Associated factors with neonatal near miss in twin pregnancies in a public referral maternity unit in Brazil

Abstract Background: Neonatal mortality is a significant problem in many low-resource countries, yet for every death there are many more new-born who suffer a life-threatening complication but survive. Neonatal near miss has been proposed as a tool for assessment of quality of care in neonates who suffered any life-threatening condition. However, there was limited evidence on magnitude of neonatal near miss and determinant factors in Ethiopia. The aim of this study was to assess proportion and associated factors of neonatal near miss among deliveries at Injibara General Hospital, Awi Zone, Northwest Ethiopia, 2019. Methods: Institutional based cross sectional study was conducted from February 1, 2019 to April 30, 2019 among 404 live births. Structured and pretested questioner used for mothers and structured checklist for neonates. Bivariate and multivariate logistic regressions model were fitted to identify factors associated with neonatal near miss. An adjusted odds ratio with 95 % confidence interval (CI) was computed to determine the level of significant. Result: Proportion of neonatal near miss was found to be 23.3 % with 95% CI: (19.1% -27.7%). Primiparous[Adjusted odds ratio(AOR):2.01, 95%CI:(1.03-3.95)], referral linkage [AOR:3.23, 95%CI:(1.89-5.513)], maternal perception of reduced fetal movement[AOR:5.95, 95%CI:2.47-14.33], premature rupture of membrane [AOR: 3.10, 95%CI: (1.27-5.59)], prolonged labor [AOR: 3.00, 95%CI:(1.28-7.06)], obstructed labor/cephalo-pelvic disproportion [AOR: 4.05; 95%CI: (1.55-10.57)] and non-reassuring fetal heart rate pattern [AOR: 3.75, 95%CI: (1.69-8.33)] were significantly associated with neonatal near miss. Conclusion: Proportion of neonatal near miss in the study area was found to be higher than studies in WHO neonatal near miss systemic review. Strength referral linkage and efforts needed to continue compressive maternal and neonatal care to avoid preventable causes of neonatal morbidity and mortality.

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A populational based study on the prevalence of neonatal near miss in a city located in the South of Brazil: prevalence and associated factors

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042017000100009 ◽

2017 ◽

Vol 17 (1) ◽

pp. 159-167 ◽

Cited By ~ 3

Author(s):

Guilherme Alberto Silva ◽

Karin Alana Rosa ◽

Elizabeth Schirin Farahani Saguier ◽

Elisa Henning ◽

Fatima Mucha ◽

...

Keyword(s):

Associated Factors ◽

Cross Sectional Study ◽

Near Miss ◽

Odds Ratios ◽

Cross Sectional ◽

Live Births ◽

South Of Brazil ◽

The City ◽

Neonatal Near Miss

Abstract Objectives: to identify the prevalence of neonatal near miss morbidity in the city of Joinville, SC and the associated factors. Methods: a populational based cross-sectional study including all live births in 2012 registered at SINASC. The near miss cases were identified based on the weight <1500g, Apgar scores at 5th minute <7, gestational age <32 weeks, use of mechanical ventilation or presence of congenital malformation. The gross odds ratios (OR) and its respective 95% confidence intervals (95% CI) were calculated and the logistic regression was performed to obtain the adjusted odds ratios and its respective 95% CI. Results: the prevalence of near miss was 33 per thousand live births (95% CI: 29-37). In the final model, a risk classification of live births according to the City Program (Programa Municipal) (ORaj= 19.7; 95% CI: 14.2 to 27.2), cesarean section (ORaj= 2.1; 95% CI:1.5 to 2.8) and public hospital (ORaj= 1.7; 95% CI: 1.2 to 2.3) remained associated to morbidity near miss. Conclusions: near miss morbidity was 7.3 times higher than neonatal mortality. To know its determinants in different national contexts may include some changes in the focus of public health actions by redirecting to preventive interventions.

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Neonatal Near Misses and Associated Factors Among Mother's Who Give a Live Neonate at Hawassa City Governmental Hospitals, 2019. A Facility Based Cross-Sectional Study Design

10.21203/rs.3.rs-70854/v1 ◽

2020 ◽

Author(s):

Anteneh Tekola Fikrie ◽

Genet Ake Baye ◽

Elias Hadona Amaje ◽

Kebede Tefera

Keyword(s):

Associated Factors ◽

Cross Sectional Study ◽

Near Miss ◽

Pregnancy Induced Hypertension ◽

Sectional Study ◽

Cross Sectional ◽

Near Misses ◽

High Prevalence ◽

Induced Hypertension ◽

Neonatal Near Miss

Abstract Background: Neonatal near miss is a neonate who nearly died but survived from a severe complication occurred during pregnancy, birth or within 0-28 days of extra-uterine life. However, there is no available data that quantifies the magnitude of neonatal near miss in Ethiopia where there is high prevalence of neonatal mortality. Therefore, this study is designed to provide information about the magnitude and associated factors of neonatal near miss among women who give a live birth at Hawassa City Governmental hospitals, 2019. Methods: A facility based cross-sectional study design was conducted on 604 mothers who gave live neonates at Adare General Hospital and Hawassa University Comprehensive and Specialized Hospital from May 9, 2019 to June 7, 2019. Face to face interviewer administered structured questionnaire with a supplementation of maternal and neonatal medical records with checklists were used to collect the data. Data were coded and entered in to Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. Descriptive statistics was run and the data were presented using frequency tables and figure. The bi-variable and multivariable logistic regression was used to identify the possible factors of neonatal near miss. Finally, Adjusted Odds Ratio and 95% Confidence Intervals were used to declare statsticall significance. Result Among all 604 selected live births an overall proportion of Neonatal Near Misses (NNM) cases, 202 (33.4 %;) (95% CI: 29.7%-37.1%) was obtained. Respiratory distress 158 (94%) and infection or sepsis 138 (84%) were found to be the leading causes of NNM cases in our study. Employed (AOR = 3.05, 95% CI: 1.46- 6.44), Pregnancy induced Hypertension (AOR = 0.43, 95%CI: 0.27-0.69) and Cesarean Section (AOR=0.49; 95%CI: 0.33-0.71) were significantly associated with neonatal near miss. Conclusion: This study revealed relatively high prevalence of neonatal near miss in the study areas. Employed women, pregnancy induced hypertension and cesarean section mode of delivery were found to be independent factors affecting the prevalence of NNM cases. Therefore, HUCSH and Adare general Hospitals should focus on proving quality antenatal care and prevention of occupational related problems among pregnant women.

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The magnitude of neonatal near miss and associated factors among live births in public hospitals of Jimma Zone, Southwest Ethiopia, 2020: A facility-based cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0251609 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251609

Author(s):

Merertu Wondimu ◽

Fikadu Balcha ◽

Girma Bacha ◽

Aklilu Habte

Keyword(s):

Associated Factors ◽

Cross Sectional Study ◽

Public Hospitals ◽

Near Miss ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Southwest Ethiopia ◽

Jimma Zone ◽

Neonatal Near Miss

Background Neonates with severe complications at birth or during the neonatal period who nearly died but survived constitute neonatal near miss (NNM) cases. Identifying NNM cases and correcting contributing factors are of the utmost importance to get relevant controls for neonatal deaths. However, limited studies are assessing the prevalence of NNM and associated factors with NNM cases in Ethiopia. So, this study is aimed at assessing the magnitude of neonatal near miss and associated factors among live births in public hospitals of Jimma zone, southwest Ethiopia, 2020. Methods A facility-based cross-sectional study was conducted among 260 neonates from April 1–30 / 2020. Face to face interviewer-administered structured questionnaire was used to collect data from the mothers and a standard checklist was used for their neonates. The data was encoded and entered into Epi-Data version 4.2 and exported to SPSS version 23 for analysis. Independent variables with marginal associations (p-value <0.25) in the bivariable analysis were eligible for multivariable logistic regression analysis to detect an association with outcome variables. Finally, adjusted odds ratios (AOR) with 95% CI were used to estimate the strength of associations, and statistical significance was declared at a p-value < 0.05. Result The magnitude of NNM was 26.7% with [95%CI: 21.6–32.5]. Hypertension during pregnancy [AOR: 3.4; 95%CI: 1.32–8.88], mode of delivery [AOR: 3.32; 95%CI: 1.48–7.45], Obstructed labor [AOR: 2.95; 95%CI: 1.32–6.45] and non-vertex fetal presentation during delivery [AOR: 4.61; 95%CI: 2.16–9.84] were identified as significantly predictors of NNM. Conclusion and recommendation Over a quarter of the neonates were with NNM cases, which is relatively higher than the report of studies done in other countries. Hypertension during pregnancy, cesarean delivery, prolonged labor, and non-vertex fetal presentation were all found to increase the likelihood of NNM. Therefore, concerted efforts are needed from local health planners and health care providers to improve maternal health care services especially in early identification of the complications and taking appropriate management.

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Neonatal Near Miss and its associated factors at Injibara General Hospital, Awi Zone, Northwest Ethiopia, 2019

10.21203/rs.2.12536/v1 ◽

2019 ◽

Author(s):

Habtamu Gebrehana Belay ◽

Simachew Kasaa Limenih ◽

Toyiba Hiyaru Wassie ◽

Minale Bezie Ambie

Keyword(s):

General Hospital ◽

Odds Ratio ◽

Associated Factors ◽

Adjusted Odds Ratio ◽

Northwest Ethiopia ◽

Near Miss ◽

Life Threatening ◽

Awi Zone ◽

Heart Rate Pattern ◽

Neonatal Near Miss

Abstract Abstract Background: Neonatal mortality is a significant problem in many low-resource countries, yet for every death there are many more new-born who suffer a life-threatening complication but survive. Neonatal near miss has been proposed as a tool for assessment of quality of care in neonates who suffered any life-threatening condition. However, there was limited evidence on magnitude of neonatal near miss and determinant factors in Ethiopia. The aim of this study was to assess proportion and associated factors of neonatal near miss among deliveries at Injibara General Hospital, Awi Zone, Northwest Ethiopia, 2019. Methods: Institutional based cross sectional study was conducted from February 1, 2019 to April 30, 2019 among 404 live births. Structured and pretested questioner used for mothers and structured checklist for neonates. Bivariate and multivariate logistic regressions model were fitted to identify factors associated with neonatal near miss. An adjusted odds ratio with 95 % confidence interval (CI) was computed to determine the level of significant. Result: Proportion of neonatal near miss was found to be 23.3 % with 95% CI: (19.1% -27.7%). Primiparous[Adjusted odds ratio(AOR):2.01, 95%CI:(1.03-3.95)], referral linkage [AOR:3.23, 95%CI:(1.89-5.513)], maternal perception of reduced fetal movement[AOR:5.95, 95%CI:2.47-14.33], premature rupture of membrane [AOR: 3.10, 95%CI: (1.27-5.59)], prolonged labor [AOR: 3.00, 95%CI:(1.28-7.06)], obstructed labor/cephalo-pelvic disproportion [AOR: 4.05; 95%CI: (1.55-10.57)] and non-reassuring fetal heart rate pattern [AOR: 3.75, 95%CI: (1.69-8.33)] were significantly associated with neonatal near miss. Conclusion: Proportion of neonatal near miss in the study area was found to be higher than studies in WHO neonatal near miss systemic review. Efforts needed to continue compressive maternal and neonatal care to avoid preventable causes of neonatal morbidity and mortality . Keywords: Neonatal Near Miss, Proportion, Awi Zone, Ethiopia

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Neonatal Near Miss and its associated factors at Injibara General Hospital, Awi Zone, Northwest Ethiopia, 2019

10.21203/rs.2.14702/v1 ◽

2019 ◽

Author(s):

Habtamu Gebrehana Belay ◽

Simachew Kassa Limenih ◽

Toyiba Hiyaru Wassie ◽

Minale Bezie Ambie

Keyword(s):

General Hospital ◽

Odds Ratio ◽

Associated Factors ◽

Adjusted Odds Ratio ◽

Northwest Ethiopia ◽

Near Miss ◽

Life Threatening ◽

Awi Zone ◽

Heart Rate Pattern ◽

Neonatal Near Miss

Abstract Background: Neonatal mortality is a significant problem in many low-resource countries, yet for every death there are many more new-born who suffer a life-threatening complication but survive. Neonatal near miss has been proposed as a tool for assessment of quality of care in neonates who suffered any life-threatening condition. However, there was limited evidence on magnitude of neonatal near miss and determinant factors in Ethiopia. The aim of this study was to assess proportion and associated factors of neonatal near miss among deliveries at Injibara General Hospital, Awi Zone, Northwest Ethiopia, 2019. Methods: Institutional based cross sectional study was conducted from February 1, 2019 to April 30, 2019 among 404 live births. Structured and pretested questioner used for mothers and structured checklist for neonates. Bivariate and multivariate logistic regressions model were fitted to identify factors associated with neonatal near miss. An adjusted odds ratio with 95 % confidence interval (CI) was computed to determine the level of significant. Result: Proportion of neonatal near miss was found to be 23.3 % with 95% CI: (19.1% -27.7%). Primiparous[Adjusted odds ratio(AOR):2.01, 95%CI:(1.03-3.95)], referral linkage [AOR:3.23, 95%CI:(1.89-5.513)], maternal perception of reduced fetal movement[AOR:5.95, 95%CI:2.47-14.33], premature rupture of membrane [AOR: 3.10, 95%CI: (1.27-5.59)], prolonged labor [AOR: 3.00, 95%CI:(1.28-7.06)], obstructed labor/cephalo-pelvic disproportion [AOR: 4.05; 95%CI: (1.55-10.57)] and non-reassuring fetal heart rate pattern [AOR: 3.75, 95%CI: (1.69-8.33)] were significantly associated with neonatal near miss. Conclusion: Proportion of neonatal near miss in the study area was found to be higher than studies in WHO neonatal near miss systemic review. Efforts needed to continue compressive maternal and neonatal care to avoid preventable causes of neonatal morbidity and mortality . Keywords: Neonatal Near Miss, Proportion, Awi Zone, Ethiopia

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Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03894-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rajbanshi Sushma ◽

Mohd Noor Norhayati ◽

Nik Hussain Nik Hazlina

Keyword(s):

Associated Factors ◽

Newborn Infants ◽

Newborn Care ◽

Cross Sectional Study ◽

Near Miss ◽

Infant Mortality Rate ◽

Sectional Study ◽

Cross Sectional ◽

The Impact ◽

Neonatal Near Miss

Abstract Background The rate of neonatal mortality has declined but lesser than the infant mortality rate and remains a major public health challenge in low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 h after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and gestational age were enrolled. Key inclusion criteria were pragmatic and management markers of NNM and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0. Results One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI) 2.07–9.84) and no formal education (aOR 2.16; 95% CI 1.12–4.14) had a positive association with NNM, while multiparity (aOR 0.52; 95% CI 0.32–0.86) and caesarean section (aOR 0.44; 95% CI 0.19–0.99) had negative associations with NNM. Conclusions Maternal characteristics and complications were associated with NNM. Healthcare providers should be aware of the impact of obstetric factors on newborn health and provide earlier interventions to pregnant women, thus increasing survival chances of newborns.

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Neonatal Near Miss and Its Associated Factors at Injibara General Hospital, Awi Zone, Northwest Ethiopia, 2019

Exploratory Research and Hypothesis in Medicine ◽

10.14218/erhm.2020.00011 ◽

2020 ◽

Vol 000 (000) ◽

pp. 1-8

Author(s):

Habtamu Gebrehana Belay ◽

Simachew Kassa Limenih ◽

Toyiba Hiyaru Wassie ◽

Minale Bezie Ambie

Keyword(s):

General Hospital ◽

Associated Factors ◽

Northwest Ethiopia ◽

Near Miss ◽

Awi Zone ◽

Neonatal Near Miss

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Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

10.21203/rs.3.rs-42794/v3 ◽

2021 ◽

Author(s):

Sushma Rajbanshi ◽

Norhayati Mohd Noor ◽

Nik Hazlina Nik Hussain

Keyword(s):

Caesarean Section ◽

Associated Factors ◽

Newborn Infants ◽

Newborn Care ◽

Cross Sectional Study ◽

Near Miss ◽

Infant Mortality Rate ◽

Sectional Study ◽

Cross Sectional ◽

Neonatal Near Miss

Abstract Background: Unlike the infant mortality rate, the rate of neonatal mortality has not significantly declined and remains a major health challenge in the low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods: A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and number of gestational weeks were enrolled. The key inclusion criterion was the pragmatic and management markers of NNM, and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0.Results: One thousand respondents were recruited. Prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI): 2.07–9.84), no education (aOR 2.16; 95% CI 1.12–4.14), multiparity (aOR 0.52; 95% CI 0.32–0.86), and caesarean section (aOR 0.44: 95% CI 0.19–0.99) were associated with NNM. Conclusions: Prevalence of NNM in Nepal was 7.9%. Mothers’ obstetric factors, maternal complications and education were associated with NNM. Women in referral hospitals should have safer access to caesarean section and be prepared for NICU intervention to save mothers and their newborns.

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Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

10.21203/rs.3.rs-42794/v2 ◽

2020 ◽

Author(s):

Sushma Rajbanshi ◽

Norhayati Mohd Noor ◽

Nik Hazlina Nik Hussain

Keyword(s):

Caesarean Section ◽

Associated Factors ◽

Multiple Logistic Regression Analysis ◽

Newborn Infants ◽

Cross Sectional Study ◽

Near Miss ◽

Infant Mortality Rate ◽

Sectional Study ◽

Cross Sectional ◽

Neonatal Near Miss

Abstract Background: Unlike the infant mortality rate, the rate of neonatal mortality has not declined and remains a major health challenge in the low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than the neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods: A hospital-based cross-sectional study was conducted at Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and number of gestational weeks were enrolled. The key inclusion criterion was the pragmatic and management markers of NNM, and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression analysis was performed using SPSS® version 24.0.Results: One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (AOR): 4.51, 95% confidence interval (CI): 2.07–9.84), maternal secondary (AOR: 0.46, 95% CI: 0.24–0.88) and tertiary education (AOR: 0.18, 95% CI: 0.05–0.56), multiparity (AOR: 0.52, 95% CI: 0.39–0.86), and caesarean section (AOR: 0.48, 95% CI: 0.19–0.99) were associated with NNM. Conclusions: The prevalence of NNM in Nepal was 7.9%. Mothers’ obstetric factors, maternal complications and education were associated with NNM. Referral hospitals should have safer access to caesarean section and be prepared to offer NICU intervention to save mothers and their newborns.

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