scholarly journals No Take Home Baby After Caesarian Birth for Foetal Distress in Women with Risk

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Risk Factors ◽  
Neonatal Outcome ◽  
Meta Analysis ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Cord Compression ◽  
High Rate ◽  
Neonatal Deaths ◽  
Fetal Ecg ◽  
Foetal Asphyxia

Sometimes interventions are done for the baby in women with risks but it turns out to be unnecessary caesarian section (CS). However it may be delayed decision and / or delayed execution of intervention, CS too, with no take home baby. While lack of adverse outcome reflected that the decision was not for a compromised foetus, still birth or asphyxiated baby at birth meant delayed decision and / or execution. Recent studies revealed an estimated 9.04 million perinatal deaths related to birth asphyxia. Of them 1.02 million were intrapartum deaths leading to still births, many after CB for foetal concern. Birth asphyxia is a significant global health problem, responsible for around 1.2 million neonatal deaths each year worldwide [1-3]. Those who survive often suffer from a range of disorders. Chauhan et al. conducted, a meta analysis comprising of 169 articles and 37 reports and concluded that the overall risk of prompt CB for fetal concern was 3.1 % (43,340 of 13,98,9740 cases) [4,5]. From time to time several hospital based studies have proved the role of various antepartum or intrapartum maternal & foetal risk factors which lead to foetal asphyxia. It is known that some disorders which could cause foetal asphyxia are obvious during pregnancy, some are labour related, be it mother or baby. Kaye reported association of primiparity, anaemia, hypertensive disorders of pregnancy, foetal growth restriction, malpresentation, antepartum haemorrhage, premature rupture of membranes, prematurity, fever, oxytocin augmentation of labour, umbilical cord prolapse, as risk factors ,with complex interplay between factors which predispose foetuses to poor outcome, due to decreased oxygenation, ACOG reported that foetal hypoxemia which if not compensated or corrected in time progressed to birth asphyxia and even death, either in utero or immediately after birth [6,7]. Gaffineet and James have reported, intrapartum hypoxia complicating around 1% of labours, resulting in foetal / neonatal deaths in 0.5/1000 pregnancies and cerebral palsy in 1 in 1000 cases diagnosed after swift delivery for clinically diagnosed “fetal distress’’ [8]. Earlier Murphy et al had suggested that reduced uterine perfusion uteroplacental vascular disease, low fetal reserve foetal asphyxia, foetal sepsis and cord compression with other gestational and antepartum factors could affect the fetal response which needed to be known. However diagnosis of FD also has to be correct and timely [9]. Cardiotocography (CTG) has been criticized for unnecessary high rate of operative delivery [10-12]. In the study by Roy, non-reassuring fetal heart rate (FHR) detected by CTG did not correlate well with neonatal outcome [13]. In the era of defensive practices, ‘play safe’ attitude results in high CS rate for non-reassuring FHR. The concept of detecting fetal acidosis, using fetal scalp blood appeared attractive, but practical difficulties in carrying it out restricted its use [14,15]. Roy et al suggested that since non-reassuring FHR detected by CTG did not correlate well with adverse neonatal outcome and resulted in unnecessary CS, fetal ECG needed to be introduced in addition to conventional CTG, wherever possible [13]. There are many such issues about timely appropriate authentic diagnosis and action.

scholarly journals Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255488
Author(s):  
Ritbano Ahmed ◽  
Hassen Mosa ◽  
Mohammed Sultan ◽  
Shamill Eanga Helill ◽  
Biruk Assefa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Birth Asphyxia ◽  
Public Health Problem ◽  
Cochrane Library ◽  
Chronic Hypertension ◽  
Factors Associated ◽  
Pooled Prevalence

Background A number of primary studies in Ethiopia address the prevalence of birth asphyxia and the factors associated with it. However, variations were seen among those studies. The main aim of this systematic review and meta-analysis was carried out to estimate the pooled prevalence and explore the factors that contribute to birth asphyxia in Ethiopia. Methods Different search engines were used to search online databases. The databases include PubMed, HINARI, Cochrane Library and Google Scholar. Relevant grey literature was obtained through online searches. The funnel plot and Egger’s regression test were used to see publication bias, and the I-squared was applied to check the heterogeneity of the studies. Cross-sectional, case-control and cohort studies that were conducted in Ethiopia were also be included. The Joanna Briggs Institute checklist was used to assess the quality of the studies and was included in this systematic review. Data entry and statistical analysis were carried out using RevMan 5.4 software and Stata 14. Result After reviewing 1,125 studies, 26 studies fulfilling the inclusion criteria were included in the meta-analysis. The pooled prevalence of birth asphyxia in Ethiopia was 19.3%. In the Ethiopian context, the following risk factors were identified: Antepartum hemorrhage(OR: 4.7; 95% CI: 3.5, 6.1), premature rupture of membrane(OR: 4.0; 95% CI: 12.4, 6.6), primiparas(OR: 2.8; 95% CI: 1.9, 4.1), prolonged labor(OR: 4.2; 95% CI: 2.8, 6.6), maternal anaemia(OR: 5.1; 95% CI: 2.59, 9.94), low birth weight(OR = 5.6; 95%CI: 4.7,6.7), meconium stained amniotic fluid(OR: 5.6; 95% CI: 4.1, 7.5), abnormal presentation(OR = 5.7; 95% CI: 3.8, 8.3), preterm birth(OR = 4.1; 95% CI: 2.9, 5.8), residing in a rural area (OR: 2.7; 95% CI: 2.0, 3.5), caesarean delivery(OR = 4.4; 95% CI:3.1, 6.2), operative vaginal delivery(OR: 4.9; 95% CI: 3.5, 6.7), preeclampsia(OR = 3.9; 95% CI: 2.1, 7.4), tight nuchal cord OR: 3.43; 95% CI: 2.1, 5.6), chronic hypertension(OR = 2.5; 95% CI: 1.7, 3.8), and unable to write and read (OR = 4.2;95%CI: 1.7, 10.6). Conclusion According to the findings of this study, birth asphyxia is an unresolved public health problem in the Ethiopia. Therefore, the concerned body needs to pay attention to the above risk factors in order to decrease the country’s birth asphyxia. Review registration PROSPERO International prospective register of systematic reviews (CRD42020165283).

scholarly journals Justification of Cesarean section in fetal distress: Experience in a tertiary care military hospital in Bangladesh

2019 ◽  
Vol 10 (1) ◽  
pp. 60-63
Author(s):  
Shakila Khanum ◽  
Liza Chowdhury
Keyword(s):  
Intensive Care ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Fetal Distress ◽  
High Rate ◽  
Military Hospital ◽  
Cross Sectional ◽  
Heart Rate Pattern

Background: The trend of Caesarean section (CS) carried out is rising worldwide. One of the most common indications of CS is fetal distress which is based on the cardiotocograph (CTG) recording, abnormal fetal heart rate pattern and meconium stained liquor. The aim of this study was to carry out an audit of CS performed due to fetal distress in a tertiary care military hospital with a view to justify the methods for diagnosis of fetal distress to fetal outcome. Methods: This cross-sectional observational study was carried out over a period of 1 year and 6 months (July 2013 to January 2015) in the Combined Military Hospital (CMH), Dhaka. All pregnant women at or beyond 37 weeks of gestation who underwent CS for fetal distress were included. Neonatal outcome were assessed based on APGAR score and neonatal intensive care admission. Results: Among the 260 (100%) women who underwent CS due to fetal distress, mean age was 27.8 ± 5.3 years. More than half (54.6%) of the women were primigravida. Majority (48%) of the patients presented with spontaneous onset of labor and in 43% cases labor was induced by medical methods. In the majority (40%) of the patients, fetal distress was diagnosed by seeing abnormal patterns in CTG. During CS, signs of fetal distress was found in the majority (64.6%) of the patients (meconium stained liquor 42.3%, cord abnormality 13.5% and placental abnormality 8.8%). APGAR score of the newborn babies was abnormal (<7) in the majority (60%) cases. More than half of the newborn babies required admission in neonatal intensive care unit for different diagnosis. There was only 4 (1.5%) cases of neonatal death. Conclusion: The rate of CS for fetal distress in this study was comparable to other study findings and within recommendation of WHO. The high rate of identifiable causes of fetal distress as well as neonatal outcome justifies doing CS in these cases. Birdem Med J 2020; 10(1): 60-63

scholarly journals A Study on Correlation of Umbilical Cord Arterial Blood pH with Perinatal Asphyxia & Early Neonatal Outcome

2020 ◽  
Vol 8 (2) ◽  
pp. 30-35
Author(s):  
Nutan Singh ◽  
Asheesh Kumar Gupta ◽  
Ajay Kumar Arya
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Neonatal Outcome ◽  
Outcome Measurement ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Arterial Blood ◽  
Blood Ph

Background: Perinatal asphyxia is one of the major causes of neonatal morbidity & mortality. Asphyxia can damage almost every organ of neonate. Our purpose was to determine the correlation of cord blood pH with birth asphyxia & early neonatal outcome. Subjects and Methods: A prospective study was conducted over a period of one year at STH Haldwani. We enrolled 108 term neonates with signs of fetal distress, thick MSL, non-reassuring NST & there were subjected for estimation of umbilical cord blood pH, APGAR score, outcome looked were resuscitation needed, NICU admission, delay in feed & encephalopathy (sarnat & sarnat stage). Results: In our study, cord blood pH had significant correlation with perinatal asphyxia(R=-0.926). Area under ROC curved showed that mean pH <7.1 (ROC=0.998) is very significant in predicting the adverse outcome. Conclusion: Cord blood pH is very sensitive and specific & has good correlation in predicting the birth asphyxia & adverse neonatal outcome. Measurement of cord blood pH is recommended in all the neonates with signs of fetal distress.

scholarly journals Clinical Profile of Birth Asphyxia in Dhulikhel Hospital: A Retrospective Study

1970 ◽  
Vol 30 (3) ◽  
pp. 141-146 ◽  
Author(s):  
S Dongol ◽  
J Singh ◽  
S Shrestha ◽  
A Shakya
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Birth Asphyxia ◽  
Clinical Information ◽  
World Health ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Neonatal Deaths ◽  
Live Births ◽  
Infant Birth

Introduction: Birth asphyxia is defined by the World Health Organization "the failure to initiate and sustain breathing at birth." The WHO has estimated that 4 million babies die during the neonatal period every year and 99% of these deaths occur in low-income and middle income countries. Three major causes account for over three quarters of these deaths, serious infection (28%) complication of preterm birth (26%) and birth asphyxia (23%). This estimation implies that birth asphyxia is the cause of around one million neonatal deaths each year. One of the present challenges is the lack of a gold standard for accurately defining birth asphyxia. Because of same reason the incidence of birth asphyxia is difficult to quantify. Objective: The aim of this study was to assess the prevalence of birth asphyxia, identify the common obstetric and neonatal risk factors, and study the cause of death. Methodology: All babies born in Dhulikhel Hospital (DH) from Jan 2007 to Oct 2009 with a diagnosis of birth asphyxia (5 min Apgar < 7 and those with no spontaneous respirations after birth) were included in the study (n=102). Clinical information was collected retrospectively from maternal records (maternal age, gravida, type of delivery, presence of meconium, induced or spontaneous labour, and pregnancy complications). The NICU records provided additional information about new born infant (birth asphyxia, stages of birth asphyxia, birth weight, sex and subsequent mortality). Results: Among the 3784 live births there were 102 babies with birth asphyxia prevalence of 26.9/1000 live births. Babies with Hypoxic ischemic encephalopathy (HIE) Stage 1 had a very good outcome but HIE III was associated with a poor outcome. Males, primipara and pregnancies with complications were associated with a higher rate of birth asphyxia. Septicaemia, necrotizing enterocolitis, preterm delivery, convulsion and, pneumothorax were associated with higher mortality and morbidity. Conclusion: Birth asphyxia was one of the commonest causes of admission and mortality in NICU. Babies with HIE Stage III had a very poor prognosis. Birth asphyxia combined with other morbidities was associated with a higher mortality. Sepsis is the commonest morbidity in cases of birth asphyxia. Maternal gravida, pregnancy complication with PROM, meconium, APH, emergency caesarean section, preterm and male sex were the risk factors for birth asphyxia. Key words: Birth asphyxia; HIE; Neonatal sepsisDOI: 10.3126/jnps.v30i3.3916J Nep Paedtr Soc 2010;30(3):141-146

scholarly journals A multicenter study of incidence, risk factors and outcomes of babies with birth asphyxia in Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Avinash K. Sunny ◽  
Prajwal Paudel ◽  
Jagannath Tiwari ◽  
Bishow Bandhu Bagale ◽  
Antti Kukka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Multiple Logistic Regression Analysis ◽  
Birth Asphyxia ◽  
Binary Logistic Regression ◽  
Fetal Distress ◽  
Low Resource Settings ◽  
Low Resource ◽  
Incidence Risk ◽  
Associated Risk Factors

Abstract Background Perinatal events which result in compromised oxygen delivery to the fetus can lead to Birth Asphyxia (BA). While the incidence, risk factors and outcomes of BA have been characterized, less is known in low resource settings. Aim To determine the incidence of Birth Asphyxia (BA) in Nepal and to evaluate associated risk factors and outcomes of this condition. Methods A nested observational study was conducted in 12 hospitals of Nepal for a period of 14 months. Babies diagnosed as BA at ≥37 weeks of gestation were identified and demographics were reviewed. Data were analyzed using binary logistic regression followed by multiple logistic regression analysis. Results The incidence of BA in this study was 6 per 1000 term livebirths and was higher among women 35 years and above. Predictors for BA were instrumented vaginal delivery (aOR:4.4, 95% CI, 3.1–6.1), fetal distress in labour (aOR:1.9, 95% CI, 1.0–3.6), malposition (aOR:1.8, 95% CI, 1.0–3.0), birth weight less than 2500 g (aOR:2.0, 95% CI, 1.3–2.9), gestational age ≥ 42 weeks (aOR:2.0, 95% CI, 1.3–3.3) and male gender (aOR:1.6, 95% CI, 1.2–2.0). The risk of pre-discharge mortality was 43 times higher in babies with BA (aOR:42.6, 95% CI, 32.2–56.3). Conclusion The incidence of Birth asphyxia in Nepal higher than in more resourced setting. A range of obstetric and neonatal risk factors are associated with BA with an associated high risk of pre-discharge mortality. Interventions to improve management and decrease rates of BA could have marked impact on outcomes in low resource settings.

scholarly journals Population-Based Estimation of the Preterm Birth Rate in Lilongwe, Malawi: Making Every Birth Count

2020 ◽  
Vol 10 (01) ◽  
pp. e78-e86
Author(s):  
Kathleen M. Antony ◽  
Peter N. Kazembe ◽  
Ryan M. Pace ◽  
Judy Levison ◽  
Henry Phiri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Birth Rate ◽  
Health Workers ◽  
Population Based ◽  
High Rate ◽  
Comorbid Conditions ◽  
Neonatal Deaths ◽  
Preterm Birth Rate ◽  
Early Neonatal Deaths

Abstract Objective The objective of this study was to perform a population-based estimation of the preterm birth (PTB) rate in regions surrounding Lilongwe, Malawi. Study Design We partnered with obstetrician specialists, community health workers, local midwives, and clinicians in a 50 km region surrounding Lilongwe, Malawi, to perform a population-based estimation of the PTB rate during the study period from December 1, 2012 to May 19, 2015. Results Of the 14,792 births captured, 19.3% of births were preterm, including preterm early neonatal deaths. Additional PTB risk factors were similarly prevalent including domestic violence, HIV, malaria, anemia, and malnutrition. Conclusion When performing a population-based estimation of the rate of PTB, including women without antenatal care and women delivering at home, the 19.3% rate of PTB is among the highest recorded globally. This is accompanied by a high rate of risk factors and comorbid conditions.

scholarly journals Epidemiology, Risk Factors and Measures for Preventing Drowning in Africa: A Systematic Review

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 637
Author(s):  
Lauren Miller ◽  
Faith Alele ◽  
Theophilus Emeto ◽  
Richard Franklin
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Unintentional Injury ◽  
High Rate ◽  
Prevention Measures ◽  
Prevention Strategies ◽  
Water Age ◽  
African Countries ◽  
Central Registry

Background and Objectives: Drowning is a leading cause of unintentional injury related mortality worldwide, and accounts for roughly 320,000 deaths yearly. Over 90% of these deaths occur in low- and middle-income countries with inadequate prevention measures. The highest rates of drowning are observed in Africa. The aim of this review is to describe the epidemiology of drowning and identify the risk factors and strategies for prevention of drowning in Africa. Materials and Methods: A review of multiple databases (MEDLINE, CINAHL, PsycINFO, Scopus and Emcare) was conducted from inception of the databases to the 1st of April 2019 to identify studies investigating drowning in Africa. The preferred reporting items for systematic review and meta-analysis (PRISMA) was utilised. Results: Forty-two articles from 15 countries were included. Twelve articles explored drowning, while in 30 articles, drowning was reported as part of a wider study. The data sources were coronial, central registry, hospital record, sea rescue and self-generated data. Measures used to describe drowning were proportions and rates. There was a huge variation in the proportion and incidence rate of drowning reported by the studies included in the review. The potential risk factors for drowning included young age, male gender, ethnicity, alcohol, access to bodies of water, age and carrying capacity of the boat, weather and summer season. No study evaluated prevention strategies, however, strategies proposed were education, increased supervision and community awareness. Conclusions: There is a need to address the high rate of drowning in Africa. Good epidemiological studies across all African countries are needed to describe the patterns of drowning and understand risk factors. Further research is needed to investigate the risk factors and to evaluate prevention strategies.

scholarly journals A clinical study on maternal and fetal outcome in pregnancy with oligohydromnios

2018 ◽  
Vol 7 (11) ◽  
pp. 4731
Author(s):  
Chetan Prakash Gupta ◽  
Jaya Choudhary ◽  
Deepika Chahar ◽  
Sapna Kumari Yadav
Keyword(s):  
Birth Asphyxia ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Cord Compression ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Common Cause ◽  
Increased Risk ◽  
Nicu Admission ◽  
Four Quadrant

Background: Oligohydramnios is associated with various maternal and fetal complication. It’s correlated fetal complications like FGR, increased risk of meconium aspiration syndrome, Birth asphyxia, low APGAR scores and increased congenital abnormalities in fetus. It’s also associated with maternal morbidities in view of operative interventions for delivery. To study effect of oligohydramnios in mother in form of, operative delivery and progress of labour. To study effect of oligohydramnios in fetus in form of fetal compromise i.e.  FGR, fetal distress, altered APGAR score, need for NICU admission. congenital anomaly and perinatal death.Methods: 50 patients with ≥ 28 weeks POG with oligohydramnios, confirmed by ultrasonographic measurement of AFI using four quadrant technique; were selected randomly after fulfilling inclusion and exclusion criteria.Results: Incidence of oligohydramnios were more found in primigravida (56%) in present study. Most common cause of oligohydramnios was idiopathic (62%) followed by PIH (20%). Most common cause of caesarean was fetal distress (23%) either due to cord compression or FGR. oligohydramnios was related to higher rate of Fetal Growth restriction and NICU admission (24%).Conclusions: Oligohydramnios is very common encounter during pregnancy, Because of its frequent occurrence; it demands intensive fetal monitoring and systemic approach to antepartum and intrapartum fetal surveillance. There is increased risk of intrapartum complication, perinatal morbidity, perinatal mortality; thus, the rate of caesarean increasing day by day.one should always know the fine line between vaginal delivery and caesarean section; move ahead with best option without hampering fetal wellbeing and avoid unnecessary operative morbidity.

scholarly journals Study of risk factors in children with birth asphyxia

2017 ◽  
Vol 4 (2) ◽  
pp. 518 ◽  
Author(s):  
Nishant Yadav ◽  
Sachin Damke
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Multiple Gestation ◽  
Maternal Risk Factors ◽  
Female Ratio ◽  
Maternal Risk ◽  
Fetal Risk

Background: Birth asphyxia is a serious clinical problem worldwide and contributes greatly to neonatal mortality and morbidity. Perinatal asphyxia is the fifth largest cause of under-5 deaths (8.5%) after pneumonia, diarrhea, neonatal infections and complications of preterm birth. Risk factors of birth asphyxia have been divided into antepartum, intrapartum and fetal. Risk factors include increasing or decreasing ma-ternal age, prolonged rupture of membranes, meconium stained fluid, multiple births, non-attendance for antenatal care, low birth weight infants, malpresentation, augmentation of labour with oxytocin, antepartum haemorrhage, severe eclampsia and pre-eclampsia, ante partum and intrapartum anemia. The objective of this study was to study the risk factors in children with birth asphyxia.Methods: Observational prospective study was conducted on babies delivered in our hospital and requiring resuscitation (basic and/or advanced). Their clinical course was observed and studied in NICU till time of discharge or death. Detailed maternal history was taken for risk factors.Results: The mean age of mothers was 24.28 years which ranged from 20 years to 29 years. Most of the population was from the lower middle and upper lower socioeconomic status as per the Modified Kuppuswamy scale. 51% neonates were born to primiparous mothers. Anemia was widely prevalent in the moth-ers of neonates requiring resuscitation. The maternal risk factors for newborns requiring resuscita-tion were PIH (23.7%) , oligohydramnios (15%),multiple gestation (3.75 %), PROM (2.5%), diabetes mellitus (2.5%) and UTI (2.5%).One third of neonates requiring resuscitation were born to unbooked mothers.In the neonates requiring resuscitation, the male to female ratio was 1:1. The fetal factors associated with resuscitation of newborns were IUGR (33.75%), fetal distress (31.25%), prematurity (26.25%), MAS (12.5%) and malpresentations (5%).Conclusions: The most common maternal risk factors for newborns requiring resuscitation was PIH followed by oligohydramnios, multiple gestation, PROM, diabetes mellitus and UTI.IUGR was the most com-mon fetal risk factor followed by fetal distress, prematurity, MAS and malpresentations. One third of neonates requiring resuscitation were born to unbooked mothers. In There was no gender predomi-nance found in this study.

scholarly journals Stillbirths, Neonatal Morbidity, and Mortality in Health-Facility Deliveries in Urban Gambia

2021 ◽  
Vol 9 ◽  
Author(s):  
Bully Camara ◽  
Claire Oluwalana ◽  
Reiko Miyahara ◽  
Alyson Lush ◽  
Beate Kampmann ◽  
...  
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Health Facility ◽  
Pregnancy Outcomes ◽  
Congenital Malformations ◽  
Neonatal Period ◽  
Birth Asphyxia ◽  
High Rate ◽  
Neonatal Deaths

Background: The Gambia Demographic and Health Survey 2013 data showed that up to 63% of deliveries in the country occur in health facilities. Despite such a high rate, there are few facility-based studies on delivery outcomes in the country. This analysis ancillary to a randomized control trial describes occurrence of poor pregnancy outcomes in a cohort of women and their infants delivering in a government health facility in urban Gambia.Methods: Using clinical information obtained during the trial, we calculated rates of poor pregnancy outcomes including stillbirths, hospitalization and neonatal deaths. Logistic regression was used to calculate odds ratio (OR) and 95% confidence interval (CI) in the risk factors analysis.Results: Between April 2013 and 2014, 829 mothers delivered 843 babies, including 13 stillbirths [15.4 (7.1–23.8)] per 1,000 births. Among 830 live born infants, 7.6% (n = 63) required hospitalization during the 8-week follow-up period. Most of these hospitalizations (74.6%) occurred during the early neonatal period (&lt;7 days of life). Severe clinical infections (i.e., sepsis, meningitis and pneumonia) (n = 27) were the most common diagnoses, followed by birth asphyxia (n = 13), major congenital malformations (n = 10), jaundice (n = 6) and low birth weight (n = 5). There were sixteen neonatal deaths, most of which also occurred during the early neonatal period. Overall, neonatal mortality rate (NMR) and perinatal mortality rate (PMR) were 19.3 (CI: 9.9–28.7) per 1,000 live births and 26.1 (CI: 15.3–36.9) per 1,000 total births, respectively. Severe clinical infections and birth asphyxia accounted for 37 and 31% of neonatal deaths, respectively. The risk of hospitalization was higher among neonates with severe congenital malformations, low birth weight, twin deliveries, and those born by cesarean section. Risk of mortality was higher among neonates with severe congenital malformations and twin deliveries.Conclusion: Neonatal hospitalization and deaths in our cohort were high. Although vertical interventions may reduce specific causes of morbidity and mortality, data indicate the need for a holistic approach to significantly improve the rates of poor pregnancy outcomes. Critically, a focus on decreasing the high rate of stillbirths is warranted.Clinical Trial Registration:ClinicalTrials.gov Identifier: NCT01800942.

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