortality rate remains high.Objective To investigate early neonatal mortality rate and the riskfactors in Wangaya Hospital.Methods A cross sectional study was carried out retrospectivelyon neonates registered at Perinatology Unit, Wangaya HospitalDenpasar, Bali since January 2006. The study was done fromOctober to November 2007. Data was obtained from medicalrecord, analyzed as univariate using chi-square test or Fisher'sexact test and multivariate logistic regression analysis model.Results Early neonatal mortality rate in Wangaya Hospital was 38.7per 1000 livebirths. Univariate analyses showed that there werefive significant risk factors of early neonatal death, i.e., respiratorydistress, asphyxia, birth weight less than 2500 grams, sepsis, andgestational age less than 3 7 weeks. Multivariate analysis showedthat those five variables were significant as risk factors of earlyneonatal death i.e., OR (95% confidence interval) for respiratorydistress: 16.8 (3.7 to 76.6)], asphyxia: 13.5 (6.1 to 29.9)], birthweight <2500 grams: 8.1 (3.3 to 19.9)], sepsis: 7.3 (3.1 to 17.1),and gestational age <37 weeks: 3.5 (1.6 to 7.8)].Conclusions Early neonatal mortality rate in Wangaya Hospitalremains high. Respiratory distress, asphyxia, birth weight <2500gram, sepsis, and gestational age <37 weeks were independent riskfactors of early neonatal death.


2019 ◽  
Vol 26 (10) ◽  
pp. 1645-1650
Author(s):  
Rabia Mushtaq ◽  
Afroza Abbas ◽  
Waqas Ahmed

Objectives: Antepartum Hemorrhage is bleeding from or into the genital tract from the period of viability of fetus (28 weeks) till the end of second stage of labor. Antepartum hemorrhage is associated with a very high perinatal mortality rate. We present our experience of perinatal outcomes in cases of antepartum hemorrhage with the aim of highlighting the cause of antepartum hemorrhage and the adverse outcomes. Study Design: Descriptive Cross sectional study. Setting: Department of Gynecology & Obstetrics, Sargodha Medical College, Sargodha. Period: Jan 2018 to Jun 2018. Material and Methods: Ninety six pregnant patients between ages of 15-45 years diagnosed as cases of antepartum hemorrhage were enrolled. Patients with coagulation disorders, twin pregnancies, abnormal lie or presentation, previous scar and any known congenital anomaly. Cause of antepartum hemorrhage and mode of delivery was recorded. Perinatal outcomes were determined in terms of frequencies of perinatal mortality, stillbirth and low birthweight babies. Results: The etiology of antepartum hemorrhage in our setup was placenta previa (43.75%); placental abruption (37.5%); Toxemia (10.41%) and unclassified causes in 8.33% patients. The perinatal mortality rate was 43.75% in our study. The overall frequency of low birthweight babies and stillbirth was 62.5% and 27.08% respectively. Conclusion: Antepartum hemorrhage is a major cause of perinatal mortality in our country. A prompt diagnosis of the cause followed by early cesarean section can help reduce the overall mortality.


Author(s):  
Manish Agrawal ◽  
Kriti Bhatnagar

Background: India has made considerable progress over the last two decades in the area of maternal and child health, through innovative and comprehensive health packages that covers the spectrum of Reproductive Child Health (RCH). Awareness of the special vulnerability of the cohort of mothers with ‘high risk factor’ has led to the popular recognition of ‘risk approach’, involving the optimal use of existing MCH services, providing essential obstetrical care for all with early detection of complications and emergency services for those who need it, thus reducing the need for intensive care along with reduction in perinantal mortality. The objective was to assess the prevalence of various maternal risk factors in pregnant women in hospital admissions and their correlation with perinatal mortality.Methods: The present study was carried out on 2050 consecutive deliveries from 1st April 2015 to 31st March 2016 at Department of Obstetrics and Gynecology and Department of Pediatrics, Muzaffarnagar Medical College, Muzaffarnagar Uttar Pradesh, India. All the pregnant women were interviewed and examined in detail at the onset of labor regarding various biosocio-economic characteristics, history of past and present medical and obstetrical complications.Results: The PNMR (93.66/1000 birth) observed in present study was still at a higher level and comparable to that in other studies done by various authors in past in this region. A significantly higher PNMR was observed with increase in maternal age and parity (3 times higher PNMR at >35 years and 2 ½ times higher PNMR at parity >5). Similarly, medical illnesses (3 times higher PNMR) and obstetrical complications (1.5 times higher PNMR) during present pregnancy were showing significant effect on perinatal outcome. In a multivariate analysis, residence (rural /urban), place and number of antenatal visits, gestational age and type of delivery remained as most significant maternal risk factors (p<0.005) after multiple logistic regression of other factors viz. maternal age, height, weight, parity, education, socio-economic status and antepartum anemia.Conclusions: It is heartening to observe that highest risk is associated with simple and easily identifiable factors like, unbooked cases, <3 antenatal visits, severe anemia, age >35 years, parity >5, weight <40 kg, height < 140cm , poor dietary calories, medical and obstetrical complications. These can identified from history only by grass root workers like traditional birth attendants and even elderly female family members. These risk determinants, labeled as simple but ‘high’ high risk are associated with poor perinatal outcome. If these factors are timely identified at community level and appropriately referred by grass root workers, it will significantly reduce perinatal mortality and improve neonatal survival.


2020 ◽  
Author(s):  
Eskinder Kebede Weldetensaye ◽  
Melani Kekulawala

Abstract Background: Ethiopia is a Sub-Saharan country that has made significant improvements in maternal mortality and under-five mortality over the past 15 years. However, perinatal mortality continues to be a major obstacle. The nation continues to have one of the highest rates of perinatal mortality in the entire world with current estimates at 33 deaths per 1000 live births.Methods: This case-control study was conducted between October 2016 and May 2017 at Tikur Anbessa Hospital (TAH) and Gandhi Memorial Hospital (GMH). All women who had a stillbirth or early neonatal mortality during this period willing to participate were included as cases. A systematic random sample of women delivering at the hospital was approached for recruitment as controls to generate a 2:1 ratio of controls to cases. Data on potential risk factors were retrieved from medical records including health passports, delivery records, and treatment charts. Statistical differences in background and social characteristics of cases and controls were determined by t-test and chi-squared (or fisher's exact test) for quantitative and categorical variables respectively. Binary logistic regression analysis was completed to determine any associations between risk factors and stillbirth/early neonatal mortality.Results: During the study period, 366 women delivering at the hospitals were enrolled as cases and 711 women delivering at the hospitals were enrolled as controls. During the study period, records from both hospitals indicated that the estimated stillbirth and neonatal mortality rates were30.7 per 1000. Neonatal causes (43.4%) were the most common, followed by antepartum (32.5%) and intrapartum (24.5%). Risk factors for stillbirths and early neonatal mortality were low maternal education (aOR 1.747, 95%CI 1.098-2.780), high parity (aOR 1.114, 95%CI .058- 2.484), previous stillbirth (aOR 9.447, 95%CI 6.245-14.289), previous preterm birth (aOR 3.620, 95%CI 2.363-5.546), and previous child with congenital abnormality (aOR 2.190, 95% 1.228-3.905), and antepartum hemorrhage during pregnancy (aOR 3.273, 95% 1.523-7.031).Conclusion: Antepartum hemorrhaging is the only risk factor in our study amenable for direct intervention. Efforts should be maximized to improve patient education and antenatal and obstetric services, particularly for women who have a history of obstetric complications identified as risk factors. Moreover, the most significant cause of mortality was asphyxia-related causes. It is imperative that obstetric capacity in rehabilitation services are strengthened and for further studies to investigate the high burden of asphyxia at these tertiary hospitals to better tailor interventions.


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