scholarly journals Causes of Preterm and Low Birth Weight Neonatal Mortality in a Rural Community in Kenya: Evidence From Verbal and Social Autopsy

2020 ◽  
Author(s):  
Beatrice Olack ◽  
Nicole Santos ◽  
Mary Inziani ◽  
Vincent Moshi ◽  
Polycarp Oyoo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Distress Syndrome ◽  
Neonatal Period ◽  
Preterm Neonates ◽  
Neonatal Deaths ◽  
Social Autopsy

Abstract BackgroundUnder-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. We aimed to establish causes of neonatal LBW and preterm mortality in Migori County, among participants of the PTBI-K (Preterm Birth Initiative-Kenya) study.MethodsThis was a cross sectional study whereby Verbal and social autopsy (VASA) interviews were conducted with caregivers of deceased LBW and preterm neonates delivered within selected 17 health facilities in Migori County, Kenya. The probable cause of death was assigned using the WHO International Classification of Diseases (ICD-10). ResultsBetween January 2017 to December 2018, 3175 babies were born preterm or LBW, and 162 (5.1%) died in the first 28 days of life in 17 participating health facilities in the PTBI-K project. VASA was conducted among 88 (53.7%) neonatal deaths. Almost half (38, 43.2%) of the deaths occurred within the first 24 hours of life. Birth asphyxia (45.5%), neonatal sepsis (26.1%), respiratory distress syndrome (12.5%) and hypothermia (11.0%) were the leading causes of death. In the early neonatal period, majority (54.3%) of the neonates succumbed to asphyxia while in the late neonatal period majority (66.7%) succumbed to sepsis. Delay in seeking medical care was reported for 4 (5.8%) of the neonatal deaths. ConclusionDeaths among LBW and preterm neonates occur early in life due to preventable causes. This calls for enhanced intrapartum and immediate postpartum care interventions targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia.

scholarly journals Causes of preterm and low birth weight neonatal mortality in a rural community in Kenya: evidence from verbal and social autopsy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beatrice Olack ◽  
Nicole Santos ◽  
Mary Inziani ◽  
Vincent Moshi ◽  
Polycarp Oyoo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Distress Syndrome ◽  
Neonatal Period ◽  
Preterm Neonates ◽  
Neonatal Deaths ◽  
Social Autopsy

Abstract Background Under-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. We aimed to establish causes of neonatal LBW and preterm mortality in Migori County, among participants of the PTBI-K (Preterm Birth Initiative-Kenya) study. Methods Verbal and social autopsy (VASA) interviews were conducted with caregivers of deceased LBW and preterm neonates delivered within selected 17 health facilities in Migori County, Kenya. The probable cause of death was assigned using the WHO International Classification of Diseases (ICD-10). Results Between January 2017 to December 2018, 3175 babies were born preterm or LBW, and 164 (5.1%) died in the first 28 days of life. VASA was conducted among 88 (53.7%) of the neonatal deaths. Almost half (38, 43.2%) of the deaths occurred within the first 24 h of life. Birth asphyxia (45.5%), neonatal sepsis (26.1%), respiratory distress syndrome (12.5%) and hypothermia (11.0%) were the leading causes of death. In the early neonatal period, majority (54.3%) of the neonates succumbed to asphyxia while in the late neonatal period majority (66.7%) succumbed to sepsis. Delay in seeking medical care was reported for 4 (5.8%) of the neonatal deaths. Conclusion Deaths among LBW and preterm neonates occur early in life due to preventable causes. This calls for enhanced implementation of existing facility-based intrapartum and immediate postpartum care interventions, targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia.

scholarly journals Trends in Neonatal Mortality at a Tertiary Level Teaching Hospital

2013 ◽  
Vol 33 (3) ◽  
pp. 213-217
Author(s):  
Srijana Basnet ◽  
Laxman Shrestha
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Teaching Hospital ◽  
Distress Syndrome ◽  
Linear Trend ◽  
Perinatal Asphyxia ◽  
Live Births

Introduction: Neonatal services at Tribhuvan University Teaching hospital (TUTH) was essentially up to level II till year 2008 and upgraded to level III care in later years. A 4 years retrospective study was carried out at TUTH, Kathmandu, Nepal to determine any change in the trend of neonatal mortality after the improvement in its services. Materials and Methods: Labor room record book, neonatal record book, perinatal audit data and neonatal record charts were used to collect the data. Results: During the study period, there were total of 15063 live births. The neonatal mortality ranges from 9.46 to 14.88 per 1000 live births per year. There was no significant fall in trend of neonatal mortality (x2 for linear trend=1.40, p=0.23). There was also no significant fall in trend in perinatal mortality rates over this period (x2 for linear trend=1.92, p=0.16).The number of neonates referred to other hospitals has been significantly reduced by 61%.(x2 for linear trend=33.18, p<0.001). Majority of the neonatal deaths (72%) occurred within first 7 days of life and more than a third (39%) died within the first 24 hours of life. Respiratory distress syndrome, perinatal asphyxia and neonatal sepsis were three major causes of death. Deaths due to respiratory distress and perinatal asphyxia has not changed significantly over the years (p=0.4 and 0.25 respectively). Incidence of low birth weight ranges from 10.8 – 16.1% of total live births. 63% of neonatal mortality occurred in low birth weight babies. This trend has not changed in over the years (x2=1.03, p=0.31). Conclusion: With the improvement in the services, though neonatal mortality remained unchanged, referral rates and mortality due to respiratory distress syndrome of prematurity has decreased. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8957   J. Nepal Paediatr. Soc. 2013;33(3):213-217

scholarly journals Infection remains a leading cause of neonatal mortality among infants delivered at a tertiary hospital in Karachi, Pakistan

2014 ◽  
Vol 8 (11) ◽  
pp. 1470-1475 ◽  
Author(s):  
Muhammad Ayaz Mustufa ◽  
Razia Korejo ◽  
Anjum Shahid ◽  
Sadia Nasim
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Distress Syndrome ◽  
Very Low Birth Weight ◽  
Neonatal Period ◽  
Healthcare Facility ◽  
Normal Birth Weight ◽  
Neonatal Deaths ◽  
Normal Birth

Introduction: The current cohort study was conducted to determine the frequency and compare the mortality rate with associated characteristics among low birth weight and normal birth weight infants during the neonatal period at a tertiary healthcare facility, Karachi. Methodology: Close-ended structured questionnaires were used to collect information from the parents of 500 registered neonates at the time of birth. Follow-ups by phone on the 28th day of life were done to determine the mortality among low birth weight and normal birth weight babies during the neonatal period. Results: The neonatal mortality rate ranged from as low as 2.4% in the normal birth weight and 16.4% in the low birth weight categories to as high as 96% in the very low birth weight category. Respiratory distress syndrome (24.2%) and sepsis (18.2%) were reported as the leading causes of neonatal deaths. The babies’ lengths of stay ranged from 2 to 24 hours, and around 90% of neonatal deaths were reported in the first seven days of life. More than 6% of neonates died at home, and 7.6% of the deceased babies did not visit any healthcare facility or doctor before their death. In the 12–15 hours before their deaths, 13.6% of the deceased babies had been unattended. Around 90% of the deceased babies were referred from a doctor or healthcare facility. Conclusions: The present estimates of neonatal mortality are very high among low birth weight and very low birth weight categories. Infectious diseases, including respiratory distress syndrome (24.2%) and sepsis (18.2%), were leading causes of neonatal deaths.

scholarly journals Neonatal Mortality and Morbidity in a Tertiary Care Hospital of Coastal South India

2018 ◽  
Vol 37 (3) ◽  
pp. 232-237
Author(s):  
Raja Kannan ◽  
Suchetha Rao ◽  
Prasanna Mithra ◽  
SM Rajesh ◽  
Bhaskaran Unnikrishnan ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Congenital Malformations ◽  
Distress Syndrome ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
New Born

Correction: On 13th June, Prasanna Mithra was added as an author of this paper.Introduction: Progress in new-born survival has been slow. There is a variation in neonatal death rates across states and geographical region of a country. Understanding the pattern of mortality is essential in improving new-born survival. This study was conducted to study the mortality and morbidity profile in Neonatal Intensive Care Unit (NICU) of a university teaching hospital.Material and Methods: This was a retrospective descriptive study including records of all neonates admitted in NICU from January 2015 to December 2016.Results 3623 neonates were admitted during the study period. Majority were preterm and low birth weight babies. Neonatal jaundice (41.4%) was the leading cause of admission. Major cause of morbidity was sepsis (26.2%). Average duration of stay were higher in out borns (8.4 days) compared to inborn (6.5 days) neonates. Among mortality a higher male predominance was seen. Neonatal sepsis (36.3%) was the single most common cause of mortality followed by respiratory distress syndrome (27.4%) and congenital malformations (18.6%). Out born neonates which were self-transported had higher mortality rate than transported by ambulance.Conclusion This study identifies sepsis, prematurity and low birth weight as the major causes of morbidity. Sepsis, respiratory distress syndrome and congenital malformations were the leading causes of mortality Understanding causes of neonatal mortality may help to implement interventions to promote new-born survival.  

scholarly journals Mortality of preterm neonates and its predictors in the Northwest part of Ethiopia: A retrospective cohort study

2019 ◽  
Author(s):  
Aklilu Endalamaw Sinshaw ◽  
Biniam Minuye ◽  
Bezatu Mengistie ◽  
Abebaw Yeshambel ◽  
Nega Assefa
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Retrospective Cohort ◽  
Distress Syndrome ◽  
Preterm Neonate ◽  
Very Low Birth Weight ◽  
Preterm Neonates

Abstract Abstract Background: Preterm birth is highly reported in some countries and disparities on survival rates of preterm neonate are escalating across countries. Providing adequate medical care during pregnancy and childbirth has been endorsed. However, neonatal mortality is continuing to be one of the sustainable development goals. To achieve this aim, data from the different geographical area is suggested. Objective: This study was aimed to assess mortality of preterm neonates and its predictors in the Northwest part of Ethiopia. Methods: Institution based retrospective cohort study was conducted among 535 preterm neonates. Data was entered into EPi-data 4.2.0.0 and transferred to STATA version 14 statistical software for analysis. Kaplan-Meier survival analysis and Log-rank test were used to see statistical differences between categories of variables. Cox proportional hazard model was used to identify independent predictors of preterm neonatal mortality. The proportional assumption test had been checked using the Schoenfeld residual test. Variables with p-value ≤ 0.05 were considered as predictors of preterm neonatal mortality. Results: In this study, 31.2% (95% CI: 27.3, 35.1) of preterm neonate were died. Preterm neonates with a gestational age of less than 32 weeks (AHR=1.74; 95%CI: 1.24, 2.46), being male sex (AHR=1.38; 95%CI: 1.01, 1.90), born from preeclampsia/ eclampsia mothers (AHR=1.95; 95%CI: 1.13, 3.36), being extremely very low birth weight (AHR=2.94; 95%CI: 1.05, 8.24), diagnosed with respiratory distress syndrome (AHR=1.70; 95%CI: 1.20, 2.41) were predictors of preterm death. Conclusion and Recommendations: Preterm neonatal mortality found to be high. Four neonatal and one maternal-related variable were recognized predictors of mortality in preterm neonates. The study suggests preventing and controlling preeclampsia/ eclampsia, especial care for neonates born with very low birth weight, born before 32 weeks of gestation, and diagnosed with respiratory distress syndrome are imperative. Keywords: Preterm, Neonate, Mortality, Ethiopia

Early versus late treatment of neonatal acidosis in low-birth-weight infants: Relation to respiratory distress syndrome

1972 ◽  
Vol 81 (6) ◽  
pp. 1178-1187 ◽  
Author(s):  
Calvin J. Hobel ◽  
William Oh ◽  
Marcia A. Hyvarinen ◽  
George C. Emmanouilides ◽  
Allen Erenberg
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Low Birth Weight Infants ◽  
Late Treatment

Passage of the First Stool in Very Low Birth Weight Infants

PEDIATRICS ◽  
1987 ◽  
Vol 79 (6) ◽  
pp. 1005-1007
Author(s):  
Meenakshi K. Jhaveri ◽  
Savitri P. Kumar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Very Low Birth Weight ◽  
Gut Hormones ◽  
Low Birth Weight Infants ◽  
Severe Respiratory Distress ◽  
Severe Respiratory Distress Syndrome

Times of first stool passage were studied in 171 infants who weighed less than 1,500 g at birth. Delayed passage (greater than 48 hours) was noted in 20.4% of this group. Significant differences were noted between the delayed and nondelayed groups for gestational age, presence of severe respiratory distress syndrome, and the time of the first enteral feeding. In very low birth weight infants, delay in the passage of the first stool is a common occurrence. This delay is probably due to physiologic immaturity of the motor mechanisms of the gut, lack of triggering effect of enteral feeds on gut hormones, and the presence of severe respiratory distress syndrome, which may singly or in concert adversely affect gastrointestinal motility.

scholarly journals Neonatal outcome in new-borns admitted in NICU of tertiary care hospital in central India: a 5-year study

2018 ◽  
Vol 5 (4) ◽  
pp. 1364 ◽  
Author(s):  
Jyotsna Verma ◽  
Shweta Anand ◽  
Nawal Kapoor ◽  
Sharad Gedam ◽  
Umesh Patel
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Distress Syndrome ◽  
Perinatal Asphyxia ◽  
Hyaline Membrane Disease ◽  
Low Birth Weight Babies ◽  
Hyaline Membrane

Background: Neonatal mortality rate contributes significantly to under five mortality rates. Data obtained from pattern of admission and outcome may uncover various aspects and may contribute and help in managing resources, infrastructure, skilled hands for better outcome in future.Methods: This retrospective study was done on 1424 neonates who were admitted at LN Medical College and JK Hospital, Bhopal in neonatal intensive care unit (NICU) in the Department of Paediatrics from January 2013-December 2017.Results: 1424 newborns admitted within 24 hours of birth were included in the study. About 767 were male neonates, (Male: female1.16:1). The low birth weight babies were 54% in our study. Among the various causes of NICU admission, Respiratory distress was present in 555 (39%) of neonates, Respiratory distress syndrome (Hyaline membrane disease) being the most common cause of respiratory distress. Neonatal sepsis accounted for morbidity in 24% of neonates, with Klebsiella being the most common organism grown in the blood culture. The incidence of congenital anomalies was 2.5%. The neonatal mortality was found to be 11% in our study. Prematurity with Respiratory distress syndrome (Hyaline membrane disease) and perinatal asphyxia were the two most common causes of neonatal mortality in the study. Extremely low birth weight neonates had the highest case fatality rate in the study, which indicates the need to develop an efficient group of professionals in teaching hospitals who will provide highly specialized and focused care to this cohort of vulnerable neonates.Conclusions: Present study has shown respiratory distress, perinatal asphyxia, and sepsis as the predominant causes of neonatal morbidity. All three are preventable causes, and our health-care programs should be directed toward addressing the risk factors in the community responsible for the development of these three morbidities. The preterm and low birth weight babies had significantly high mortality even with standard intensive care; therefore, a strong and effective antenatal program with extensive coverage of all pregnant females specifically in outreach areas should be developed which will help in decreasing preterm deliveries and also lower the incidence of low birth weight babies.

scholarly journals A profile on the spectrum of neonatal mortality and morbidity pattern of extramural neonates in the Specialised Neonatal Care Unit (SNCU) in a tertiary care hospital

2018 ◽  
Vol 5 (2) ◽  
pp. 427 ◽  
Author(s):  
Anuradha D. ◽  
Rajesh Kumar S. ◽  
Aravind M. A. ◽  
Jayakumar M. ◽  
J. Ganesh J.
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Low Birthweight ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Care Hospital ◽  
Neonatal Deaths

Background: Every year, nearly four million newborn babies die in the first month of life. India carries the single largest share (around 25-30%) of neonatal deaths in the world. Neonatal deaths constitute two thirds of infant deaths in India. 45% of the deaths occur within the first two days of life. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively at the appropriate time. It was further estimated that health facility-based interventions can reduce neonatal mortality by 23-50% in different settings. Facility-based newborn care, thus, has a significant potential for improving the survival of newborns in India. This research has been planned with an aim to study the profile of pattern of admissions in a SNCU and their outcomes following admission and management in the unit.Methods: All babies referred for neonatal problems (less than 28 days) and admitted in NICU will be included. Both term and preterm babies will be considered. The criteria for admission includes various causes like low birth weight, preterm, birth asphyxia, respiratory distress, hyperbilirubinemia, congenital anomalies, risk factors (maternal, neonatal, prenatal), infections and outcome will be analysed.Results: Among the 2927 admissions term babies and boys outnumbered. The common causes for admission were birth asphyxia, respiratory distress, low birthweight and preterm. Most babies had an uncomplicated stay. The mortality in the extramural neonates was due to neonatal sepsis, extreme preterm and congenital malformations.Conclusions: Intensive and interventional management, along with good neonatal monitoring and care can reduce the mortality and improve the survival of low birth weight babies and other treatable problems. Thus, a combined effort of management by pediatricians, nursing care, neonatal intensive care unit can improve the survival rates of neonates.

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