scholarly journals Mortality rate and associated factors among preterm babies born in Moshi, north – Tanzania: A prospective cohort study

2019 ◽  
Author(s):  
Rose Chengo ◽  
Frida Mowo ◽  
Clifford Silver Tarimo ◽  
Michael Johnson Mahande
Keyword(s):  
Cohort Study ◽  
Mortality Rate ◽  
Neonatal Mortality ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Associated Factors ◽  
Neonatal Mortality Rate ◽  
Live Births ◽  
Extremely Preterm ◽  
Preterm Babies

Abstract Introduction Globally, approximately 15 million babies are born before term each year. Of these, more than 1 million die within the first 28 days of their life. Understanding the mortality rate and its predictors during neonatal period among preterm babies is crucial to help designing interventions to avert the situation. This study aimed to determine the neonatal mortality rate and associated factors among preterm babies born in Moshi Municipality, Tanzania. Methodology A prospective cohort study was conducted in three hospitals in Moshi Municipality from December 2016 to May 2017. All live births at gestational age of <37 weeks and those of <24 hours were studied. Babies who died prior to gestation age assessment and those whose mother did not consent were excluded. Cox regression model was used to estimate maternal and fetal factors associated with neonatal mortality. A p-value of <0.05 was considered statistically significant. Results A total of 311 of preterm babies were recruited from 265 mothers and were followed for 28 days. The neonatal mortality rate was 6.5deaths per 1,000 preterm live births (95% CI: 4.83-8.61). It was higher among extremely preterm babies compared to very preterm ones (HR: 38.24; 95% CI: 16.62-87.96) versus (HR: 8.01; 95% CI: 3.96-16.20) respectively. Apgar score of <7 at 1st minute (HR: 14.03; 95% CI: 7.27-27.06), respiratory distress syndrome (HR: 8.14; 95% CI: 4.27-15.54) and antepartum hemorrhage (HR: 3.32; 95% CI: 1.49-7.39) were significantly associated with neonatal mortality. Conclusion Preterm birth complication is the major cause of neonatal death in the study setting. Interventions to address the identified risk factors may reduce neonatal mortality among preterm babies.

Retrospective analysis of neonatal deaths secondary to infections in England and Wales, 2013–2015

2020 ◽  
pp. fetalneonatal-2020-319093
Author(s):  
Godwin Oligbu ◽  
Leila Ahmed ◽  
Laura Ferraras-Antolin ◽  
Shamez Ladhani
Keyword(s):  
Mortality Rate ◽  
Retrospective Analysis ◽  
Neonatal Mortality ◽  
Mortality Rates ◽  
Neonatal Mortality Rate ◽  
England And Wales ◽  
Neonatal Deaths ◽  
Live Births ◽  
Extremely Preterm ◽  
Related Mortality

ObjectiveTo estimate the overall and infection-related neonatal mortality rate and the pathogens responsible using electronic death registrations.DesignRetrospective analysis of national electronic death registrations data.SettingEngland and Wales.PatientsNeonates aged <28 days.Main outcome measuresOverall and infection-related mortality rate per 1000 live births in term, preterm (28–36 weeks) and extremely preterm (<28 weeks) neonates; the contribution of infections and specific pathogens; comparison with mortality rates in 2003–2005.ResultsThe neonatal mortality rate during 2013–2015 (2.4/1000 live births; 5095 deaths) was 31% lower than in 2003–2005 (3.5/1000; 6700 deaths). Infection-related neonatal mortality rate in 2013–2015 (0.32/1000; n=669) was 20% lower compared with 2003–2015 (0.40/1000; n=768), respectively. Infections were responsible for 13.1% (669/5095) of neonatal deaths during 2013–2015 and 11.5% (768/6700) during 2003–2005. Of the infection-related deaths, 44.2% (296/669) were in term, 19.9% (133/669) preterm and 35.9% (240/669) extremely preterm neonates. Compared with term infants (0.15/1000 live births), infection-related mortality rate was 5.9-fold (95% CI 4.7 to 7.2) higher in preterm (0.90/1000) and 188-fold (95% CI 157 to 223) higher in extremely preterm infants (28.7/1000) during 2013–2015. A pathogen was recorded in 448 (67%) registrations: 400 (89.3%) were bacterial, 37 (8.3%) viral and 11 (2.4%) fungal. Group B streptococcus (GBS) was reported in 30.4% (49/161) of records that specified a bacterial infection and 7.3% (49/669) of infection-related deaths.ConclusionsOverall and infection-related neonatal mortality rates have declined, but the contribution of infection and of specific pathogens has not changed. Further preventive measures, including antenatal GBS vaccine may be required to prevent the single most common cause of infection-related deaths in neonates.

scholarly journals Prospective cohort study of mortality in very low birthweight infants in a single centre in the Eastern Cape province, South Africa

2021 ◽  
Vol 5 (1) ◽  
pp. e000918
Author(s):  
Isabel A Michaelis ◽  
Ingeborg Krägeloh-Mann ◽  
Ncomeka Manyisane ◽  
Mikateko C Mazinu ◽  
Esme R Jordaan
Keyword(s):  
South Africa ◽  
Cohort Study ◽  
Birth Weight ◽  
Mortality Rate ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Low Birthweight ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Overall Mortality

BackgroundNeonatal mortality is a major contributor worldwide to the number of deaths in children under 5 years of age. The primary objective of this study was to assess the overall mortality rate of babies with a birth weight equal or below 1500 g in a neonatal unit at a tertiary hospital in the Eastern Cape Province, South Africa. Furthermore, different maternal-related and infant-related factors for higher mortality were analysed.MethodsThis is a prospective cohort study which included infants admitted to the neonatal wards of the hospital within their first 24 hours of life and with a birth weight equal to or below 1500 g. Mothers who consented answered a questionnaire to identify factors for mortality.Results173 very low birth weight (VLBW) infants were recruited in the neonatal department between November 2017 and December 2018, of whom 55 died (overall mortality rate 32.0%). Twenty-three of the 44 infants (53,5%) with a birth weight below 1000 g died during the admission. One hundred and sixty-one mothers completed the questionnaire and 45 of their babies died.Main factors associated with mortality were lower gestational age and lower birth weight. Need for ventilator support and sepsis were associated with higher mortality, as were maternal factors such as HIV infection and age below 20 years.ConclusionThis prospective study looked at survival of VLBW babies in an underprivileged part of the Eastern Cape of South Africa. Compared with other public urban hospitals in the country, the survival rate remains unacceptably low. Further research is required to find the associated causes and appropriate ways to address these.

Stroke-related mortality, disability and associated factors in two regional hospitals in Cameroon: A prospective cohort study

2021 ◽  
Vol 429 ◽  
pp. 119614
Author(s):  
Angwafor Anye ◽  
David Ojong ◽  
Nkouonlack Cyrille ◽  
Wepnyu Njamnshi ◽  
Leonard Ngarka ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Associated Factors ◽  
Regional Hospitals ◽  
Related Mortality

scholarly journals Infant mortality: comparison between two birth cohorts from Southeast and Northeast, Brazil

2004 ◽  
Vol 38 (6) ◽  
pp. 773-779 ◽  
Author(s):  
Valdinar S Ribeiro ◽  
Antônio A M Silva ◽  
Marco A Barbieri ◽  
Heloisa Bettiol ◽  
Vânia M F Aragão ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Protective Factor ◽  
Infant Mortality Rate ◽  
Northeast Brazil ◽  
Birth Cohorts ◽  
Neonatal Mortality Rate ◽  
Live Births

OBJECTIVE: To obtain population estimates and profile risk factors for infant mortality in two birth cohorts and compare them among cities of different regions in Brazil. METHODS: In Ribeirão Preto, southeast Brazil, infant mortality was determined in a third of hospital live births (2,846 singleton deliveries) in 1994. In São Luís, northeast Brazil, data were obtained using systematic sampling of births stratified by maternity unit (2,443 singleton deliveries) in 1997-1998. Mothers answered standardized questionnaires shortly after delivery and information on infant deaths was retrieved from hospitals, registries and the States Health Secretarys' Office. The relative risk (RR) was estimated by Poisson regression. RESULTS: In São Luís, the infant mortality rate was 26.6/1,000 live births, the neonatal mortality rate was 18.4/1,000 and the post-neonatal mortality rate was 8.2/1,000, all higher than those observed in Ribeirão Preto (16.9, 10.9 and 6.0 per 1,000, respectively). Adjusted analysis revealed that previous stillbirths (RR=3.67 vs 4.13) and maternal age <18 years (RR=2.62 vs 2.59) were risk factors for infant mortality in the two cities. Inadequate prenatal care (RR=2.00) and male sex (RR=1.79) were risk factors in São Luís only, and a dwelling with 5 or more residents was a protective factor (RR=0.53). In Ribeirão Preto, maternal smoking was associated with infant mortality (RR=2.64). CONCLUSIONS: In addition to socioeconomic inequalities, differences in access to and quality of medical care between cities had an impact on infant mortality rates.

scholarly journals Incidence and Determinants of Newborn Mortality in the First Three Days of Delivery in Northwestern Ethiopia: A Prospective Cohort Study

2021 ◽  
Author(s):  
Mulugeta Worke ◽  
Afework Mekonnen ◽  
Simachew Limeneh
Keyword(s):  
Cohort Study ◽  
Neonatal Mortality ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Quality ◽  
Antenatal Visit ◽  
Maternal Complications ◽  
Newborn Mortality

Abstract Background: Addressing the target of sustainable development goals of reducing perinatal mortality was still a global challenge, and it is a concern in Ethiopia. Therefore, this study planned to determine the incidence and determinants of neonatal mortality in the first three days among babies delivered in Amhara Regional State’s referral hospitals. Methods: A hospital-based prospective cohort study design was conducted among 810 neonates in the first three days of delivery between March 1 and August 30, 2018. The neonates were followed, starting from the time of admission to 72 hours. An interviewer-administered questionnaire and medical record review were conducted for data collection. Data were entered into Epi-data manager version 4.4 and analyzed using STATA™ version 16.0 for the analysis. Cox-Proportional hazard model was used to determine the survival time of the newborns. Results: The overall incidence of newborn mortality in this study was 151/1,000 births. Neonatal mortality was significantly high among newborns whose mothers came between 17 and 28 weeks of gestation for the first visit; among those whose mothers labour was not monitored with a partograph, mothers experience postpartum haemorrhage, develop fistula in the first 24 hours, and experience obstructed labour. However, 39% were less risky among newborns whose mothers were directly admitted and whose mothers had visited health facilities in less than 1-hour, both. Conclusions: This study revealed that about 1 in 7 newborns died in the early three days of life. Timing of the first antenatal visit, quality of labour monitoring, maternal complications, and delay in seeking the care were the determinants. Thus, scaling-up of evidence-based interventions and harmonized efforts to improve antenatal care quality, promote institutional deliveries, provide optimal essential and emergency obstetric care, and ensure immediate postnatal care may improve neonatal survival.

scholarly journals Candida Infective Endocarditis: an Observational Cohort Study with a Focus on Therapy

2015 ◽  
Vol 59 (4) ◽  
pp. 2365-2373 ◽  
Author(s):  
Christopher J. Arnold ◽  
Melissa Johnson ◽  
Arnold S. Bayer ◽  
Suzanne Bradley ◽  
Efthymia Giannitsioti ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Amphotericin B ◽  
Prospective Cohort Study ◽  
Antifungal Therapy ◽  
Subgroup Analysis ◽  
Prospective Cohort ◽  
Content Type

ABSTRACTCandidainfective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens forCandidainfective endocarditis. This prospective cohort study was based on 70 cases ofCandidainfective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion,Candidainfective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.

scholarly journals Course of maternal fatigue and its associated factors during the first 6 months postpartum: a prospective cohort study

Nursing Open ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. 186-196 ◽  
Author(s):  
Hiroko Iwata ◽  
Emi Mori ◽  
Akiko Sakajo ◽  
Kyoko Aoki ◽  
Kunie Maehara ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Associated Factors ◽  
Maternal Fatigue

scholarly journals A community based study of neonatal mortality in Aligarh by using verbal autopsy

2018 ◽  
Vol 5 (6) ◽  
pp. 2491
Author(s):  
Ambren Chauhan ◽  
M. Salman Shah ◽  
Najam Khalique ◽  
Uzma Eram
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Verbal Autopsy ◽  
Birth Asphyxia ◽  
Survival Strategies ◽  
Biological Factors ◽  
Neonatal Mortality Rate ◽  
Community Based ◽  
Cross Sectional ◽  
Live Births

Background:Neonatal mortality rate is regarded as an important and sensitive indicator of the health status of a community. Children face the highest risk of dying in their first month of life. The present study was aimed to 1) determine the prevalence of neonatal mortality rate 2) identify socio-biological factors in relation to neonatal mortality.3) determine the causes of neonatal mortality. Methods:A community based cross sectional study was conducted in the field practice areas of Department of Community Medicine, AMU, Aligarh. All the live births and all neonatal deaths were taken for one year from June 2016 to May 2017. A standard Verbal autopsy questionnaire (WHO 2012) was used as a study tool. Results:The prevalence of neonatal mortality rate was38.2/1000 live births. The early neonatal mortality rate was 28.3/1000 live births and late neonatal mortality rate was 9.9/1000 live births. The associated socio –biological factors were gender [OR-2.381, 95% CI-1.037-5.468], birth order [OR-4.090, 95% CI-1.119-14.946] and gestational age [OR-12.62, 95% CI-3.26-48.82]. The leading causes of deaths among newborns were preterm births (22.2%), birth asphyxia (22.2%), other causes (19%), ARI (14.3%), congenital anomalies (14.3%) and diarrhoeaandneonatal sepsis accounted for (4.8%) each. Conclusions: The neonatal mortality rate assessed by verbal autopsy is higher than nationally reported. Most of the deaths were in early neonatal period. There is a need for programs encouraging the use of antenatal care, encouraging institutional deliveries and care of LBW neonates; as well as implementation of community-based newborn survival strategies.

scholarly journals Socio-demographic determinants of under-five mortality in rural Agra

2017 ◽  
Vol 4 (9) ◽  
pp. 3108
Author(s):  
Krishan Kumar ◽  
Rajiv Srivastava ◽  
S. K. Mishra
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Nuclear Family ◽  
Well Being ◽  
Infant Mortality Rate ◽  
Age Group ◽  
Neonatal Mortality Rate ◽  
Important Indicator ◽  
Live Births

Background: One of the most important indicator or index of socio-economic development of a country or region is infant mortality rate. The present study was undertaken to assess the quantum of childhood mortality and to find out the social factors associated with these deaths by verbal autopsies. Methods: This one year cross-sectional study was undertaken in a purposively selected community Development Block Sainyan, district Agra among children aged between 0-5 years using multistage random sampling technique. Suitable statistical methods were applied. Results: Out of total 8355 families surveyed, a total of 185 deaths were reported among children. Number of deaths was higher among those belonging to nuclear family and lower socioeconomic status. The neonatal mortality rate was estimated to be 33.55/1000 live births. The post neonatal mortality rate was found to be 40.78/1000 live births and infant mortality rate was 74.33/1000 live births. Mortality rate in 1-5 year age group children was 10.6/1000 same age group children, while 0-5 yrs. mortality was estimated to be 22.39/1000 children of same age group. Out of 185 children who died, 52.7% were unimmunized and another 35.67% were partially immunized. Conclusions: Female education and socioeconomic well-being should be strengthened. 

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