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

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.

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Incidence and determinants of newborn mortality in the first three days of delivery in Northwestern Ethiopia: a prospective cohort study

10.21203/rs.3.rs-58092/v1 ◽

2020 ◽

Author(s):

Mulugeta Dile Worke ◽

Afework Tadele Mekonnen ◽

Simachew Kassa Limenih

Keyword(s):

Cohort Study ◽

Neonatal Mortality ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Emergency Obstetric Care ◽

Antenatal Visit ◽

Maternal Complications ◽

Obstructed Labor ◽

Newborn Mortality

Abstract Background: Addressing, the target of sustainable development goals of reducing perinatal mortality, was still a global challenge, and the magnitude of newborn death in the first three days of life takes a significant role in Ethiopia. Therefore, this study planned to determine the incidence and determinants of neonatal mortality in the first three days among babies delivered in referral hospitals of Amhara Regional State, North-Western Ethiopia. Method: A hospital-based prospective cohort study design was conducted among 810 early 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 [AHR=1.67;95% CI: 1.02, 2.73], among those whose mothers labor was not monitored with a partograph [AHR=2.66; 95% CI: 1.70, 4.15], mothers experience postpartum hemorrhage [AHR 2.88; 95% CI: 1.69, 4.89], develop fistula in the first 24 hours [AHR=3.75; 95% CI: 1.23, 11.43], and experience obstructed labor [AHR=2.14; 95% CI: 1.35, 3.38]. However, it was 39% less risky among newborns whose mothers were directly admitted, and whose mothers had visited health facilities in less than 1-hour, both [AHR=0.61; 95% CI: 0.38, 0.97]. Conclusion: This study revealed that about 1 in 7 newborns died in the early three days of life. The timing of the first antenatal visit, quality of labor monitoring, maternal complications, and delay in seeking the care were found to be the determinants. Thus, scaling-up of evidence-based interventions, and harmonized efforts aimed to improve the quality of antenatal care, promote institutional deliveries, provide optimal essential and emergency obstetric care, and ensure immediate postnatal care may improve neonatal survival.

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Incidence and determinants of neonatal mortality in the first three days of delivery in northwestern Ethiopia: a prospective cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04122-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mulugeta Dile Worke ◽

Afework Tadele Mekonnen ◽

Simachew Kassa Limenh

Keyword(s):

Cohort Study ◽

Neonatal Mortality ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Proportional Hazards Model ◽

Cox Proportional Hazards ◽

Care Quality ◽

Cox Proportional Hazards Model ◽

Antenatal Visit ◽

Maternal Complications

Abstract Background Addressing sustainable development goals to reduce neonatal mortality remains a global challenge, and it is a concern in Ethiopia. As a result, the goal of this study was to assess the incidence and determinants of neonatal mortality in the first 3 days among babies delivered in the referral hospitals of the Amhara National Regional State. Methods A hospital-based prospective cohort study was conducted among 810 neonates in the first 3 days of delivery between March 1 and August 30, 2018. The neonates were followed up from the time of admission to 72 h. Interviewer-administered questionnaires and medical record reviews were conducted for data collection. Data were entered into Epi-data manager version 4.4 and analysed using STATA™ version 16.0. The neonate’s survival time was calculated using the Cox-Proportional hazards model. Results The overall incidence of neonatal mortality in this study was 151/1000 births. Neonatal mortality was significantly higher among neonates 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 experienced postpartum haemorrhage and developed a fistula first 24 h, and experienced obstructed labour. However, 39% were less risky among neonates whose mothers were directly admitted and whose mothers had visited health facilities in less than 1-h, both. Conclusions This study revealed that approximately 1 in 7 neonates died within the first 3 days of life. The determinants were the timing of the first antenatal visit, quality of labour monitoring, maternal complications, and delay in seeking care. Thus, scaling up evidence-based interventions and harmonising 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.

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Incidence of and risk factors for severe maternal complications associated with hypertensive disorders after 36 weeks’ gestation in uncomplicated twin pregnancies: A prospective cohort study

Journal of Obstetrics and Gynaecology Research ◽

10.1111/jog.13650 ◽

2018 ◽

Vol 44 (7) ◽

pp. 1221-1227 ◽

Cited By ~ 1

Author(s):

Ryo Yamamoto ◽

Keisuke Ishii ◽

Haruka Muto ◽

Shiyo Ota ◽

Haruna Kawaguchi ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Maternal Complications ◽

Hypertensive Disorders ◽

Twin Pregnancies

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I-ACT: Integrated study on effect of Activity on ComplicaTions in pregnancy: study protocol of a multiethnic prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2018-025970 ◽

2019 ◽

Vol 9 (4) ◽

pp. e025970 ◽

Cited By ~ 1

Author(s):

Meijin Cai ◽

Kok Hian Tan ◽

Seng Bin Ang

Keyword(s):

Physical Activity ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Gestational Hypertension ◽

Statistical Tests ◽

Demographic Factors ◽

Antenatal Visit ◽

Maternal Weight ◽

Socio Demographic Factors

IntroductionPhysical activity (PA) during first 20 weeks of pregnancy may lower risks of gestational diabetes mellitus (GDM) and gestational hypertension (GH), though evidence of association remains inconclusive. Current studies rely heavily on subjective assessment of PA levels. Wearable activity trackers provide a convenient and objective surrogate index for PA validated by evidence-based steps/day categorisation along a physical inactivity/activity continuum. I-ACT primarily aims to examine objectively measured PA levels and patterns in first and second trimesters of pregnancy and the association with GDM and/or GH in Singapore, a multiethnic Asian population. Secondary aims include investigating the bio-socio-demographic factors associated with sedentary behaviour, and association of early pregnancy PA level with maternal weight at 6 weeks postdelivery. Results may facilitate identification of high-risk mothers-to-be and formulation of interventional strategies.Methods and analysisProspective cohort study that will recruit 408 women at first antenatal visit at <12 weeks’ gestation. Baseline bio-socio-demographic factors and PA levels assessed by participant characteristics form and the International Physical Activity Questionnaire (IPAQ), respectively. An activity tracker (Fitbit) will be provided to be worn daily from date of recruitment to end of 20 weeks’ gestation. Tracker-recorded data will be synchronised with an application on participant’s smartphone. Compliance will be reinforced with fortnightly reminders. After 20 weeks, a second IPAQ and a feedback form will be administered. GDM screened at 24–28 weeks’ gestation. GH diagnosed after 20-weeks gestation. Maternal weight assessed at 6 weeks postdelivery. Appropriate statistical tests will be used to compare continuous and categorical PA measurements between first and second trimesters. Logistic regression will be used to analyse associations.Ethics and disseminationEthical approval obtained from the Centralised Institutional Review Board of SingHealth (reference 2017/2836). Dissemination of results will be via peer-reviewed research publications both online and in print, conference presentations, posters and medical forums.

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Neonatal mortality in the neonatal intensive care unit of Debre Markos referral hospital, Northwest Ethiopia: a prospective cohort study

BMC Pediatrics ◽

10.1186/s12887-020-1963-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Animut Alebel ◽

Fasil Wagnew ◽

Pammla Petrucka ◽

Cheru Tesema ◽

Nurilign Abebe Moges ◽

...

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Mortality ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Neonatal Intensive Care ◽

Northwest Ethiopia ◽

Referral Hospital

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INISIASI MENYUSU DINI MENJAGA KESTABILAN SUHU PADA BAYI BARU LAHIR

Media Ilmu Kesehatan ◽

10.30989/mik.v7i1.267 ◽

2018 ◽

Vol 7 (1) ◽

pp. 51-59

Author(s):

Nuli Nuryanti Zulala ◽

Mei Neni Sitaresmi ◽

Sulistyaningsih Sulistyaningsih

Keyword(s):

Cohort Study ◽

Neonatal Mortality ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Lower Risk ◽

Neonatal Death ◽

Breastfeeding Initiation ◽

Axillary Temperature ◽

Exclusion Criteria ◽

The Difference

Background: Hypothermia contributes 6.3% to neonatal mortality. Interventions to keep newborns warm can reduce neonatal mortality by 18-42%. Early Breastfeeding Initiation (EBI) is a simple intervention that reduces the risk of neonatal death. Objective: The aim of this study to determine the difference of axillary temperature of newborn between improper EBI group and proper EBI group for 24 hours. Methods: This prospective cohort study was conducted at Aisyiyah Muntilan Hospital. Sixty-two healthy newborns from healthy mothers born in November 2016 who meet the inclusion and exclusion criteria. Subjects were grouped in improper EBI groups (n=32) and proper EBI groups (n=32). Axila temperature measurements were performed at 1st minute, 30th minute, 60th minute, 6th hour, 12th hour, 24th hour. Results: The result of the hypotermic occurrence is more happened on improper EBI than proper EBI. EBI is able to prevent hypothermia during the first 24 hours of newborn life Conclussions: Infants with proper EBI have a lower risk of hypothermia.

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