Analysis of factors associated with early neonatal deaths through linkage between SIM and SINASC, in Sergipe, Brazil

In Brazil, more than 70% of neonatal deaths are concentrated in the early neonatal period, with about 41.2% of them occurring in the first 24 hours of life. Thus, the objective of this study was to carry out an analysis of factors associated with early neonatal deaths that occurred in Sergipe, Brazil, through the linkage of records in the information systems: Live Birth Information System (SINASC) and Mortality Information System (SIM). This study was carried out in Sergipe, Brazil, in which an analysis was made of secondary data on children born and early neonatal deaths in Sergipe between 2006 and 2019 registered in the SINASC and in the SIM. A linkage was carried out between the databases, identifying 484,629 live births, 480,784 survivors and 3,845 who died with less than 7 days of life, with a low percentage of ignored data or absent. Maternal age was similar between groups. However, the newborns who died had lower weight, gestational age and Apgar in the first and fifth minutes than the survivor group. Regarding the newborn, there were more deaths in males and in congenital malformations. As for information about the mother and pregnancy, there were more deaths in single women, multiple pregnancies, lower gestational ages and vaginal delivery. There was an association between neonatal deaths and lower Apgar in the first and fifth minutes, lower weights, lower gestational ages, male gender, congenital malformations, women with multiple pregnancies, vaginal births and single mothers.

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Preterm labour in multiple pregnancies

Fetal and Maternal Medicine Review ◽

10.1017/s0965539500000784 ◽

1993 ◽

Vol 5 (2) ◽

pp. 105-119 ◽

Cited By ~ 2

Author(s):

James P Neilson ◽

Caroline A Crowther

Keyword(s):

Perinatal Mortality ◽

Preterm Labour ◽

Multiple Pregnancy ◽

High Rate ◽

Fetal Malformation ◽

Multiple Pregnancies ◽

Neonatal Deaths ◽

Late Abortion ◽

Early Neonatal Deaths ◽

Singleton Pregnancies

Multiple pregnancy is associated with a high rate of perinatal loss – mainly due to preterm labour but with important contributions from fetal malformation, intrauterine growth retardation and twin-twin transfusion syndrome. The overall perinatal mortality rate is consistently around six times that of singleton pregnancies but the rate rises progressively with the number of fetuses. Rates of 63,164,200,214 and 416 per 1000 births have been recently reported for twins, triplets, quadruplets, quintuplets and sextuplets respectively. In addition to these alarming figures, it should be emphasized that the restricted concept of perinatal mortality obscures the real extent of loss. If we include late abortion (after 20 weeks), late neonatal deaths and deaths in infancy from perinatal causes, as well as the usual indices of perinatal mortality (stillbirths and early neonatal deaths) we find that the total loss rate from twin pregnancy alone doubles and may be close to 10%. Although the rate of loss from multiple pregnancies is now substantially higher than that associated with the pregnancies of diabetic women, the challenge of multiple pregnancy has not been met with the same commitment or organisation of specialized perinatal services as has diabetes.

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Factors associated with mortality due to neonatal pneumonia in India: a protocol for systematic review and planned meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-017616 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017616 ◽

Cited By ~ 2

Author(s):

N Sreekumaran Nair ◽

Leslie Edward Lewis ◽

Theophilus Lakiang ◽

Myron Godinho ◽

Shruti Murthy ◽

...

Keyword(s):

Meta Analysis ◽

Grey Literature ◽

Secondary Data ◽

Research Knowledge ◽

Neonatal Deaths ◽

Factors Associated ◽

Assessment Development ◽

Indian Context ◽

Ethical Approval

IntroductionIndia contributes to the highest number of neonatal deaths globally. It also has the greatest number of pneumonia-related neonatal deaths in the developing world. We aim to systematically review the evidence for the factors associated with mortality due to neonatal pneumonia in the Indian context, to address the lack of consolidated evidence on this important issue.Methods and analysisThis protocol is part of a series of three reviews on neonatal pneumonia in India. Observational studies reporting on outcome of neonatal pneumonia in the Indian context, and published in English in peer-reviewed and indexed journals will be eligible for inclusion. Outcomes of this review will be the factors determining mortality due to neonatal pneumonia. A total of nine databases will be searched. Electronic and hand searching of published and grey literature will be performed. Selection of studies will be done in title, abstract and full text screening stages. Risk of bias, independently assessed by two authors, will be evaluated. Meta-analysis will be performed and heterogeneity assessed. Pooled effect estimates will be stated with 95% confidence intervals. Narrative synthesis will be done where meta-analysis cannot be performed. Publication bias will be evaluated and sensitivity analysis performed according to study quality. Quality of this review will be evaluated using AMSTAR (Assessing the Methodological quality of Systematic Reviews) and GRADE (Grades of Recommendation, Assessment, Development & Evaluation). A summary of findings table will be reported using GRADEPro.Ethics and disseminationSince this is a review involving analysis of secondary data which is available in the public domain, and does not involve human participants, ethical approval was not required. The findings of the study will be shared with all stakeholders of this research. Knowledge dissemination workshops will be conducted with relevant stakeholders to transfer the evidence, tailored to the stakeholder (eg, policy briefs, publications, information booklets, etc).

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Maternal characteristics and the risk of neonatal mortality in Brazil between 2006 and 2016

International Journal of Population Studies ◽

10.18063/ijps.v5i2.1130 ◽

2020 ◽

Vol 5 (2) ◽

Author(s):

Pedro Henrique Costa ◽

Luciana Correia Alves ◽

Carlos Eduardo Beluzo ◽

Natalia Martins Arruda ◽

Rodrigo Campos Bresan ◽

...

Keyword(s):

Information System ◽

Neonatal Mortality ◽

Neonatal Period ◽

Public Health Care ◽

Maternal Characteristics ◽

Neonatal Deaths ◽

The Public ◽

Infant Deaths ◽

Demographic Profiles ◽

Pregnancy And Childbirth

Neonatal deaths account for more than 60% of infant deaths and are a major concern in Brazil. The reduction of the occurrence of these events appears to be more challenging than post-neonatal deaths, as such a reduction depends more on factors related to the pregnancy and childbirth than sanitary and health conditions. The aim of the present study was to evaluate the influence of maternal factors (schooling, marital status, and age) on the risk of neonatal mortality in Brazil between 2006 and 2016. Data were collected from the Brazilian Institute of Geography and Statistics as well as two information systems of the public health-care system: Mortality Information System and Live Birth Information System. The total valid sample size was 28,362,359 children. Visualization and classification methods were performed. The results revealed a considerably higher risk of neonatal deaths when the mothers were unmarried, had a low level of schooling, and were outside the 20-34-year-old age group. Different demographic profiles in Brazil exert an influence on neonatal health. The identification of the risk factors of neonatal mortality can assist in ensuring pregnancy, delivery, and a neonatal period of greater quality.

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Hubungan Kelengkapan Kunjungan ANC, Umur Ibu Hamil dan Konsumsi Fe <90 Tablet dengan Kematian Neonatal

Jurnal Epidemiologi Kesehatan Komunitas ◽

10.14710/jekk.v6i1.8159 ◽

2021 ◽

pp. 218-222

Author(s):

Kukuh Purwo Saputro ◽

Mexitalia Setiawati ◽

Suhartono Suhartono ◽

Dwi Sutiningsih

Keyword(s):

Observational Study ◽

Neonatal Mortality ◽

Random Sampling ◽

Neonatal Period ◽

Simple Random Sampling ◽

Case Control ◽

Maternal Factors ◽

Neonatal Deaths ◽

Infant Deaths ◽

Factors Associated

Background: Neonatal deaths are those that occur in the neonatal period when the baby is born up to 28 days (0-28 days). Neonatal mortality contributes to 56% of infant deaths due to complications such as BBLR, asphyxia, and infections that should be prevented by taking into account the condition of the mother before and during pregnancy because it will determine the condition of the baby being born. This study aimed to determine maternal factors associated with neonatal mortality.Methods: The design of an analytic observational study using a case-control. The population of the study was infants born in Banjarnegara District in 2018. The sample of the study was 65 cases and 65 controls taken by simple random sampling. The data were analyzed univariate and bivariate.Result: The results showed a significant relationship between the completeness of the ANC visit (p = 0.029; OR = 3.6 (95% CI = 1.222-10.595)) and the consumption of Fe <90 tablets (p = 0.0001; OR = 4, 1 (95% CI = 1,942-8,816)) with neonatal mortality. There was no relationship between the age of pregnant women <20 years old and >35 years old with neonatal mortality.Conclusion: The conclusion of this study is the variables that are statistically related to neonatal mortality are completeness of ANC visit and consumption of Fe <90 tablets.

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THE INCIDENCE OF CONGENITAL MALFORMATIONS: A STUDY OF 5,964 PREGNANCIES

PEDIATRICS ◽

10.1542/peds.14.5.505 ◽

1954 ◽

Vol 14 (5) ◽

pp. 505-522

Author(s):

RUSTIN MCINTOSH ◽

KATHARINE K. MERRITT ◽

MARY R. RICHARDS ◽

MARY H. SAMUELS ◽

MARJORIE T. BELLOWS

Keyword(s):

Birth Order ◽

Congenital Malformations ◽

Maternal Age ◽

Neonatal Period ◽

Incidence Rates ◽

Organ System ◽

Neonatal Deaths ◽

Products Of Conception ◽

A Prospective Study ◽

Relationship Of

I. The plan is described of a prospective study of the outcome of 5,964 pregnancies, with special emphasis on the relationship of factors in fetal environment to the incidence of abortions, stillbirths, neonatal mortality and congenital malformations. II. Data are presented on the overall incidence of congenital malformations according to sex, race, weight at delivery, maternal age and order of birth. A. The incidence of congenital malformations among 5,739 products of conception weighing over 500 grams was 7.5%. The rate was 7.0% among infants born alive and surviving the neonatal period, 13.6% among antepartum deaths, 23.3% among intrapartum deaths, 29.6% among neonatal deaths and 70.6% among deaths occurring between the ages of one and 12 months. B. The following relationships in incidence rates among live-born infants surviving the neonatal period were found. 1. The rate among males (8.4%) was half again as high as among females (5.5%). 2. Non-white infants had a higher rate (7.8%) than white infants (6.3%). 3. Infants weighing 2,500 grams or less had a higher proportion with defects (9.7%) than did those weighing over 2,500 grams (6.7%), although this difference occurred entirely among females. 4. Maternal age had no effect on the incidence of congenital malformations. 5. White infants of lower birth order had a lower rate (5.3%) than did those of higher birth orders (8.2%). No difference according to birth order was observed among non-white infants. III. A system of classification of malformations is described and discussed. Incidence rates by organ system groups are presented. A. Less than one-half of the malformations found among live-born infants were suspected or noted at birth. B. Malformations of musculo-skeletal system and skin were more frequent than malformations of other systems. Incidence rates by organ system groups are directly related to problems of diagnosis. C. Of the malformed live-born infants, 14.8% had more than one malformation and in 9.1% more than one system was involved. Of the malformed stillbirths and neonatal deaths, 66.0% had more than one malformation and in 51.1% more than one system was involved.

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Perinatal factors associated with early neonatal deaths in very low birth weight preterm infants in Northeast Brazil

BMC Pediatrics ◽

10.1186/s12887-014-0312-5 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 8

Author(s):

Eveline Campos Monteiro de Castro ◽

Álvaro Jorge Madeiro Leite ◽

Maria Fernanda Branco de Almeida ◽

Ruth Guinsburg

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Very Low Birth Weight ◽

Northeast Brazil ◽

Perinatal Factors ◽

Neonatal Deaths ◽

Factors Associated ◽

Early Neonatal Deaths

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The utility of delivery ward register data for determining the causes of perinatal mortality in one specialized and one general hospital in south Ethiopia

BMC Pediatrics ◽

10.1186/s12887-021-03058-4 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Tesfalidet Beyene ◽

Catherine Chojenta ◽

Roger Smith ◽

Deborah Loxton

Keyword(s):

Birth Weight ◽

Mortality Rate ◽

Perinatal Mortality ◽

Maternal Deaths ◽

Apgar Scores ◽

Neonatal Deaths ◽

Factors Associated ◽

South Ethiopia ◽

Early Neonatal Mortality ◽

Early Neonatal Deaths

Abstract Background Globally, the burden of perinatal mortality is high. Reliable measures of perinatal mortality are necessary for planning and assessing prenatal, obstetric, and newborn care services. However, accurate record-keeping is often a major challenge in low resource settings. In this study we aimed to assess the utility of delivery ward register data, captured at birth by healthcare providers, to determine causes of perinatal mortality in one specialized and one general hospital in south Ethiopia. Methods Three years (2014–2016) of delivery register for 13,236 births were reviewed from July 12 to September 29, 2018, in two selected hospitals in south Ethiopia. Data were collected using a structured pretested data extraction form. Descriptive statistics assessed early neonatal mortality rate, stillbirth rate, perinatal mortality rate and causes of neonatal deaths. Factors associated with early neonatal deaths and stillbirths were examined using logistic regression. The adjusted odds ratios with a 95% confidence interval were reported to show the strength of the association. Result The perinatal mortality ratio declined from 96.6 to 75.5 per 1000 births during the three-year study period. Early neonatal mortality and stillbirth rates were 29.3 per 1000 live births and 55.2 per 1000 total births, respectively. The leading causes of neonatal death were prematurity 47.5%, and asphyxia 20.7%. The cause of death for 15.6% of newborns was not recorded in the delivery registers. Similarly, the cause of neonatal morbidity was not recorded in 1.5% of the delivery registers. Treatment given for 94.5% of neonates were blank in the delivery registers, so it is unknown if the neonates received treatment or not. Factors associated with increased early neonatal deaths were maternal deaths and complications, vaginal births, APGAR scores less than 7 at five minutes and low birth weight (2500 g). Maternal deaths and complications and vaginal births were associated with increased stillbirths. Conclusion Our findings show that an opportunity exists to identify perinatal death and newborn outcomes from the delivery ward registers, but some important neonatal outcomes were not recorded/missing. Efforts towards improving the medical record systems are needed. Furthermore, there is a need to improve maternal health during pregnancy and birth, especially neonatal care for those neonates who experienced low APGAR scores and birth weight to reduce the prevalence of perinatal deaths.

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

Frontiers in Pediatrics ◽

10.3389/fped.2021.579922 ◽

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 (<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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Birth, stillbirth and death registration data completeness, quality and utility in population-based surveys: EN-INDEPTH study

Population Health Metrics ◽

10.1186/s12963-020-00231-2 ◽

2021 ◽

Vol 19 (S1) ◽

Author(s):

Simon Kasasa ◽

◽

Davis Natukwatsa ◽

Edward Galiwango ◽

Tryphena Nareeba ◽

...

Keyword(s):

Neonatal Death ◽

Neonatal Period ◽

Population Based ◽

Descriptive Statistics ◽

Reproductive Age ◽

Birth Registration ◽

Death Registration ◽

Neonatal Deaths ◽

Live Births ◽

Factors Associated

Abstract Background Birth registration is a child’s first right. Registration of live births, stillbirths and deaths is foundational for national planning. Completeness of birth registration for live births in low- and middle-income countries is measured through population-based surveys which do not currently include completeness of stillbirth or death registration. Methods The EN-INDEPTH population-based survey of women of reproductive age was undertaken in five Health and Demographic Surveillance System sites in Bangladesh, Ethiopia, Ghana, Guinea-Bissau and Uganda (2017–2018). In four African sites, we included new/modified questions regarding registration for 1177 stillbirths and 11,881 livebirths (1333 neonatal deaths and 10,548 surviving the neonatal period). Questions were evaluated for completeness of responses, data quality, time to administer and estimates of registration completeness using descriptive statistics. Timing of birth registration, factors associated with non-registration and reported barriers were assessed using descriptive statistics and logistic regression. Results Almost all women, irrespective of their baby’s survival, responded to registration questions, taking an average of < 1 min. Reported completeness of birth registration was 30.7% (6.1-53.5%) for babies surviving the neonatal period, compared to 1.7% for neonatal deaths (0.4–5.7%). Women were able to report age at birth registration for 93.6% of babies. Non-registration of babies surviving the neonatal period was significantly higher for home-born children (aOR 1.43 (95% CI 1.27–1.60)) and in Dabat (Ethiopia) (aOR 4.11 (95% CI 3.37–5.01)). Other socio-demographic factors associated with non-registration included younger age of mother, more prior births, little or no education, and lower socio-economic status. Neonatal death registration questions were feasible (100% women responded; only 1% did not know), revealing extremely low completeness with only 1.2% of neonatal deaths reported as registered. Despite > 70% of stillbirths occurring in facilities, only 2.5% were reported as registered. Conclusions Questions on birth, stillbirth and death registration were feasible in a household survey. Completeness of birth registration is low in all four sites, but stillbirth and neonatal death registration was very low. Closing the registration gap amongst facility births could increase registration of both livebirths and facility deaths, including stillbirths, but will require co-ordination between civil registration systems and the often over-stretched health sector. Investment and innovation is required to capture birth and especially deaths in both facility and community systems.

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