Stillbirth and Neonatal mortality in Jordan: Findings from Jordan Stillbirths and Neonatal Deaths Surveillance System (Preprint)

2021 ◽  
Author(s):  
Yousef Khader ◽  
Nihaya Al-Sheyab ◽  
Mohammad Alyahya ◽  
Ziad El-Khatib ◽  
Khulood Shattnawi ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Low Income ◽  
Surveillance System ◽  
Death Rate ◽  
Congenital Malformations ◽  
Low Birthweight ◽  
Chromosomal Abnormalities ◽  
Mortality Rates ◽  
Low Income Countries ◽  
Neonatal Deaths

BACKGROUND Stillbirth and neonatal mortality declined significantly in high- and some middle- income countries because of the significant improvements in obstetric and neonatal care. Yet, stillbirth and neonatal mortality rates remain high in low-income countries. The main reason for low progress in reducing such stillbirths and neonatal deaths in Jordan is the scarcity of data on causes and contributing factors leading to these deaths. OBJECTIVE This study aimed to determine the rates, causes and risk factors of stillbirth and neonatal mortality in Jordan. METHODS An electronic stillbirth and neonatal deaths surveillance system was established in five large hospitals in Jordan. Data on all births, stillbirths and neonatal deaths and their causes during the period May 2019 – December 2020 were exported from the system and analyzed. RESULTS A total of 29,592 women gave birth to 31,106 babies during a period of 20 months in the selected hospitals. The stillbirth rate was 10.5 per 1,000 total births, the neonatal death rate was 14.2 per 1,000 live births, and the perinatal death rate was 21.4 per 1,000 total births. Of all neonatal deaths, 29.4% died within the first day of life and 77.8% died during the first week of life. For neonatal deaths occurred pre-discharge, the leading causes of death were respiratory and cardiovascular disorders (35.0%), low birth weight and prematurity (32.7%), and congenital malformations, deformations and chromosomal abnormalities (19.5%). Almost one third of stillbirths had unspecified cause of death (33.3% of antepartum stillbirths and 28.9% of intrapartum stillbirths). Acute antepartum event was responsible of 27.4% of antepartum stillbirths and acute intrapartum event was responsible for 13.2% of intrapartum stillbirths. Congenital malformations, deformations and chromosomal abnormalities contributed to 18.1% of antepartum stillbirths and 34.2% of intrapartum stillbirths. CONCLUSIONS There is a relative stability of stillbirth and neonatal mortality rates in Jordan. Several identified maternal and/or fetal conditions that contributed to stillbirths and/or neonatal deaths in Jordan are preventable. Focused care needs to be directed high-risk pregnant women and to neonates with low birthweight and respiratory problems.

scholarly journals Rate, determinants, and causes of stillbirth in Jordan: Findings from the Jordan Stillbirth and Neonatal Deaths Surveillance (JSANDS) system

2020 ◽  
Author(s):  
Khulood Kayed Shattnawi ◽  
Yousef S. Khader ◽  
Mohammad S. Alyahya ◽  
Nihaya Al-Sheyab ◽  
Anwar Batieha
Keyword(s):  
Birth Weight ◽  
Congenital Malformations ◽  
Low Birthweight ◽  
Very Low Birth Weight ◽  
Chromosomal Abnormalities ◽  
Data Entry ◽  
Maternal Complications ◽  
Middle Income ◽  
Neonatal Deaths ◽  
Normal Birth

Abstract Background: Annually, 2.6 million stillbirths occur around the world, with about 98% occur in low and middle-income countries. The stillbirth rates in these countries are 10 times higher than the rates in high-income countries. Methods: An electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in five large hospitals located in three of the largest cities in Jordan in August 2019. JSANDS was developed as a secure on-line data entry system to collect, organize, analyse, and disseminate data on stillbirths, neonatal deaths, and their contributing conditions. Data on births, stillbirths and their contributing conditions contributing, and other demographic and clinical characteristics in the period between August 2019 – January 2020 were extracted and analysedResults: A total of 10328 births were registered during the reporting period. Of the total births, 102 were born dead (88 antepartum stillbirths and 14 intrapartum stillbirths) with a rate of 9.9 per 1000 total births. The main contributing fetal conditions of antepartum stillbirths were antepartum death of unspecified cause (33.7%), acute antepartum event (hypoxia) (33.7%), congenital malformations and chromosomal abnormalities (13.3%), and disorders related to the length of gestation and fetal growth (10.8%). The main contributing maternal conditions of antepartum stillbirths included complications of placental cord and membranes (48.7%), maternal complications of pregnancy (23.1%), and maternal medical and surgical conditions (23.1%). Contributing fetal conditions of intrapartum stillbirths included congenital malformations deformations and chromosomal abnormalities, other specified intrapartum disorder, intrapartum death of unspecified cause (33.3% each). Contributing maternal conditions of intrapartum stillbirths included complications of placental cord and membranes. In the multivariate analysis, the odds of stillbirth for very low birth weight (<1500 gm) babies and for low birthweight babies (1500-2499 gm) were 14.1 times 4.3 times that odds for babies born with normal birth weight, respectively. The stillbirth rate was significantly higher among preterm deliveries compared to full-term deliveries (OR = 5.6). Conclusions: Although the rate of stillbirth is lower than that in other countries in the region, there is an opportunity to prevent such deaths. While the majority of stillbirths occurred during the antepartum period, care should be taken for early identification of high-risk pregnancies and ensuring adequate antenatal obstetric interventions.

scholarly journals Rate, determinants, and causes of stillbirth in Jordan: Findings from the Jordan Stillbirth and Neonatal Surveillance (JSANDS) system

2020 ◽  
Author(s):  
Khulood Kayed Shattnawi ◽  
Yousef S. Khader ◽  
Mohammad Alyahya ◽  
Nihaya Al-Sheyab ◽  
Anwar Batieha
Keyword(s):  
Birth Weight ◽  
Congenital Malformations ◽  
Low Birthweight ◽  
Very Low Birth Weight ◽  
Chromosomal Abnormalities ◽  
Data Entry ◽  
Maternal Complications ◽  
Middle Income ◽  
Neonatal Deaths ◽  
Normal Birth

Abstract Background: Annually, 2.6 million stillbirths occur around the world, with about 98% occur in low and middle-income countries. The stillbirth rates in these countries are 10 times higher than the rates in high-income countries.Methods: An electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in five large hospitals located in three of the largest cities in Jordan in August 2019. JSANDS was developed as a secure on-line data entry system to collect, organize, analyse, and disseminate data on stillbirths, neonatal deaths, and their causes. Data on births, stillbirths and their causes, and other demographic and clinical characteristics in the period between August 2019 – January 2020 were extracted and analysed.Results: A total of 10328 births were registered during the reporting period. Of the total births, 102 were born dead (88 antepartum stillbirths and 14 intrapartum stillbirths) with a rate of 9.9 per 1000 total births. The main fetal causes of antepartum stillbirths were antepartum death of unspecified cause (33.7%), acute antepartum event (33.7%), congenital malformations and chromosomal abnormalities (13.3%), and disorders related to the length of gestation and fetal growth (10.8%). The main maternal causes of antepartum stillbirths included complications of placental cord and membranes (48.7%), maternal complications of pregnancy (23.1%), and maternal medical and surgical conditions (23.1%). Fetal causes of intrapartum stillbirths included congenital malformations deformations and chromosomal abnormalities, other specified intrapartum disorder, intrapartum death of unspecified cause (33.3% each). Maternal causes of intrapartum stillbirths included complications of placental cord and membranes. In the multivariate analysis, the odds of stillbirth for very low birth weight (<1500 gm) babies and for low birthweight babies (1500-2499 gm) were 14.1 times 4.3 times that odds for babies born with normal birth weight, respectively. The stillbirth rate was significantly higher among preterm deliveries compared to full-term deliveries (OR = 5.6).Conclusions: Although the rate of stillbirth is lower than that in other countries in the region, there is an opportunity to prevent such deaths. While the majority of stillbirths occurred during the antepartum period, care should be taken for early identification of high-risk pregnancies and ensuring adequate antenatal obstetric interventions.

scholarly journals Neonatal Mortality in Jordan: Rate, Determinants, and Causes Using Jordan Stillbirth and Neonatal Surveillance System

2020 ◽  
Author(s):  
Nihaya A Al-sheyab ◽  
Yousef S. Khader ◽  
Khulood K. Shattnawi ◽  
Mohammad S. Alyahya ◽  
Anwar Batieha
Keyword(s):  
Neonatal Mortality ◽  
Surveillance System ◽  
Low Birthweight ◽  
Multivariable Analysis ◽  
Preterm Births ◽  
Medical Intervention ◽  
Post Discharge ◽  
Large Cities ◽  
Neonatal Deaths ◽  
Term Births

Abstract Background It has been estimated that 27.8 million neonates will die between 2018 and 2030 if no improvements in neonatal mortality take place. The aim was to determine the rate, determinants, and causes of neonatal mortality in Jordan.Methods In August 2019, an electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in in three large cities through five hospitals. Data on all births, neonatal mortality and their causes, and other characteristics in the period between August 2019 – January 2020 were exported from the JSANDS and analysed.Results A total of 10328 births were registered in the study period, with a rate of 14.1 deaths per 1000 LBs; 76% were early neonatal deaths and 24% were late deaths. 25%of all deaths occurred in the first day of life. Multivariable analysis showed that the odds of neonatal deaths was 20.8 (95% CI 2.8,153.1) in Ministry of Health hospitals compared to private hospitals, OR 31.8 (95% CI 18.8,53.8) for very low birth (< 1500gram) neonates, OR 13 (95% CI 7.8,21.6) in preterm births compared to full-term births, and OR 2.7 (95% Cl 1.2,6.0) among housewives compared to employed women. Main causes of neonatal deaths that occurred pre-discharge were respiratory and cardiovascular disorders (43%) and low birthweight and preterm (33%). The main maternal conditions that attributed to these deaths were complications of the placenta and cord, complications of pregnancy, and medical and surgical conditions. The main cause of neonatal deaths that occurred post-discharge were low birthweight and preterm (42%).Conclusions The rate of neonatal mortality have not decreased since 2012 and the majority of neonatal deaths occurred could have been prevented. Regular antenatal visits, in which any possible diseases or complications of pregnant women or foetal anomalies, need to be fully documented and monitored with appropriate and timely medical intervention to minimize such deaths.

scholarly journals Analysis of neonatal mortality in Tomsk

2003 ◽  
Vol 2 (3) ◽  
pp. 99-102
Author(s):  
T. Ye. Tropova ◽  
T. S. Krivonogova ◽  
L. A. Matveyeva ◽  
R. A. Zlobina
Keyword(s):  
Medical Care ◽  
Neonatal Mortality ◽  
Congenital Malformations ◽  
Neonatal Deaths ◽  
New Born ◽  
Article Analysis

Dynamics of neonatal mortality in Tomsk within the period of 1999—2001 has been analyzed in the article. Analysis has been made according to the T. Kern’s method by G.S. Muchiyev’s and O.G. Frolova’s modification. This method permits to evaluate the dynamics of neonatal mortality from the viewpoint of its averting and gives opportunities to reveal the errors at all stages of medical care of women and new-born children. 170 cases of neonatal deaths have been analyzed. There has been marked the decrease of both early and common neonatal mortality due to avertable reasons. Unavertable death reasons tend to increase due to congenital malformations. Ways of the further decrease of neonatal mortality have been defined.

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.

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 Neonatal mortality and leading causes of deaths: a descriptive study in China, 2014–2018

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042654
Author(s):  
Yuxi Liu ◽  
Leni Kang ◽  
Chunhua He ◽  
Lei Miao ◽  
Xiaoqiong Qiu ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Middle Income ◽  
Government Interventions ◽  
Neonatal Deaths ◽  
Live Births ◽  
Urban And Rural Areas

ObjectiveThe present study estimated the national and urban–rural levels and causes of neonatal deaths in China annually between 2014 and 2018 to provide data support for the further end of preventable neonatal deaths for China and other low-income and middle-income countries.MethodsThe study was based on data from the National Maternal and Child Health Surveillance System. All neonates of surveillance districts (gestational week: ≥28 weeks) who died after delivery have been involved in the study. The mortality rate and the leading causes of death for neonates were analysed.ResultsThe neonatal mortality rate (NMR) of China has steadily decreased from 5.9 deaths per 1000 live births in 2014 to 3.9 deaths per 1000 live births in 2018. The NMR in 2018 of urban and rural areas was 2.2 deaths per 1000 live births and 4.7 deaths per 1000 live births, respectively. The leading preventable causes of neonatal deaths are the same in the urban and rural areas were same, which were preterm birth, intrapartum complications and pneumonia. Mortality rates of these three causes fell significantly between 2014 and 2018 but contributed to a higher proportion of deaths in rural areas than urban areas. The proportion of preventable deaths accounted for 74.6% in 2018.ConclusionsThe NMR of China has decreased steadily from 2014 to 2018. However, the inequality between urban and rural areas still exists. The goal of government interventions should be to reduce the health inequality of neonates and further take targeted measures to eliminate preventable neonatal death.

Sign in / Sign up

Export Citation Format

Share Document