scholarly journals The Influence of Gestational Age and Birth Weight on Neonatal Mortality

2020 ◽  
Vol 8 (3) ◽  
Author(s):  
Wedi Iskandar ◽  
Yeni Andayani ◽  
Lia Marlia ◽  
Burhan Burhan ◽  
Aris Primadi

Prematurity and low birth weight are some of the causes of neonatal death and significant health problem. This study aimed to determine the influence of gestational age and birth weight on neonatal mortality at the Al Islam Hospital Bandung in 2015–2019. It was a case-control retrospective observational analysis using medical records of the Al Islam Bandung Hospital from January 1, 2015, to December 31, 2019. The inclusion criteria for infants were born alive. Exclusion criteria had severe congenital abnormalities and gestational age <26 weeks. The chi-square test evaluated the univariate comparison test of risk factors between 2 groups. Multiple logistic regression to assess neonatal mortality's predictive factors and the percentage contribution of the influence was calculated (Nagelkerke’s R2 analysis). The number of infants enrolled in 2015–2019 was 6,791 neonates, and who died was 56 neonates (0.82%). In premature infants and low birth weight there was a very significant relationship with neonatal mortality, respectively p=0.000 (p<0.05) OR=30.397 (CI=16.506–55.976), and p=0.000 (p<0.05) OR=41.206 (CI=18.611–91.233). In the multiple logistic regression test, p=0.000 (p<0.05), with a Nagelkerke’s R2 value of 0.344 or 34.4%. This presence that gestational age and birth weight significantly affects neonatal mortality, either partially or simultaneously. The percentage contribution of the influence of gestational age and birth weight to neonatal mortality was 34.4%. PENGARUH USIA GESTASI DAN BERAT BADAN LAHIR TERHADAP KEMATIAN NEONATUSPrematuritas dan berat badan lahir rendah merupakan beberapa penyebab kematian neonatus dan masalah kesehatan yang signifikan. Penelitian ini bertujuan mengetahui pengaruh usia gestasi dan berat badan lahir terhadap kematian neonatus di RS Al Islam Bandung tahun 2015–2019. Penelitian ini merupakan penelitian observasional retrospektif kasus kontrol menggunakan data rekam medis RS Al Islam Bandung periode 1 Januari 2015 hingga 31 Desember 2019. Kriteria inklusi bayi lahir hidup. Kriteria eksklusi bayi dengan kelainan kongenital berat dan usia gestasi <26 minggu. Uji chi-square mengevaluasi perbandingan univariat faktor risiko antara 2 grup. Regresi logistik multipel untuk mengevaluasi faktor prediktif kematian neonatus dan persentase kontribusi pengaruh dihitung (Analisis R2 Nagelkerke). Jumlah bayi yang dirawat tahun 2015–2019 sebanyak 6.791 dan yang meninggal sebanyak 56 (0,82%). Pada bayi lahir prematur dan berat badan lahir rendah terdapat hubungan sangat bermakna terhadap kematian neonatus, berturut-turut p=0,000 (p<0,05) OR=30,397 (CI=16,506–55,976) dan p=0,000 (p<0,05) OR=41,206 (CI=18,611–91,233). Pada uji regresi logistik multipel, p=0,000 (p<0,05) dengan nilai R2 Nagelkerke sebesar 0,344 atau 34,4%. Usia gestasi dan berat badan lahir berpengaruh bermakna terhadap kematian neonatus, baik secara parsial maupun simultan. Persentase sumbangan pengaruh usia gestasi dan berat badan lahir terhadap kematian neonatus sebesar 34,4%.

2021 ◽  
Vol 2 (2) ◽  
pp. 38-49
Author(s):  
Asriwati Amirah ◽  
Thomson P Nadapdap ◽  
Suryani Suryani

This study aims to determine the factors associated with neonatal mortality 0-28 days in Central Aceh District in 2020. This research is a quantitative study with a case control research design and uses a retrospective approach. The study population was all mothers giving birth whose babies died at the age of 0-28 days from January to December 2020. The sample in this study was 120 respondents consisting of 60 cases and 60 controls. The sampling technique used was total sampling. Data analysis using chi square test and multiple logistic regression test. The results of the bivariate analysis using the chi square test showed that there were 2 variables that were significantly related to neonatal mortality, namely the maternal age variable with p value = 0.012 and the pregnancy examination variable with p value = 0.047. The results of multivariate analysis with multiple logistic regression test showed that there were 3 variables that influenced neonatal mortality, namely the maternal age variable with a p value of 0.001, the birth spacing variable with a p value of 0.018 and the pregnancy examination variable with a p value of 0.018, while the most dominant variable affecting the incidence of death Neonatal age is the variable of maternal age with an OR value of 4.397.


2021 ◽  
pp. 178-180
Author(s):  
Nwoga HO ◽  
Ajuba MO ◽  
Igweagu CP

Background: Low Birth Weight (LBW) is a major adverse outcome of pregnancy. Methods: A prospective cohort study conducted at a tertiary health facility in Nigeria. Data was retrieved from the ante-natal and delivery card of women that delivered within the time of data collection. Data was analyzed using SPSS version 25 and variables were presented as frequencies, percentages, means, and standard deviation. Bivariate analysis was done using chi-square test with the level of signicance set at p ≤ 0.05. Binary logistic regression was used to determine factors that predicted low birth weight. Results:The prevalence of LBW was 11.1%. About 48% of the mothers delivered through caesarean section while 53.9% booked within 14-28weeks gestation. On logistic regression agricultural workers had 4 times odds of having LBW babies when compared to the unemployed while the un-booked mothers had 11 times odds of having LBW babies when compared to those that booked at >28weeks gestational age. Conclusion: The prevalence of LBW was high. Booking status of the mother and having complications during pregnancy were strongly associated with preterm delivery.


1970 ◽  
Vol 4 (2) ◽  
pp. 74-84
Author(s):  
Talita de Faria Bustamante ◽  
Thamires de Almeida Gonçalves ◽  
Gislene Ferreira ◽  
Adriene Gomes De Moraes

Objetivos: Conhecer as causas e variáveis maternas, do recém-nascido e da própria unidade, relacionadas com a mortalidade da UTI Neonatal do Hospital Escola de Itajubá – MG, entre maio de 2012 a outubro de 2013. Métodos: Estudo descritivo envolvendo 68 recém-nascidos acompanhados até desfecho clínico. Foram analisadas variáveis maternas, da gestação, parto e recém-nascido. Foi utilizado o teste Qui-quadrado para relacionar estas variáveis com a taxa de mortalidade. Resultados: Ocorreram 12 óbitos, com uma taxa de mortalidade de 17,6%. Observou-se relevância apenas nas variáveis relacionadas à Idade Gestacional, baixo peso ao nascer, diagnóstico a internação, Apgar no 1o minuto e escore CRIB II. A mortalidade dos recém-nascidos com peso < 1000g foi de 50%. Os recém-nascidos prematuros com Idade Gestacional <31 semanas foram reesposáveis por 47,6% dos óbitos, sendo a prematuridade o principal diagnóstico à internação, e todos os óbitos estarem a ela relacionados. Conclusão: As principais variáveis associadas à mortalidade neonatal foram a idade gestacional e o baixo peso ao nascer. Além destas, incluíram-se outros fatores de risco como o Apgar no 1o minuto, o escore CRIB II e o diagnóstico principal. Originando um desafio, que precisa ser enfrentado por obstetras, neonatologistas e o poder público. Palavras-chave: UTI neonatal, mortalidade neonatal, prematuridade. ABSTRACTObjectives: To know the causes and variables of the mother, the newborn and the unit, related to the mortality of the Neonatal ICU from the teaching hospital in Itajubá – MG, between May 2012 and October 2013. Methods: A descriptive study involving 68 newborns followed up until clinical outcome. Variables of the mother and newborn, as well as pregnancy and childbirth were analyzed. Chi-square test was used to correlate these variables with mortality. Results: 12 deaths occurred, with a mortality rate of 17,6%. There were relevance on the variables related to gestational age, low birth weight, admission diagnosis, Apgar at 1st minute and CRIB II score. The mortality of the newborns weighing <1000g was 50%. Preterm newborns with gestational age <31 weeks were responsible for 47,6% of deaths, being prematurity the principal diagnosis on admission and all deaths related to it. Conclusion: The main variables associated with neonatal mortality were gestational age and low birth weight. Besides these, were included risk factors such as Apgar score at 1st minute, CRIB II score and primary diagnosis. Originating a challenge, that must be faced by obstetricians, neonatologists and public authorities. Keywords: neonatal ICU, neonatal mortality, prematurity.  


2020 ◽  
Vol 5 (2) ◽  
pp. 85-88
Author(s):  
Lina Astuty

Research: Pre-eclampsia is a disease with signs of hypertension, edema, and proteinuria arising from pregnancy. This disease generally occurs in the third trimester of pregnancy, but can occur earlier, for example in hydatidiform mole (Wiknjosastro, 2005: 282). Preeclampsia and Eclampsia are one of the main causes of maternal mortality in Indonesia. The incidence of preeclampsia ranges from 5-15% of all pregnancies in the world. Based on the 2003 Indonesian Demographic and Health Survey (IDHS), the incidence of preeclampsia in Indonesia is estimated at 3.4–8.5%. The research method used analytical observational method through a case control approach, which is an analytical study concerning how risk factors are studied using a retrospective approach. In other words, the effect is identified now, then the risk factor is identified as having existed or occurred in the past. Research Results The results of the significance test using the Chi-Square test showed a significant relationship to the occurrence of low birth weight (LBW) in mothers with preeclampsia. This is indicated by the value of p = 0.000 which is smaller than α = 0.05, so Ho is rejected. While the results of the calculation of the Odds Ratio show that preeclampsia is one of the causes of LBW, this is indicated by the OR value of 3.028. Conclusion: There is a relationship between preeclampsia and low birth weight in dr. Soedarso Pontianak in 2018 with a probability value (ρ) = 0.000.


Author(s):  
Devika V. Desai ◽  
Nigamananda Mishra ◽  
Gayatri V. Savani

Background: It has been since antiquity that the importance of amniotic fluid and fetal growth with perinatal outcome is being documented. But the lacunae lies in studying the relationship between borderline amniotic fluid and perinatal outcome. The following study was undertaken to provide recent data that would help predict perinatal outcome in borderline AFI pregnancies.Methods: About 144 patients were considered in the study OPD/IPD patients in obstetrics and gynecology department in Bhabha Atomic Research Centre and Hospital, with about 72 cases with borderline amniotic fluid index (5-8 cm) and controls with amniotic fluid index ≥9-25 cm. Patients were selected and subjected to history taking, examination, ultrasound test with doppler studies and perinatal outcome documented over a period of one year.Results: The incidence of borderline AFI in my study was 16%. 58% were primigravidas. Meconium stained liquor was found in 18% cases compared to 7% controls. Low birth weight was found in 12.5% cases and 2.7% in controls. On applying statistical test analysis chi square test, it was found that borderline amniotic fluid index in relation to presence of meconium stained amniotic fluid and low birth weight, p value was found to be statistically significant (<0.05).Conclusions: Borderline amniotic fluid and perinatal outcome had significant relationship in terms of meconium stained liquor and birth weight while rest had no significance. Thus, borderline amniotic fluid patients require vigilant fetal surveillance.


PRILOZI ◽  
2017 ◽  
Vol 38 (2) ◽  
pp. 79-84
Author(s):  
Orhideja Stomnaroska ◽  
Elizabeta Petkovska ◽  
Sanja Ivanovska ◽  
Snezana Jancevska ◽  
Dragan Danilovski

Abstract Aim: Severe neonatal hypoglycaemia (HG) leads to neurologic damage, mental retardation, epilepsy, impaired cardiac performance and muscle weakness. The aim was to assess the frequency and severity of HG in a population of newborns. Patients and methods: We investigated 739 patients with neonatal hypoglycaemia (HG) (M:F=370:369) born at the University Clinic for Gynaecology and Obstetritics in Skopje in the period 2014-2016 and treated at the neonatal intensive care unit (NICU). 1416 babies were treated in the same period in NICU, and HG was observed in 52.18%. The birth weight was dominated by children with low birth weight: very low birth weight (VLBW)(<1500g) 253 children, (34,23%), low birth weight (1500-2500g) 402 (54.39%), appropriate for gestational age (AGA) 78(10.55%), and high birth weight (>4000g) 6 babies (0.81%). The gestational age was also dominated by children with low gestational age: gestational week (GW) 20-25 four children (0.54%), 26-30 GW 133 babies (17.99%), 31-35 GW472 (63.87%), and 36-40 GW130 neonates (17.59 %). 241 mothers (32.61%) have had an infection during pregnancy, 82 preeclampsia or eclampsia (11.09%), 20 diabetes mellitus (2.70%), 78 placental situations (placenta previa, abruption) (10.55%). In this study 47 babies (6.35%) with HG and co-morbidities died. There was a significant positive correlation between HG birth weight (p<0.01), gestational age (p<0.05), and the lowest Apgar score (p<0.01). Neonatal deaths were significantly correlated with GA (р>0,01), co-morbidities of the mothers (р>0,05) but not with the birth weight (р>0,05). In contrast, a significant positive correlation was found between convulsions and body weight (р<0.05). The lowest Apgar score was positively correlated with the gestational age (0.01), but not with the birth weight (0.05). Conclusion: Low birth weight, low gestational age, maternal risk factors, hypoxic-ischemic encephalopathy and neonatal infections are associated with HG and are a significant factor in overall neonatal mortality. Those results indicate that diminishing the frequency of the neonatal HG and the rates of neonatal mortality requires complex interaction of prenatal and postnatal interventions.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036162
Author(s):  
Md Mostaured Ali Khan ◽  
Md Golam Mustagir ◽  
Md Rafiqul Islam ◽  
Md Sharif Kaikobad ◽  
Hafiz TA Khan

ObjectiveThis study is concerned with helping to improve the health and care of newborn babies in Bangladesh by exploring adverse maternal circumstances and assessing whether these are contributing towards low birth weight (LBW) in neonates.Study designs and settingsData were drawn and analysed from the Bangladesh Demographic and Health Survey, 2014. Any association between LBW and adverse maternal circumstances were assessed using a Chi-square test with determinants of LBW identified by multivariate logistic regression analysis.ParticipantsThe study is based on 4728 children aged below 5 years and born to women from selected households.ResultsThe rate of LBW was around 19.9% (199 per 1000 live births) with the highest level found in the Sylhet region (26.2%). The rate was even higher in rural areas (20.8%) and among illiterate mothers (26.6%). Several adverse maternal circumstances of the women included in the survey were found to be significant for increasing the likelihood of giving birth to LBW babies. These circumstances included the women being underweight (adjusted odds ratio (AOR) 1.26, 95% CI 1.06 to 1.49); having unwanted births (AOR 1.22, 95% CI 1.03 to 1.44); had previous pregnancies terminated (AOR 1.28, 95% CI 1.05 to 1.57); were victims of intimate partner violence (AOR 1.23, 95% CI 1.05 to 1.45) and taking antenatal care <4 times (AOR 1.23, 95% CI 1.03 to 1.48). Other important risk factors that were revealed included age at birth <18 years (AOR 1.42, 95% CI 1.11 to 1.83) and intervals between the number of births <24 months (AOR 1.25, 95% CI 1.01 to 1.55). When taking multiple fertility behaviours together such as, the ages of the women at birth (<18 years with interval <24 months (AOR 1.26, 95% CI 1.02 to 1.57) and birth order (>3 with interval <24 months (AOR 1.68, 95% CI 1.18 to 2.37), then the risk of having LBW babies significantly increased.ConclusionThis study finds that adverse maternal circumstances combined with high-risk fertility behaviours are significantly associated with LBW in neonates. This situation could severely impede progress in Bangladesh towards achieving the sustainable development goal concerned with the healthcare of newborns.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Martin Ackah ◽  
Mohammed Gazali Salifu ◽  
Hosea Boakye

Introduction. Injuries are of public health concern and the leading cause of residual disability and death among teenagers, especially in low- and middle-income countries (LMICs). In Ghana, the burden of injury among adolescents is under-reported. Hence, the study sought to determine the prevalence of serious injuries (SI) and the potential factors influencing these injuries among school children in Ghana. Methods. This study was conducted in Ghana among Junior High School (JHS) and senior high school students (SHS) using the 2012 Global School-Based Student Health Survey (GSHS) data. The GSHS employed two-stage cluster sampling method. Serious injuries (SI) and independent factors were measured via self-administered questionnaires. Pearson chi-square test between each explanatory variable and serious injuries was conducted and the level of statistical significance was set at 5%. The significant variables from the chi-square test were selected for multiple logistic regression analysis. Multiple logistic regression was performed to estimate the adjusted odds ratio (AOR) at 95% confidence interval (CI). Results. The prevalence of SI in the past 12 months was 66% [CI=61.8–70.2] . The most common cause of SI was fall, 36%. The common types of injuries were cut/stab wounds and broken/dislocated bone. In the multiple logistic regression analysis, after controlling for other variables, educational level (AOR = 0.64, CI = 0.44–0.90, p  < 0.015), suicidal ideation (AOR = 1.58, CI = 1.00–2.48, p  < 0.002), suicidal attempt (AOR = 1.88, CI = 1.29–2.72, p  < 0.001), having at least one close friend (AOR = 1.49, CI = 1.17–1.89, p  < 0.002), school truancy (AOR = 1.66, CI = 1.31–2.09, p  < 0.000), smoking marijuana (AOR = 2.64, CI = 1.22–5.69), and amphetamine use (AOR = 2.95, CI = 1.46–5.69) were independently associated with SI. Conclusion. The findings of the study established a high prevalence of SI among adolescents in Ghana, with cut/stab wound and broken/dislocated bone being the most reported type of injuries. This study also revealed that factors such as educational level, suicidal ideation, suicidal attempt, at least one close friend, school truancy, smoking marijuana, and amphetamine use are associated with SI among the adolescents. Therefore, pragmatic interventional programs should be targeted at these factors to curb the rate of SI among junior and senior school students.


2020 ◽  
Vol 1 ◽  
pp. 78-81
Author(s):  
Yuni Arisandi ◽  
Sodikin Sodikin

Hyperbilirubinemia is a problem that often occurs in newborns characterized by icterus, yellowish pigmentation of the skin, sclera, and nails. Many factors cause hyperbilirubinemia in infants such as the type of labor, birth weight, gestational age, gender, and asphyxia.This research aimed to discover the factors associated with the occurrence of hyperbilirubinemia in infants.This was a quantitative research with a retrospective cohort design. There were 83 respondents as the research sample taken using a random sampling technique. The research data were analyzed using the chi-square test and multivariate logistic regression. The majority of respondents underwent labor with actions (59 respondents / 71.1%), delivered male babies (51 respondents / 61.4%), delivered babies with normal birth weight (56 respondents / 67.5%), had a full-term pregnancy (54 respondents / 65.1%), and did not experience asphyxia (65 respondents / 78.3%). In addition, most respondents gave birth to babies with hyperbilirubinemia (43 respondents / 51.8%). Chi-square test results indicated a correlation between the type of labor (p = 0.008), birth weight (p = 0.019), gestational age (p = 0.000), and asphyxia (p = 0.013) with the incidence of hyperbilirubinemia. While the variable of gender (p = 0.106) had no correlation. The most influential factor was gestational age (p = 0.027) with an odds ratio of 4.011. In conclusion: The types of labor, birth weight, gestational age, and asphyxia have a correlation with the occurrence of hyperbilirubinemia.


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