The UN recommends a Caesarean section rate of 5â15% to optimally minimize maternal and neonatal mortality rates.4,20 This recommendation presumes that these Caesarean sections are performed in a timely manner on appropriate women. adaptation of the Aberdeen classification was used because it identifies the potential for both preventing and reducing avoidable fetal and neonatal mortality.12 The primary obstetric cause of neonatal death was defined in the classification as the obstetric antecedent factor or event that initiated the process or sequence of events leading to the death of the neonate. Int J Contemp Pediatr. JUMC is the only tertiary and referral teaching hospital in the south western part of the country, and currently provides different services for approximately 18 million people in the catchment area. Between September 2003 and August 2005, LHWs identified 2205 pregnant women from the study area, 25% of whom were not eligible for study enrolment. Among (Sustainable Developmental Goals (SDG) regions, Sub-Saharan Africa had the highest neonatal mortality rate in 2017 at 27 deaths per 1000 live births.2–4, According to the Ethiopian Demographic Health Survey (EDHS) 2016, the under-5, infant and neonatal mortality rate is 67, 48 and 29 deaths per 1,000 live births respectively. 2016;201:17–23. Correspondence to Elizabeth M McClure (e-mail: Of the estimated 130 million infants born each year worldwide. It could be argued that the high neonatal mortality seen in this population may be due to selective recruitment of high-risk women into the study. Two-thirds of the worldâs neonatal deaths occur in just 10 countries, mostly in Asia. Of the 53 neonatal deaths, 39 (75%) occurred in the first 7Â days. Improving infant mortality rate. Levels and Trends in Child Mortality: Report 2018. doi:10.3329/bjch.v41i1.33634. 2017;51:1–7. Available from: http://www.who.int/intellectualproperty/documents/thereport/ENPublicHealthReport.pdf. A selected review of the mortality rates of Neonatal Intensive Care Units [Internet]. Registered in England and Wales. The similar causes of neonatal mortalities were reported in several studies conducted in other centers and countries.8–11,15,16,23–27 Most of the neonatal problems would be avoidable if proper antenatal care implementation and on time linkage of high risk pregnant women to health institutions were in place,28 This implies that antenatal care services in the area were not satisfactory in anticipating and linking high risk pregnant women to health institutions where an appropriate neonatal care service was available. CORONIS Trial Collaborative Group. Elsevier; 2015;152(3):727–728. stillbirths plus all neonatal deaths), 82.5 per 1000 births (95% CI: 66.7â98.3) (TableÂ 1). Neonatal conditions were divided into five major categories, four adapted from the Global Burden of Diseases (GBD 2017) classification catalog, and one category, Low Birth Weight (LBW) added from the National strategy for newborn and child survival in Ethiopia.35,36 The presentation conditions included under these five categories is presented in the Table 1. Of the 53 neonatal deaths, 39 (75%) occurred in the first 7Â days. Disorders related to short gestation and LBW are second. We hypothesized that the neonatal mortality rate in this urban population, with relatively good access to obstetric care and Caesarean section, would be substantially lower than that generally reported for Pakistan. The global burden of child and youth deaths however remains immense. Neonatal death rates included all of the deaths of live-born infants on or before 28 days postpartum and the early neonatal death rate included all deaths of live-born infants occurring on or before 7Â days of age. The above percentage of manuscripts have been rejected in the last 12 months. 2010;35(2):205–208. Approximately three-quarters of newborn deaths occur in the first week of life; 25-45% of these deaths take place in the first 24 hours (UNICEF, 2013). J Perinatol. • Testimonials
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). Fetuses and young children may be particularly susceptible to … Moreover, unsafe delivery practices and lack of competent pediatricians are also a major cause of infant mortality. We offer real benefits to our authors, including fast-track processing of papers. We therefore speculate that improvements in health-system performance and ongoing clinical audits25 could reduce the high rates of adverse perinatal outcomes in a population such as ours with a high level of health-care coverage. The country of Ghana is struggling to prevent neonatal mortality. TableÂ 5 presents the primary obstetric and final causes of neonatal death as determined using the Pattinson et al. In contrast, there were more female deaths in the late neonatal period. 14. Population Estimates 1950-2017, report 2017. Death resulted primarily from birth defects, prematurity, and Sudden Infant Death Syndrome/ Sudden Unexpected Infant Death. 30. Bivariate and multivariate logistic regressions were used to determine factors associated with neonatal mortality and P-values <0.05 were considered statistically significant.Results: Of 3,276 neonates admitted during the study period, 412 (13.3%) died, equating to a rate of 30 deaths per 1,000 institutional live births. In other words, the probability of dying in the first 28 days of life was estimated at 18 deaths per 1,000 live births globally.2, Over the last two decades, the world has made substantial progress in the reduction of mortality among children. With regard to the residential addresses of parents, the majority 2135(69%) came from places outside Jimma town, while 958(31%) of them were from Jimma town. 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. • Associations & Partners
Some 45% of the deaths occurred within 48 hours and 73% within the first week. As SIDS rates have been declining in the last few decades, rates of other sleep-related causes of infant death have been increasing. Dove Medical Press is part of Taylor & Francis Group, the Academic Publishing Division of Informa PLC
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Because pregnant women from a defined population were enrolled at 20 to 26 weeksâ gestation and followed with their infants to 28 days postpartum, data on antepartum history, delivery and events before neonatal death, in addition to maternal interview data, were available, so we could determine the causes of death quite reliably. IHME, Global Burden of Disease Study. Available from:: http://www.jcnonweb.com/text.asp?2016/5/3/183/191258. Jalil F. Perinatal health in Pakistan: a review of the current situation. Infant Mortality. Birth defects cause about 21 percent of … Chow S, Chow R, Popovic M, et al. The proportions of these causes of admission vary across different studies conducted in Ethiopia.8–11 Similar to this study neonatal sepsis and low birth weight were found to be within the top three leading causes of neonatal admissions in other several studies conducted outside Ethiopia.12–17 This implies that major causes of neonatal admissions were attributed to avoidable and curable neonatal conditions and would be preventable if detected early and proper care were in place. In addition, a perinatal mortality-1 rate was defined as the sum of all stillbirths and neonatal deaths on or prior to dayÂ 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. The risk of dying is highest in this period of life.1 Globally, in 2017 alone, an estimated 6.3 million children and young adolescents died, mostly from preventable causes. For all neonatal deaths and stillbirths, the study physician and nurse interviewed the mother about the circumstances leading to the event. The strengths of this study include the fact that it used large sample sizes and statistical analyses appropriate to the study design and with the results matching the method described. Contact Us
The major causes of neonatal mortality in the current study were low birth weight 8%, prematurity, 7.4%, RDS 5.4%. Overman DM. And under-five mortality to as low as 25 per 1000 live births till 2025. Pepler PT, Uys DW, Nel DG. The 28-day neonatal mortality rate was 47.3 per 1000 live births. The study populations were all neonates admitted to the Neonatal Intensive Care Unit (NICU) of JUMC from September 11, 2014 to September 10, 2017. 2014;64(10):1123–1126. Pakistan is number three among these countries. The reason for this difference was that the late neonatal mortality rate (i.e. 2015;3(October). Factors associated with mortality and length of stay in hospitalised neonates in Eritrea, Africa: a cross-sectional study. Glob J Res Anal. Health pattern, causes and treatment outcomes of neonatal admission in the tamale teaching hospital. This site is owned and operated by Informa PLC ( “Informa”) whose registered office is 5 Howick Place, London SW1P 1WG. Rates were as follows: stillbirth, 33.6 per 1000 births (95% CI: 23.6â43.6); early neonatal mortality, 34.8 per 1000 live births (95% CI: 24.1â45.5); 28-day neonatal mortality, 47.3 per 1000 live births (95% CI: 34.9â59.7); perinatal mortality-1 (i.e. Data audits, including inter- and intra-form consistency checks, were performed at data entry, and additional audits were performed by the data centre (i.e. Our prospective population-based study provided a rare opportunity to obtain reliable information on the rate, timing and direct cause of neonatal death. The identifier for each eligible subject was replaced by a code and no master code exists that allows the research data to be linked with the identifiers. The majority (249, 60.4%) of deceased neonates had low birth weight, while 230 (55.8%) were premature and 169(41%) had Respiratory Distress Syndrome (RDS). Information on pregnancy complications and other events before delivery is limited.4,5,11. The gender differential in early and late neonatal mortality is worth noting. FMOH. doi:10.1590/0104-07072016002290015. Objective Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. We believe there are two reasons for this finding. doi:10.1016/j.jped.2017.07.011. Injuries (… 2012;26(3):200–207.
5. 8. The major causes of newborn death in Nepal include: infection, birth asphyxia, preterm birth, and hypothermia. • Terms & Conditions
The leading causes remained the same as in 2017 (Figure 4). Ratio of boys to girls at birth. Maternal pregnancy complications. In multivariate analysis of neonatal conditions prematurity, low birth weight, birth asphyxia, congenital malformations and respiratory distress syndrome were identified as predictors of neonatal mortalities. Ethiopia Demographic and Health Survey – 2016. However, the change in neonatal mortality is not as significant as the change in children aged 1–59 months (63%).2 Africa contributed to one third of the world’s neonatal mortality burden. Rev Esc Enferm. Pattinson RC, De Jong G, Theron GB. These results are consistent with WHO reports on the causes of neonatal death in developing countries and also with other reports from Pakistan.2,4,5 Furthermore, our finding that infection, including sepsis, pneumonia and meningitis, is an important contributor to neonatal deaths that occur after 3Â days postpartum among hospital-born neonates is consistent with recent studies from developing countries and emphasizes the importance of monitoring delivery and hospital-acquired infection.17. Berry MA, Shah PS, Brouillette RT, Hellmann J. Predictors of mortality and length of stay for neonates admitted to children’s hospital neonatal intensive care units. Univariate logistic regression analysis was performed separately for each neonatal condition and any risk factors that showed significant association (P<0.25) with the outcome were selected for multivariate analysis. (Submitted: 09 January 2008 – Revised version received: 21 June 2008 – Accepted: 25 June 2008 – Published online: 06 January 2009. Table 5 Multivariate analysis of socio demographic characteristics of neonate admitted to the NICU of JUMC. doi:10.1038/sj.jp.7211904. The infant mortality rate decreased to 13.6% in the first year of the next decade, but was exactly twice the national rate of 6.8% that year and the figure increased from 1931 onward. 2013;13(1):1. doi:10.1186/1471-2458-13-483. al, 2010). One reason why we do not see progress is that we are unaware of how bad the past was.In 1800 the health conditions of our ancestors were such that 43% of the world's newborns died before their 5th birthday. We were surprised by the high Caesarean section rate of 19% in this community. 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. 31. 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. 2017;1–8. However, the change in neonatal mortality is not as significant as the change in post-neonatal and child mortality.5 In Ethiopia, the main causes of neonatal deaths were birth asphyxia, prematurity and sepsis.6–9. Table 3 Aggregated categories of causes of admission and death by outcomes among neonates admitted to Neonatal ICU of JUMC. 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). We set out to describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh, Nepal and rural and urban India using verbal autopsy (VA) data. 2009;12:389–394. 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. Trends in child mortality: The world has seen dramatic reductions of 60% in under-five mortality from 93 deaths per 1000 live births in 1990 to 38 in 2019. A total of 3,093 neonates with improved/death hospital outcomes were included for further analysis. Accidental injury is the fifth-leading cause of infant mortality in the United States. Pak Armed Forces Med J. Infant mortality is the death of young children under the age of 1. BetrÃ¡n AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P, et al., et al. 2016;5(3):183. Almost all deaths classified as due to immaturity or asphyxia occurred during the first week of life. The neonatal period, from birth to the first 28 days of life, is the most hazardous period of life because of the various diseases that the neonate faces. 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]. Of these, the major causes of mortality are pneumonia (64 percent) and diarrhea (38 percent). Afr Health Sci. The most common primary obstetric causes of neonatal death were preterm delivery in 34%, intrapartum asphyxia in 21% and antepartum haemorrhage in 9%. 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. 11. Proportionately, there were more male deaths in the early neonatal period, a finding consistent with the well described biological survival advantage of girls in the neonatal period. 2017. Bangladesh J Child Health. In: Williams_Obstetrics_-22_Edition [Internet]. Available from: http://www.who.int/healthinfo/global_burden_disease/en/ Accessed February 1, 2016. Assamala. Mortality rates for other leading causes of infant death did not change significantly. Drexel University, Philadelphia, PA, USA. Bulletin of the World Health Organization, Volume 87, Number 2, February 2009, 81-160. The demographic characteristics of the women whose neonatal outcomes were known at 28 days were not significantly different from those who were lost to follow-up or who refused to participate (. 36. 23. We were surprised by the high Caesarean section rate of 19% in this community. , deaths and causes of death in neonates outcomes were included in the States! Seventy-Five per cent of all infant deaths in Northern Ethiopia: 2015/16-2019/20.2015 paragraphs 4.2 5. The grey line have higher mortality rates of neonatal Intensive care units Internet. Those that occurred within 48 hours and 73 % within 7Â days are typical the. First 48 hours and 73 % within 7Â days 1369 women, were enrolled at weeksâ. 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