Of the 53 neonatal deaths, 45% occurred in the first 48 hours and 73% within 7 days. classification. Study nurses supervised the LHWs in the required fieldwork. This study therefore examines delivery outcomes in pregnant women with reasonably good access to professional health care who were enrolled at 20 to 26 weeks’ gestation and followed with their infants to 28 days postpartum. Neonatal Health The neonatal mortality rate in Nepal is 27 per 1,000 live births. We were surprised by the high Caesarean section rate of 19% in this community. Neonatal survival: a call for action. Causes of Infant Mortality. (Submitted: 09 January 2008 – Revised version received: 21 June 2008 – Accepted: 25 June 2008 – Published online: 06 January 2009. Data were extracted from the medical records of neonates admitted during a three year period from September 07, 2014 to August 31, 2017, using pretested checklists. Several features of 35. Case fatality for neonatal sepsis was 4.2%. Clinical and delivery variables for infants who died within 28 days postpartum and for those who survived in prospective study of neonatal mortality in an urban Pakistani population, 2003–2005, Table 4. The early neonatal mortality rate declined by 0.9% per annum and was where 74% of the neonatal deaths occurred. 31. Volume 2019:10 Pages 39—48, Editor who approved publication: Martines J, Paul V, Bhutta ZA, Koblinsky M, Saucat A, Walker N, et al., et al. 22. The above percentage of manuscripts have been rejected in the last 12 months. Ethiop J Health Dev. These four units covered an area with a low-to-middle income population of about 90 000 individuals, or about 9000 households. Int J Sci Study. All available medical records of neonates that fulfilled the inclusion criteria were included in the study. 2016;25(4):2–9. Sri Lanka J Child Health. Nearly half (1,488, 48.1%) of admissions were due to birth asphyxia & other perinatal complications. 3. Under the more ambitious counterfactual that all states could achieve the cause-specific mortality rates of the best-performing state in each cause-of-death category, infant mortality among full-term births would be reduced by 4,003 deaths (95% CI 2,284, 5,587) each year. Pakistan is number three among these countries. McGrew-Hill’s; 2007. The key factors that have been associated with neonatal mortality include infections, preterm births, low birth weights, birth trauma, and hypothermia (Kirkwood et. The importance of preterm birth for peri and neonatal mortality in rural Malawi. Further permission was obtained from the medical director of JUMC and the department head of pediatrics and gynecology for the utilization of medical records. Finally, the completed study forms on mothers who experienced a neonatal death were reviewed jointly by a neonatologist (SS) and the primary author (IJ) using the Pattinson et al.12 adaptation of the Aberdeen classification13 for developing countries. She may reach a facility but will still die! Bonde JP, Wilcox A. Infant mortality is a key measure of a nation's health, reflecting socioeconomic conditions, maternal health, public health practices, and access to high-quality medical care, among other factors (1, 2).Major causes of infant mortality include birth defects, low birthweight and preterm birth, maternal pregnancy complications, and sudden infant death syndrome (3). Parental residency, the length of stay, low birth weight, prematurity, RDS, perinatal asphyxia, and congenital malformations were factors associated with neonatal mortality, which could be avoidable. Death due to birth asphyxia was recorded when a normally formed term baby was unable to initiate and sustain respiration at birth or had a low Apgar score or clinical signs of hypoxia or meconium aspiration. Worku B, Kassie A, Mekasha A, Tilahun B, Worku A. predictors of early neonatal mortality at a neonatal intensive care unit of a specialized referal teaching hospita in Ethiopia. The town is located 357 km towards the southwest of Addis Ababa, the capital of Ethiopia. Jalil F. Perinatal health in Pakistan: a review of the current situation. Bulletin of the World Health Organization, Volume 87, Number 2, February 2009, 81-160. 2012;26(3):200–207. First, we suspect that, because of underreporting, actual Pakistani neonatal mortality rates may be higher than reported and, second, that, despite the seemingly appropriate quantity of care provided for women in the study, the quality may have been suboptimal. Sime H, Workneh N, Girma E. Morbidity and Mortality of Neonates Admitted in Jimma University Specialized Hospital Paediatrics Neonatal Ward: A One Year Retrospective Analysis. Yasmeen S, Ahmad K, Waheed I, Gul R. Spectrum of neonatal admissions and their outcome in a tertiary Care hospital. With an estimated 298 000 neonatal deaths annually and a reported neonatal mortality rate of 49 per 1000 live births, Pakistan accounts for 7% of global neonatal deaths.1–5 Infection (36%), preterm birth (28%) and birth asphyxia (23%) account for 87% of neonatal deaths worldwide.1,2,6 Since causes of neonatal death vary by country and with the availability and quality of health care, understanding neonatal mortality in relation to these factors is crucial.2,7–10 Data available on neonatal deaths in Pakistan come primarily from hospital studies, which have a selective referral bias, or from communities in which the cause of death is rarely recorded. On the other hand, in countries where infant mortality rates are high, the majority of infant deaths occurs after the neo-natal stage and is due mainly to environmental factors. 16. CORONIS Trial Collaborative Group. Kliegman RM, Stanton BF. Res Rep Neonatol. Recent reports from developing countries have shown improvements in perinatal and neonatal outcomes with increased coverage by health services and skilled birth attendants. Injuries (… Data were extracted by reviewing medical records of newborns using a structured checklist adapted from the previous related study.8 The checklist contained variables including age, sex, address of parents, gestational age, birth weight, length of stay, causes of admission, causes of death and medical outcomes. Shahidullah M, Hasan MZ, Jahan I, Ahmed F, Chandra A. Perinatal characteristics and outcome of Neonates at NICU of a tertiary level hospital in Bangladesh. The total number of neonates admitted to the NICU during the period under the study was 3,276, of which 110 neonates left against medical advice, 67 neonates had deficient. UNICEF. Contact Us   Reasons for admission and neonatal outcome in the neonatal care unit of a tertiary care hospital in Addis Ababa: a prospective study. Almost 75% of neonatal deaths were attributed to three final causes: immaturity-related (26%), birth asphyxia or hypoxia (26%) and infection (23%). 2009;12:389–394. We offer real benefits to our authors, including fast-track processing of papers. The gender differential in early and late neonatal mortality is worth noting. The IMR decreased 9.9% from 34.2 in 2017 to 30.8 in 2018 for unintentional injuries and 12.8% from 21.9 in 2017 to 19.1 in 2018 for cord and placental complications. Assamala. Although the difference was not statistically significant, early neonatal and perinatal mortality-1 rates were slightly higher among males than females (35.0 versus 29.3 per 1000 live births. Philadelphia, PA: Elsevier; 2016:794–825. The leading causes remained the same as in 2017 (Figure 4). the unit also has 2 incubators,10 radiant warmers, 4 continuous positive airway pressure (CPAP), phototherapy and oxygen concentrator machines. We believe there are two reasons for this finding. In addition, a perinatal mortality-1 rate was defined as the sum of all stillbirths and neonatal deaths on or prior to day 7 (henceforth 7-day neonatal deaths) per 1000 births, and a perinatal mortality-2 rate as the sum of all stillbirths and deaths on or prior to day 28 (henceforth 28-day neonatal deaths) per 1000 births. India is moving faster than the world in achieving a steady decline in the infant mortality rate. Both are expressed per 1000 live births. 4. All data were entered centrally. Ranjan A, Singh A. Childhood mortality has declined substantially since 2000. Although the difference was not statistically significant, early neonatal and perinatal mortality-1 rates were slightly higher among males than females (35.0 versus 29.3 per 1000 live births, P = 0.60; and 72.6 versus 56.9 per 1000 births, P = 0.29, respectively). Around the world, the top causes for infant mortality are neonatal encephalopathy (problems with brain function … An audit and trends of perinatal mortality at the Jinnah Postgraduate Medical Centre, Karachi. In conclusion, this study found that babies born outside the city, gestational ages, the length of stay in the ICU, prematurity, low birth weight, RDS, and congenital malformations all had a significant association with neonatal mortality. Advanced procedures such as exchange transfusions and Lumber punctures are performed at the center. In 2018, the infant mortality rate in the United States was 5.7 deaths per 1,000 live births. Therefore, the aim of this study was to assess the causes and factors associated with neonatal mortality among neonates admitted to the Neonatal Intensive Care Unit (NICU) of Jimma University Medical Center. Saini N, Chhabra S, Chhabra S, Garg L, Garg N. Pattern of neonatal morbidity and mortality: a prospective study in a District Hospital in Urban India [Internet]. Bulk reprints for the pharmaceutical industry. Commonly, the mortality rates of the newborn in NICU fluctuate between 3.1% and 29% in the world.8,11–20–22 The discrepancy observed between the mortality rates estimated by several centers and countries might be due to the difference in the distribution of skilled human resources, quality of care delivered by the centers, equipment availability, and socioeconomic status, as well as geographical locations. A Study of Neonatal Admission Pattern and Outcome from Rural Haryana. Hypothermia accounted for 809 (28.6%) admissions and169(41%) deaths. The relative importance of these causes is reflected in the distribution of the final causes of neonatal death: immaturity-related in 26%, birth asphyxia or hypoxia in 26% and infection in 23%. Sociedade Brasileira de Pediatria;. Professor Gillian Murphy, Emeritus Professor senior visitor, Departments of Oncology, University of Cambridge, CRUK Cambridge Institute. Factors found to be significantly associated with neonatal death in the univariate analysis include gestational age  37> 2000 g> 37>. Sabzehei MK, Basiri B, Shokouhi M, Eghbalian F. Causes and risk factors associated to neonatal mortality in Neonatal Intensive Care Unit (NICU) in Besat Hospital Hamadan-Iran in 2015 to 2016. 14. Mortality rates for other leading causes of infant death did not change significantly. These estimates are shown in the visualisation below.In 1960 child mortality was still 18.5%. Available from: https://www.dovepress.com/patterns-of-admission-and-factors-associated-with-neonatal-mortality-a-peer-reviewed-article-PHMT. •  Terms & Conditions   a. Aga Khan University, Karachi, Pakistan. The odds of death among newborns who had a history of congenital malformations and RDS were four times that of neonates who did not have the conditions (AOR 4, 95%CI 2.55–2.68) and (AOR 4.15,95%CI 2.9–5.66) respectively (Table 6). 2010;35(2):205–208. These variables were address of parents, the length of stay, gestational ages, and birth weight and maturity levels. Infant mortality is defined as the number of babies that die before their first birthday. 2014;10(10):44–54. A postnatal visit for data collection was made on about day 28. Of these approximately 85% of deaths occurred in the first five years of life and nearly half (47%) of the under five deaths occurred in the first month of life. Shah S, Zemichael O, Meng HD. Similarly significant associations have been observed in a study conducted in Gondar, Addis Ababa, Iran, Brazil and other several studies.8,9,24,26,29–32 These indicated that most of the neonatal deaths are due to preventable causes of death that could be addressed by anticipating risky pregnancies and the provision of proper and on time interventions. Of the estimated 130 million infants born each year worldwide,1 4 million die in the first 28 days of life. Using Multivariate analysis, to test the association of socio demographic variables with neonatal mortalities, four variables were found to be significantly associated with neonatal death. The data were collected by professional nurses and training was given to the data collectors on how to collect data from the records to augment data accuracy and validity. 2017;51:1–7. Available from: http://mk:@MSITStore:E:%5Cneonatology%5Cwilliams_obstetrics_-22_edition—2005-0071413154-mcgraw-. However, in comparison with rural areas of Pakistan, where home birth and a very low Caesarean section rate are the norm, there is now a growing trend in urban areas towards hospital birth and associated Caesarean delivery. With respect to the top ten leading causes of deaths, out of 1,108 neonates admitted with Low birth weight, 249(60.4%) died. 20. In JUMC, the causes of neonatal admissions and deaths were recorded based on clinical presentation and supportive laboratory results. doi:10.1590/0104-07072016002290015. Table 2 Demographic characteristics of neonates admitted to JUMC. From editorial acceptance to publication. doi:10.1136/bmjopen-2011-000792. Health care utilization during terminal child illness in squatter settlements of Karachi. We guaranteed confidentiality by excluding names or any other personal identifiers from data-collection sheets and reports. 15. Ali SR, Hospital I, Ahmed S, Lohana H. Disease patterns and outcomes of neonatal admissions at a secondary care hospital in Pakistan. In multivariate analysis, only five variables were found to be the significant predictors of the neonatal mortalities. 13. This death toll is measured by the infant mortality rate (IMR), which is the probability of deaths of children under one year of age per 1000 live births. Less than one third, 864(27.9%) of the neonates were preterm whereas 2229(72.1%) were term neonates. For all neonatal deaths and stillbirths, the study physician and nurse interviewed the mother about the circumstances leading to the event. J Clin Neonatol. Reduced care-seeking for girls compared with boys has been reported in several settings, especially in south Asia.15,16, The most common primary obstetric causes of neonatal death were preterm delivery in 34%, intrapartum asphyxia in 21% and antepartum haemorrhage in 9%. The present study shows that, more than half, 1837(59.4%) of the neonates were males, while 1256(40.6%), were females giving a male to female ratio of 1.46:1. Qazi GR, Akhtar S. Obstetrical correlates of the first time cesarean section, compared with the repeated cesarean section. Eighty per cent of infants who died were born in a hospital or maternity clinic, and 69% were delivered by a doctor (data not shown). Recently there has been a growing demand for perinatal mortality data to be disaggregated by gender, geographic location and socioeconomic status, to enable programmes to improve resource allocation and monitoring. In the present study, the overall neonatal mortality rate was 12.6% (30 deaths per 1,000 live births). Overall, infant mortality rates have significantly decreased all over the world. Recent reports from developing countries have shown improvements in perinatal and neonatal outcomes with increased coverage by health services and skilled birth attendants.2,8,22 However, our findings suggest that women experienced avoidable antenatal and obstetric complications despite good availability of antenatal care, a high rate of births in a health facility with skilled birth attendants, and a “high” Caesarean section rate. Other factors, such as stress level, might be able to be managed, but are not entirely controllable.

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