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.

Antenatal Transfers and Bronchopulmonary Dysplasia Incidence

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 805-805
Author(s):  
SAMUEL SEPKOWITZ
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Bronchopulmonary Dysplasia ◽  
Patient Selection ◽  
Neonatal Intensive Care ◽  
Mortality Rates ◽  
Neonatal Intensive Care Units ◽  
Referral Center

Hobar et al attempted to compare weight-specific neonatal mortality rates among 11 neonatal intensive care units. All patients were inborn. Finding a statistically significant variability of outcome among these neonatal intensive care units, after the effects of birth weight, gender, and race were considered and accounted for, the authors wondered whether other population variables might explain the differences in outcome. One source of variability that would alter population risk among the neonatal intensive care units is patient selection by antenatal transfers into a referral center for delivery.

scholarly journals Cause and Predictors of Neonatal Mortality among Neonates Admitted to the Neonatal Intensive Care Units of Public Hospitals in Eastern Ethiopia: Facilities Based Prospective Follow-up Study

2020 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Causes Of Death ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia

Abstract Background The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa including Ethiopia. This region shows the least progress to reducing neonatal mortality and it continues to be a significant public health issue. The facilities-based causes and predictors of neonatal death in the neonatal intensive care unit are not well documented in this study setting. Hence, the aim of this study was to determine the causes and predictors of neonatal mortality among infants admitted to the neonatal intensive care units in Eastern Ethiopia. Methods Facilities-based prospective follow-up study was conducted among neonates admitted to the neonatal intensive care units of public hospitals in Eastern Ethiopia from November to December 2018. Data were collected using a pre-tested, structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. Epi-Data 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis respectively. Multivariable logistic regression was used to find out the predictors of facilities-based neonatal mortality. Results The proportion of facilities-based neonatal mortality was 20%(95% CI: 16.7-23.8%) The causes of death were complications of preterm birth 28.58%, birth asphyxia 22.45%, infection 18.36%, meconium aspiration syndrome 9.18%, respiratory distress syndrome 7.14% and congenital malformation 4.08%. Low birth weight, preterm births, length of stay in NICU, low 5 minute Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals, Eastern Ethiopia. Conclusion The proportion of facilities-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving timing and quality of ANC is essential for early detection, anticipating high-risk newborns and timely interventions. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could lead to a reduction of neonatal death in this setting.

scholarly journals Cause and predictors of neonatal mortality among neonates admitted to neonatal intensive care units in public hospitals in eastern Ethiopia: A facility-based prospective follow-up study

2020 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Causes Of Death ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia

Abstract Background: The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa, including Ethiopia. This region shows the least progress in reducing neonatal mortality and continues to be a significant public health issue. In this study setting, the causes and predictors of neonatal death in the neonatal intensive care units are not well documented. Hence, this study aimed to determine the causes and predictors of neonatal mortality among infants admitted to neonatal intensive care units in eastern Ethiopia. Methods: A facility-based prospective follow-up study was conducted among neonates admitted to neonatal intensive care units in public hospitals in eastern Ethiopia from November 1 to December 30, 2018. Data were collected using a pre-tested structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. Epi-Data 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis, respectively. Multivariable logistic regression was used to identify the predictors of facility-based neonatal mortality.Results: The proportion of facility-based neonatal mortality was 20%(95% CI:16.7-23.8%). The causes of death were complications of preterm birth (28.58%), birth asphyxia (22.45%), neonatal infection (18.36%), meconium aspiration syndrome (9.18%), respiratory distress syndrome (7.14%), and congenital malformation (4.08%). Low birth weight, preterm births, length of stay in the neonatal intensive care unit, low 5 minutes APGAR score, hyperthermia, and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals in eastern Ethiopia.Conclusions: The proportion of facility-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving the timing and quality of antenatal care is essential for early detection, anticipating high-risk newborns, and timely interventions. Furthermore, early initiation of feeding and better referral linkage to tertiary health facilities could lead to a reduction in neonatal death in this setting.

scholarly journals Cause and Predictors of Neonatal Mortality among Neonates admitted to Neonatal Intensive Care Units of Public Hospitals in eastern Ethiopia: Facilities based Prospective follow-up study

2020 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia ◽  
Follow Up Study

Abstract Background: The first month is the most crucial period for child survival. Neonatal mortality is stagnated in sub-Saharan Africa including Ethiopia. And the trend in reduction is slower than infant and child mortality. The facilities-based cause and predictor of neonatal death in the neonatal intensive care unit were not well documented in this study setting. Hence the aim of this study was to determine the cause and predictors of neonatal mortality among neonates admitted in neonatal intensive care units in eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted in neonatal intensive care units of public hospitals in eastern Ethiopia from November to December 2018. Data were collected using pre-tested, structured questionnaire and follow-up checklist. The main outcomes, cause of death was set by senior pediatricians and residents. Epi-Data 3.1 and SPSS 25 version software were used for entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality.Result: The proportion of facilities-based neonatal mortality was 20%. The top five cause of death was a complication of prematurity 49%, birth asphyxia 37.8%, infection 32.6%, meconium aspiration syndrome 17.3% and congenital malformation 6.1%. Low birth weight, preterm births, length of stay, low 5thminutes Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among Neonates admitted in neonatal intensive care units in public hospitals, eastern Ethiopia.ConclusionIn summary, the proportion of facilities-based Neonatal death was unacceptably high. The main causes of death were preventable and treatable. Hence, early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could contribute for reduction of neonatal death in this setting.

Birth Weight and Illness Severity: Independent Predictors of Neonatal Mortality

PEDIATRICS ◽  
1993 ◽  
Vol 91 (5) ◽  
pp. 969-975 ◽  
Author(s):  
Dougbas K. Richardson ◽  
Ciaran S. Phibbs ◽  
James E. Gray ◽  
Marie C. McCormick ◽  
Kathryn Workman-Daniels ◽  
...  
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Logistic Model ◽  
Neonatal Intensive Care ◽  
Goodness Of Fit ◽  
Clinical Score ◽  
Illness Severity ◽  
Major Determinant

Background. Low birth weight is a major determinant of neonatal mortality. Yet birth weight, even in conjunction with other demographic markers, is inadequate to explain the large variations in neonatal mortality between intensive care units. This variation probably reflects differences in admission severity. The authors have recently developed the Score for Neonatal Acute Physiology (SNAP), an illness severity index specific for neonatal intensive care, and demonstrated illness severity to be a major determinant of neonatal mortality. Objective. To define the relative contributions of birth weight and illness severity to the risk of neonatal mortality and to identify other significant independent risk factors. Methods. Logistic regression was used to analyze data from a cohort of 1621 consecutive admissions to three neonatal intensive care units (92 deaths), to test six alternative predictive models. The best logistic model was then used to develop a simple additive clinical score, the SNAP Perinatal Extension (SNAP-PE). Results. These analyses demonstrated that birth weight and illness severity are powerful independent predictors across a broad range of birth weights and that their effects are additive. Below 750 g, there is an interaction between birth weight and SNAP. Other factors that showed independent predictive power were low Apgar score at 5 minutes and small size for gestational age. Separate derivation and test samples were used to demonstrate that the SNAP-PE is comparable to the best logistic model and has a sensitivity and specificity superior to either birth weight or SNAP alone (receiver-operator characteristic area .92 ± .02) as well as excellent goodness of fit. Conclusion. This simplified clinical score provides accurate mortality risk estimates for application in a broad array of clinical and research settings.

scholarly journals Cause and Predictors of Neonatal Mortality among Neonates admitted to Neonatal Intensive Care Units of Public Hospitals in eastern Ethiopia: Facilities based Prospective follow-up study

2019 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia ◽  
Follow Up Study

Abstract Background: The first month is the most crucial period for child survival. Neonatal mortality is stagnated in sub-Saharan Africa including Ethiopia. And the trend in reduction is slower than infant and child mortality. The facilities-based cause and predictor of neonatal death in the neonatal intensive care unit were not well documented in this study setting. Hence the aim of this study was to determine the cause and predictors of neonatal mortality among neonates admitted in neonatal intensive care units in eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted in neonatal intensive care units of public hospitals in eastern Ethiopia from November to December 2018. Data were collected using pre-tested, structured questionnaire and follow-up checklist. The main outcomes, cause of death was set by senior pediatricians and residents. Epi-Data 3.1 and SPSS 25 version software were used for entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality. Result: The proportion of facilities-based neonatal mortality was 20%. The top five cause of death was a complication of prematurity 49%, birth asphyxia 37.8%, infection 32.6%, meconium aspiration syndrome 17.3% and congenital malformation 6.1%. Low birth weight, preterm births, length of stay, low 5 th minutes Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among Neonates admitted in neonatal intensive care units in public hospitals, eastern Ethiopia. Conclusion In summary, the proportion of facilities-based Neonatal death was unacceptably high. The main causes of death were preventable and treatable. Hence, early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could contribute for reduction of neonatal death in this setting. Keywords: Facilities based study, Neonatal mortality, predictors, NICU, Ethiopia

Variations of Apgar score of very low birth weight infants in different neonatal intensive care units

2009 ◽  
Vol 98 (9) ◽  
pp. 1433-1436 ◽  
Author(s):  
Mario Rüdiger ◽  
Helmut Küster ◽  
Egbert Herting ◽  
Angelika Berger ◽  
Christoph Müller ◽  
...  
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Intensive Care Units ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Neonatal Intensive Care Units ◽  
Low Birth Weight Infants

scholarly journals Cause and predictors of neonatal mortality among neonates admitted to the Neonatal Intensive Care Units of public Hospitals in eastern Ethiopia: Facilities based prospective follow-up study

2020 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Causes Of Death ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia

Abstract Background: The first month is the most crucial period for child survival and neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa including Ethiopia. This region shows the least progress to reducing this high mortality rate and it continues to be a significant public health issue. The facilities-based cause and predictors of neonatal death in the neonatal intensive care unit are not well documented in this study setting. Hence, the aim of this study was to determine the cause and predictors of neonatal mortality among infants admitted to the neonatal intensive care units in Eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted to the neonatal intensive care units of public hospitals in Eastern Ethiopia from November to December 2018. Data was collected using a pre-tested, structured questionnaire and a follow-up checklist. The main outcomes and cause of death was set by pediatricians and residents. Epi-Data 3.1 and SPSS 25 Version software were used for data entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality. Result: The proportion of facilities-based neonatal mortality was 20%. The top five causes of death were a complication of prematurity (49%), birth asphyxia (37.8%), infection (32.6%), meconium aspiration syndrome (17.3%) and congenital malformation (6.1%). Low birth weight, preterm births, length of stay in NICU , low 5 minute Apgar score , hyperthermia and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals, Eastern Ethiopia. Conclusion In summary, the proportion of facilities-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving ANC and this would lead to early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could lead to a reduction of neonatal death in this setting.

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 Perinatal Outcome of the Second Twin

2015 ◽  
Vol 10 (1) ◽  
pp. 89-93
Author(s):  
R Joshi ◽  
G Baral
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Admission Rate ◽  
Second Twin

Aims: The purpose of this study was to determine the perinatal outcome of the second twin compared to the first one. Methods: This is a hospital based comparative study of 60 pregnant women with twin pregnancy at Paropakar Maternity and Women’s Hospital, Kathmandu from 14 January 2013 to13 April 2013. Apgar score and admission to neonatal intensive care unit of the first and the second twins were studied in relation to the gestational age, chorionicity, mode of delivery, inter-delivery interval and birth weight. Mc Nemars test was used with 0.05 as the level of significance. Results: Among 60 sets of twins, Apgar score of the second twin was found to be lower than the first one (p=0.02) in general and in preterm gestation (p=0.049), dichorionic diamniotic chorionicity (p=0.012), vaginal delivery (p<0.001), inter-delivery interval of <30 minutes (p=0.007) and birth weight discordance of <30 % (p=0.014). Admission to neonatal intensive care unit was not significant (p=0.5). Conclusions: Second twin had low Apgar score and the neonatal admission rate was similar for both twins. 

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