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

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.

1970 ◽  
Vol 27 (2) ◽  
pp. 79-82
Author(s):  
M Shrestha ◽  
BL Bajracharya ◽  
DS Manandhar

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


2018 ◽  
Vol 71 (5) ◽  
pp. 2527-2534 ◽  
Author(s):  
Michelle Thais Migoto ◽  
Rafael Pallisser de Oliveira ◽  
Ana Maria Rigo Silva ◽  
Márcia Helena de Souza Freire

ABSTRACT Objective: to analyze the Early Neonatal Mortality risk factors according to the risk stratification criteria of the Guideline of the Rede Mãe Paranaense Program. Method: a case-control epidemiological study with secondary data from the Mortality and Live Birth Information System in 2014. The crude analysis was performed by the Odds Ratio association measure, followed by the adjusted analysis, considering risk factors as independent variables, and early neonatal death as dependent variable. Results: were considered as maternal risk factors: absence of partner and miscarriages; neonatal: male, low birth weight, prematurity, Apgar less than seven in the fifth minute, presence of congenital anomaly; and care: up to six prenatal appointments. Conclusion: an innovative study of risk factors for early neonatal death from the Guideline's perspective, a technological management tool for maternal and child health, in search of its qualification and greater sensitivity.


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.


Author(s):  
Kareem Abiodun John ◽  
Fasoranti Ifedayo Olabisi ◽  
Alonge Abel Olumuyiwa ◽  
Kareem Adesola Olawumi ◽  
Bewaji Temitayo Olubunmi ◽  
...  

Background: The neonatal mortality rate remains high in developing countries despite the significant reduction in under-five mortality globally. Therefore, periodic evaluations on the causes of mortality are an aspect of health status, which could be performed to improve the neonatal mortality rate. Objectives: The present study aimed to determine the pattern and causes of neonatal mortality in the Federal Medical Center in Owo, Ondo State, Southwest Nigeria. Methods: This retrospective study was conducted using the hospital records of the neonates admitted over a five-year period from 1st of January 2015 to 31st of December 2019. Results: In total, 2,065 neonates were admitted, including 208 cases of neonatal deaths. Mortality occurred in 127 males (61.1%) and 81 females (38.9%), with the male-to-female ratio of 1.6:1. Among the recorded deaths, 114 cases (54.8%) occurred within the first 24 hours of admission, while 94 neonates (45.2%) died after 24 hours of admission. In addition, the mortality rate was higher among outborn neonates (n = 120; 57.7%) compared to inborn neonates (n = 88; 42.3%). The major causes of neonatal deaths included birth asphyxia (46.6%), prematurity (23.1%), and sepsis (17.8%). The overall mortality rate over the five-year period was 10.1%, which is equivalent to 19 deaths per 1,000 live births. Conclusions: According to the results, preventable diseases such as birth asphyxia, prematurity, and sepsis remain the major causes of neonatal mortality, of which neonatal deaths occur mostly within 24 hours of admission.


Author(s):  
Chacha D Mangu ◽  
Susan F Rumisha ◽  
Emanuel P Lyimo ◽  
Irene R Mremi ◽  
Isolide S Massawe ◽  
...  

Abstract Background Globally, large numbers of children die shortly after birth and many of them within the first 4 wk of life. This study aimed to determine the trends, patterns and causes of neonatal mortality in hospitals in Tanzania during 2006–2015. Methods This retrospective study involved 35 hospitals. Mortality data were extracted from inpatient registers, death registers and International Classification of Diseases-10 report forms. Annual specific hospital-based neonatal mortality rates were calculated and discussed. Two periods of 2006–2010 and 2011–2015 were assessed separately to account for data availability and interventions. Results A total of 235 689 deaths were recorded and neonatal deaths accounted for 11.3% (n=26 630) of the deaths. The majority of neonatal deaths (87.5%) occurred in the first week of life. Overall hospital-based neonatal mortality rates increased from 2.6 in 2006 to 10.4 deaths per 1000 live births in 2015, with the early neonates contributing 90% to this rate constantly over time. The neonatal mortality rate was 3.7/1000 during 2006–2010 and 10.4/1000 during 2011–2015, both periods indicating a stagnant trend in the years between. The leading causes of early neonatal death were birth asphyxia (22.3%) and respiratory distress (20.8%), while those of late neonatal death were sepsis (29.1%) and respiratory distress (20.0%). Conclusion The majority of neonatal deaths in Tanzania occur among the early newborns and the trend over time indicates a slow improvement. Most neonatal deaths are preventable, hence there are opportunities to reduce mortality rates with improvements in service delivery during the first 7 d and maternal care.


2019 ◽  
Vol 66 (3) ◽  
pp. 315-321
Author(s):  
M Innerdal ◽  
I Simaga ◽  
H Diall ◽  
M Eielsen ◽  
S Niermeyer ◽  
...  

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.


Author(s):  
U. N. Tumanova ◽  
M. P. Shuvalova ◽  
A. I. Schegolev

The article contains the analysis of Rosstat data for 2012–2016 on early neonatal death due to congenital developmental anomalies. From 2012 to 2016 there was an annual progressive decrease in the number of early neonatal deaths (from 6969 to 4113) in the Russian Federation. The total number of newborns died in the first 168 hours of life due congenital anomalies decreased from 1126 (2012) to 759 (2016), while the values of early neonatal mortality decreased from 366.4 to 217.8. However, the proportion of such infants increased from 16.2% (2012) to 18.5% (2016) from the total number of deaths in the early neonatal period. The type of defects and the frequency of their registration as the initial cause of early neonatal death differ in the federal districts of the Russian Federation and there are certain gender differences.Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.


2019 ◽  
pp. 124-130
Author(s):  
Rasmiya Lafta ◽  
Husam Habeeb

Background: Neonatal mortality accounts for nearly half of the deaths of children under the age of five, the main leading causes for which are respiratory distress, infection, and congenital anomalies. Action plans, which call for the elimination of preventable deaths of newborn babies, set specific targets to reduce neonatal mortality. This retrospective descriptive study was conducted in the Basra Teaching Hospital for maternity and childhood from January 2019 to February 2020, including all the neonates who were admitted in the first and second neonatal care units of the hospital. Aim: This study aims to study the main causes of neonatal deaths in newborn babies in the neonatal care units at the main maternity and pediatric hospital of the Basra government. Patients and methods: A total of 716 neonatal deaths were registered along with days of life before death and the cause of death; the cases were classified as early (1–6) days death and late (7–28) days death. Results: In this study, we found that the main causes of early neonatal death were respiratory distress syndrome (68.4%), congenital anomalies (11.4%), infection (10.9%), birth asphyxia (7.2%), and other neonatal conditions (inborn error of metabolism, hemorrhagic disease of newborn, severe anemia, and unspecified causes) (2.1%), while for late neonatal death, respiratory distress (27.2%), congenital problems (17.7%), infection (45.6%), birth asphyxia (6.1%), and other conditions (3.4%) were cited. Conclusions: It is important to direct the health resources towards preventable causes of neonatal deaths both before, during and after the delivery of a baby when the higher risk factors are preventable (prematurity, birth problems, and sepsis). Using all available resources to decrease preterm labors and mother education toward pregnancy and to improve the facilities and quality of neonatal care at the delivery room and neonatal care units. Keywords: neonate, prematurity, congenital problems, birth asphyxia


BMJ Open ◽  
2017 ◽  
Vol 7 (5) ◽  
pp. e013350 ◽  
Author(s):  
Osita Kingsley Ezeh

ObjectivesTo assess trends in early neonatal mortality (ENM) and population-attributable risk (PAR) estimates for predictors of ENM in Nigeria.Design, setting and participantsA cross-sectional data on 63 844 singleton live births within the preceding 5 years from the 2003, 2008 and 2013 Nigeria Demographic and Health Surveys were used. Adjusted PARs were used to estimate the number of early neonatal deaths attributable to each predictor in the final multivariable Cox regression model.Main outcome measuresENM, defined as the death of a live-born singleton between birth and 6 days of life.ResultsThe ENM rate slightly declined from 30.5 (95% CI 26.1 to 34.9) to 26.1 (CI 24.3 to 27.9) during the study period. Approximately 36 746 (CI 14 656 to 56 920) and 37 752 (CI 23 433 to 51 126) early neonatal deaths were attributable to rural residence and male sex, respectively. Other significant predictors of ENM included small neonates (attributable number: 25 884, CI 19 172 to 31 953), maternal age <20 years (11 708, CI 8521 to 17 042), caesarean section (6312, CI 4260 to 8521) and birth order ≥4 with a short birth interval (≤2 years) (18 929, CI 12 781 to 25 563)).ConclusionsTo improve early neonatal survival in Nigeria, community-based interventions are needed for small neonates, and to promote delayed first pregnancy, child spacing and timely referral for sick male neonates and caesarean delivery.


Author(s):  
UN Tumanova ◽  
AI Schegolev ◽  
AA Chausov ◽  
MP Shuvalova

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.


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