Articles de revues : « Neonatal deaths »

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Mrisho, Mwifadhi, David Schellenberg, Fatuma Manzi, Marcel Tanner, Hassan Mshinda, Kizito Shirima, Beverly Msambichaka, Salim Abdulla et Joanna Armstrong Schellenberg. « Neonatal Deaths in Rural Southern Tanzania : Care-Seeking and Causes of Death ». ISRN Pediatrics 2012 (24 janvier 2012) : 1–8. http://dx.doi.org/10.5402/2012/953401.

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Introduction. We report cause of death and care-seeking prior to death in neonates based on interviews with relatives using a Verbal Autopsy questionnaire. Materials and Methods. We identified neonatal deaths between 2004 and 2007 through a large household survey in 2007 in five rural districts of southern Tanzania. Results. Of the 300 reported deaths that were sampled, the Verbal Autopsy (VA) interview suggested that 11 were 28 days or older at death and 65 were stillbirths. Data was missing for 5 of the reported deaths. Of the remaining 219 confirmed neonatal deaths, the most common causes were prematurity (33%), birth asphyxia (22%) and infections (10%). Amongst the deaths, 41% (90/219) were on the first day and a further 20% (43/219) on day 2 and 3. The quantitative results matched the qualitative findings. The majority of births were at home and attended by unskilled assistants. Conclusion. Caregivers of neonates born in health facility were more likely to seek care for problems than caregivers of neonates born at home. Efforts to increase awareness of the importance of early care-seeking for a premature or sick neonate are likely to be important for improving neonatal health.

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Alharam, Zahra Mansour, Isaada Elsaeti et Mohamed Alferjani. « Neonatal Mortality in the Neonatal Intensive Care Unit at Benghazi Pediatric Hospital– Libya. » AL-MUKHTAR JOURNAL OF SCIENCES 35, n^o 4 (31 décembre 2020) : 284–93. http://dx.doi.org/10.54172/mjsc.v35i4.331.

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This research aims to study mortality rates and identify the direct causes of neonatal deaths among newborns at Benghazi Pediatric Hospital. A descriptive case series study was conducted during 2015. Data included; birth weight, gender, residency, duration of hospital stay, age of neonates at death, and causes of death. Out of 1610 neonatal admissions reviewed, the total number of deaths was 122 during 2015. The data focused on death certificates of neonates and showed that the male gender was predominant (62.3 %). Most of them had a birth weight ranged between 2-2.9 Kg. Approximately 52 % of neonatal deaths in one day were of newborns <1 week old, and 54% were full-term newborns. The most frequent direct single cause of death in neonates was prematurity, then neonatal sepsis and congenital heart disease respectively. The study concluded that the most frequent causes of infant mortality related deaths were prematurity then neonatal sepsis. Furthermore, future research is recommended, and the calculation of early and late neonatal mortality rate with the availability of total live births.

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Eshete, Akine, et Sileshi Abiy. « When Do Newborns Die ? Timing and Cause-Specific Neonatal Death in Neonatal Intensive Care Unit at Referral Hospital in Gedeo Zone : A Prospective Cohort Study ». International Journal of Pediatrics 2020 (15 février 2020) : 1–8. http://dx.doi.org/10.1155/2020/8707652.

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Background. Maternal, newborn, and child health have a high stake in the global health agenda, however, neonates’ risk of dying is unacceptable in the world. Ethiopia is one of the countries with high burden of neonatal morbidity and mortality. Yet, timing and cause-specific neonatal death are under-investigated. The present study aimed to determine the timing and cause-specific neonatal death. Methods. We conducted a prospective cohort study at Dilla University Referral Hospital Neonatal Care Unit from November 2016 to January 2018. All admitted neonates to the neonatal care unit were followed from cohort entry up to the occurrence of an event (death) or end of follow-up. We generated descriptive statistics to determine the timing of neonatal death and the cause of deaths. Results. Overall, 11.6% of neonates died during the follow-up. We found that 34.0% and 64.3% of deaths occurred during the first and second weeks of neonatal life, respectively. Neonatal sepsis and low birth weight were the main causes of death and hospital admission. Jaundices and low birth weight were the most common causes of death during the early neonatal period, whereas birth asphyxia, low birth weight, and sepsis were during late neonatal life. However, for other causes of death, the slight difference was seen between the death patterns in early and late neonatal periods. Conclusions. The timing and cause-specific neonatal deaths were varying among different time of the neonatal periods that needs to design context-based policy and interventions.

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Abdul-Mumin, Alhassan, Cesia Cotache-Condor, Sheila Agyeiwaa Owusu, Haruna Mahama et Emily R. Smith. « Timing and causes of neonatal mortality in Tamale Teaching Hospital, Ghana : A retrospective study ». PLOS ONE 16, n^o 1 (13 janvier 2021) : e0245065. http://dx.doi.org/10.1371/journal.pone.0245065.

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Neonatal deaths now account for more than two-thirds of all deaths in the first year of life and for about half of all deaths in children under-five years. Sub-Saharan Africa accounts up to 41% of the total burden of neonatal deaths worldwide. Our study aims to describe causes of neonatal mortality and to evaluate predictors of timing of neonatal death at Tamale Teaching Hospital (TTH), Ghana. This retrospective study was conducted at TTH located in Northern Ghana. All neonates who died in the Neonatal Intensive Care Unit (NICU) from 2013 to 2017 were included and data was obtained from admission and discharge books and mortality records. Bivariate and multivariate logistic regression were used to assess predictors of timing of neonatal death. Out of the 8,377 neonates that were admitted at the NICU during the 5-year study period, 1,126 died, representing a mortality rate of 13.4%. Of those that died, 74.3% died within 6 days. There was an overall downward trend in neonatal mortality over the course of the 5-year study period (18.2% in 2013; 14.3% in 2017). Preterm birth complications (49.6%) and birth asphyxia (21.7%) were the top causes of mortality. Predictors of early death included being born within TTH, birth weight, and having a diagnosis of preterm birth complication or birth asphyxia. Our retrospective study found that almost 3/4 of neonatal deaths were within the first week and these deaths were more likely to be associated with preterm birth complications or birth asphyxia. Most of the deaths occurred in babies born within health facilities, presenting an opportunity to reduce our mortality by improving on quality of care provided during the perinatal period.

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Liu, Yuxi, Leni Kang, Chunhua He, Lei Miao, Xiaoqiong Qiu, Weipeng Xia, Jun Zhu et al. « Neonatal mortality and leading causes of deaths : a descriptive study in China, 2014–2018 ». BMJ Open 11, n^o 2 (février 2021) : e042654. http://dx.doi.org/10.1136/bmjopen-2020-042654.

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ObjectiveThe present study estimated the national and urban–rural levels and causes of neonatal deaths in China annually between 2014 and 2018 to provide data support for the further end of preventable neonatal deaths for China and other low-income and middle-income countries.MethodsThe study was based on data from the National Maternal and Child Health Surveillance System. All neonates of surveillance districts (gestational week: ≥28 weeks) who died after delivery have been involved in the study. The mortality rate and the leading causes of death for neonates were analysed.ResultsThe neonatal mortality rate (NMR) of China has steadily decreased from 5.9 deaths per 1000 live births in 2014 to 3.9 deaths per 1000 live births in 2018. The NMR in 2018 of urban and rural areas was 2.2 deaths per 1000 live births and 4.7 deaths per 1000 live births, respectively. The leading preventable causes of neonatal deaths are the same in the urban and rural areas were same, which were preterm birth, intrapartum complications and pneumonia. Mortality rates of these three causes fell significantly between 2014 and 2018 but contributed to a higher proportion of deaths in rural areas than urban areas. The proportion of preventable deaths accounted for 74.6% in 2018.ConclusionsThe NMR of China has decreased steadily from 2014 to 2018. However, the inequality between urban and rural areas still exists. The goal of government interventions should be to reduce the health inequality of neonates and further take targeted measures to eliminate preventable neonatal death.

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Shahidullah, Mohammod, M. Zahidul Hasan, Ismat Jahan, Firoz Ahmed, Arjun Chandra Dey, Sanjoy Kumer Dey et MA Mannan. « Perinatal Characteristics and Outcome of Neonates at NICU of a Tertiary Level Hospital in Bangladesh ». Bangladesh Journal of Child Health 41, n^o 1 (20 août 2017) : 34–39. http://dx.doi.org/10.3329/bjch.v41i1.33634.

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Background: One of the Millennium Development Goals (MDG-4) is to reduce child mortality up to two-thirds by 2015. In most developing countries, a higher proportion of neonatal deaths are observed. It has been recognized that without a substantial reduction in neonatal deaths, MDG-4 will not be met.Objective: To assess the perinatal characteristics, pattern of admissions and outcome of neonates in a tertiary care centre in Bangladesh.Methods: A retrospective review of consecutive neonatal admissions to Bangabandhu Sheikh Mujib Medical University, between January and December 2013, was conducted. Data were collected from the neonatal admission, discharge and death registers. Standard definitions of the conditions were used to diagnose the clinical conditions.Results: Total 683 neonates were admitted to the NICU. Among them 56.1% were inborn and males were 56.8%. Total 61.3% neonates were low birth weight and 60.3 % were preterm. The overall cesarean section rate was 61.9%. Total 35.3% neonates had sepsis and perinatal asphyxia was present in 16.8% neonates. Congenital anomaly was present in 17.6% neonates. The mean duration of hospital stay was 11.1 days and overall mortality rate was 14.9%.Conclusion: Prematurity, neonatal infections, birth asphyxia and congenital anomalies were the main causes of neonatal hospital admission and neonatal deaths in this study.Bangladesh J Child Health 2017; VOL 41 (1) :34-39

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Alferjani, Dr Mohamed Masoud, Dr Fatema Alsedawi, Dr Salema Alzhawi et Dr Fadwa Abdalhamid Aldeghaily. « Causes of Admissions and Deaths in Neonate Department Benghazi Children Hospital 2019 ». Scholars Journal of Applied Medical Sciences 10, n^o 1 (24 janvier 2022) : 114–22. http://dx.doi.org/10.36347/sjams.2022.v10i01.019.

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This research aims to study the causes of neonatal admissions and deaths among newborns at neonate department in Benghazi Children Hospital. A cross sectional retrospective study was conducted during 2019. Data included; causes of admission, causes of deaths, gender, age, residency, area of referral, duration of hospital stay. Out of 1720 neonatal admissions reviewed, the total number of deaths was 229, the overall mortality rate was (13.3%) but much higher (25.2%) among the referred babies. The male gender was predominant admissions and deaths (61.3% and 63% respectively). Most of neonatal admissions and deaths were occurred in the first week of life. The most frequent cause of admission was neonatal jaundice 492 (28.6%) followed by RD 380 (22.1%). The common cause of death was prematurity and its related problems 66 (28.3%), then neonatal sepsis 51 (22.3%) and congenital heart disease 36(15.7%).

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Ibrahim, Riyadh M. « Morbidity and Mortality Pattern of Neonates Admitted to Neonatal Care Unit.Central Teaching Pediatric Hospital Baghdad ». AL-Kindy College Medical Journal 16, n^o 1 (5 septembre 2020) : 38–48. http://dx.doi.org/10.47723/kcmj.v16i1.188.

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Background; Neonatal period is a very vulnerable period of life due to many problems, In spite of advances in perinatal and neonatal care still, the mortality rate of neonate high especially in developing country The World Health Organization estimates that globally four million neonatal deaths per year, Developing countries account for around 99% of the neonatal mortality in the world, In Iraq. Neonatal mortality rate about 19 per 1000 live births which represent 56% of child death below 5 years age in 2012. .Objectives The aims of the study were to determine the institutional new-born case fatality rate and the cause of admission and death in the neonatal care unit.Method; Across-section study was carried out of the Neonatal Care Unit of Central Teaching Hospital of Pediatric in Baghdad Al-krakh Health DirectorateResult; During 2015, 1977 neonates were admitted, Mortality rate was 9%, Four main causes of death were identified; Respiratory related condition, Bacterial sepsis, premature neonate (Disorder related to short gestational and low birth weight not relayed to elsewhere classification) and congenital malformation 37.5%, 33.3%, 7.1% and 7.1% respectively , The main causes of morbidity were Neonatal jaundice, Respiratory related condition, Bacterial sepsis 37.5%, 35.2%. 14.1% respectively Conclusions: The majority of neonatal morbidity and mortality can be prevented by appropriate interventions

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Heráclio, Isabela De Lucena, Ana Paula Timóteo Vieira, Aline Luzia Sampaio Guimarães, Conceição Maria de Oliveira, Paulo Germano de Frias et Cristine Vieira do Bonfim. « Vigilância do óbito evitável : comparação entre fetal e neonatal precoce ». Revista Recien - Revista Científica de Enfermagem 11, n^o 34 (27 juin 2021) : 354–63. http://dx.doi.org/10.24276/rrecien2021.11.34.354-363.

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Comparar características sociodemográficas, assistenciais e epidemiológicas de óbitos fetais e neonatais precoces evitáveis investigados. Estudo transversal, cuja fonte de dados foi a ficha de investigação do óbito fetal, em menor de um ano, preenchida pela vigilância do Recife (PE). Procedeu-se a comparação entre os grupos de óbitos fetais e neonatais precoces evitáveis, utilizando o teste Qui-quadrado de Pearson, com a=5%. Dos 117 óbitos analisados, 94 (80,3%) eram fetais. A avaliação da assistência à saúde evidenciou falhas em 95,6% dos óbitos perinatais, destacando-se a assistência ao pré-natal, com falhas em 75,6% dos fetais e 90% nos neonatais precoces. Os óbitos reduzíveis por adequada atenção à mulher na gestação constituíram o principal grupo de evitabilidade (64,1%). Houve falhas na assistência na quase totalidade dos óbitos. A comparação entre os óbitos perinatais evitáveis permitiu avaliar a qualidade da assistência e pode contribuir com a elaboração de estratégias de redução.Descritores: Mortalidade perinatal, Saúde Materno-infantil, Estatísticas Vitais, Vigilância em Saúde Pública. Preventable death surveillance: a comparison between fetal and neonatalAbstract: To compare sociodemographic, health care and epidemiologic characteristics of investigated preventable fetal and premature neonatal deaths. Cross-sectional study, whose data source was the fetal death investigation form, in less than a year, filled out by Recife’s surveillance (PE). Then, a comparison proceeded between fetal and premature neonatal preventable death groups, utilizing the Pearson’s Chi-square test, with a=5%. From 117 analyzed deaths, 94 (80.3%) were fetal. The evaluation of healthcare presented failures in 95.6% of perinatal deaths, emphasizing the assistance to prenatal, with failures of 75.6% of fetal and 90% in premature neonatal deaths. Deaths reducible by adequate assistance for women during pregnancy were the main preventable group (64.1%). There were deficiencies in the assistance in almost all deaths. The comparison among avoidable perinatal deaths allowed the evaluation of care quality and may enable contributions towards the elaboration of reduction strategies.Descriptors: Perinatal Mortality, Maternal and Child Health, Vital Statistics, Public Health Surveillance. Vigilancia del óbito evitable: comparación entre fetal y neonatal precozResumen: Comparar características sociodemográficas, de auxílio social y epidemiológicas de óbitos fetales y neonatales precoces evitables investigados. Estudio transversal, cuya fuente de datos fue la ficha de investigación del óbito fetal, en menor de un año, rellenada por la vigilancia de Recife (PE). Se procedió a la comparación entre los grupos de óbitos fetales y neonatales precoces evitables, empleando el test Qui-cuadrado de Pearson, con a=5%. De los 117 óbitos analizados, 94 (80,3%) eran fetales. La evaluación de la asistencia a la salud denotó fallos en 95,6% de los óbitos perinatales, destacándose la asistencia prenatal con fallos en el 75,6% de los óbitos perinatales y 90% de los neonatales precoces. Los óbitos reductibles por atención adecuada a la mujer gestante constituyeron el principal grupo de evitabilidad (64,1%). Hubo fallos en la asistencia en la casi totalidad de los óbitos. La comparación entre los óbitos perinatales evitables permitió evaluar la calidad de la asistencia y puede enriquecer la elaboración de estrategias de reducción. Descriptores: Mortalidad perinatal, Salud Materno-Infantil, Estadísticas Vitales, Vigilancia en Salud Pública.

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Deviany, Poppy E., Philip W. Setel, Henry D. Kalter, Trisari Anggondowati, Martini Martini, Fitri Nandiaty, Kamaluddin Latief et al. « Neonatal mortality in two districts in Indonesia : Findings from Neonatal Verbal and Social Autopsy (VASA) ». PLOS ONE 17, n^o 3 (14 mars 2022) : e0265032. http://dx.doi.org/10.1371/journal.pone.0265032.

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Background The Government of Indonesia is determined to follow global commitments to reduce the neonatal mortality rate. Yet, there is a paucity of information on contributing factors and causes of neonatal deaths, particularly at the sub-national level. This study describes care-seeking during neonates’ fatal illnesses and their causes of death. Methods We conducted a cross-sectional community-based study to identify all neonatal deaths in Serang and Jember Districts, Indonesia. Follow-up interviews were conducted with the families of deceased neonates using an adapted verbal and social autopsy instrument. Cause of death was determined using the InSilicoVA algorithm. Results The main causes of death of 259 neonates were prematurity (44%) and intrapartum-related events (IPRE)-mainly birth asphyxia (39%). About 83% and 74% of the 259 neonates were born and died at a health facility, respectively; 79% died within the first week after birth. Of 70 neonates whose fatal illness began at home, 59 (84%) sought care during the fatal illness. Forty-eight of those 59 neonates went to a formal care provider; 36 of those 48 neonates (75%) were moderately or severely ill when the family decided to seek care. One hundred fifteen of 189 neonates (61%) whose fatal illnesses began at health facilities were born at a hospital. Among those 115, only 24 (21%) left the hospital alive–of whom 16 (67%) were referred by the hospital. Conclusions The high proportion of deaths due to prematurity and IPRE suggests the need for improved management of small and asphyxiated newborns. The moderate to severe condition of neonates at the time when care was sought from home highlights the importance of early illness recognition and appropriate management for sick neonates. Among deceased neonates whose fatal illness began at their delivery hospital, the high proportion of referrals may indicate issues with hospital capability, capacity, and/or cost.

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Dhahir, Asmar, et Shahla Alalaf. « Maternal and neonatal characteristics that influence early neonatal deaths in a maternity teaching hospital ». Zanco Journal of Medical Sciences 26, n^o 2 (14 août 2022) : 96–107. http://dx.doi.org/10.15218/zjms.2022.011.

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Background and objective: Low early neonatal death reflects health care progress in any country. We aimed to determine the prevalence of early neonatal deaths and the associated maternal and neonatal factors in a hospital-based study. Methods: This audit study was conducted on all newborns in the labor ward and neonatal intensive care unit of a maternity teaching hospital in Erbil city, Kurdistan Region, Iraq, from January 1, 2020, to December 31, 2020. Fetal and maternal factors were determined and correlated with early neonatal deaths. Results: The early neonatal death rate was 6.7%. All categories of preterm deliveries (extreme, very, and moderate preterm) were significantly associated with early neonatal deaths (odds ratios [ORs] = 45.1, 6.2, and 2.1, respectively). The primiparous and grand multiparous women had a higher risk of early neonatal deaths (ORs = 8.4 and 13.0, respectively). Obese women had a higher risk of early neonatal deaths (OR = 3.3). The risk of early neonatal deaths was significantly high when the number of antenatal care visits was less than four (OR = 8.1). Delivery by cesarean section was associated with high risk (OR = 3.8). Regarding the Apgar scores in the first and fifth minutes after birth, early neonatal death was significantly higher among those with severely depressed scores. Conclusion: High parity, inadequate antenatal attendance, obesity, and mode of delivery, were contributing factors to early neonatal deaths. Early prenatal care can assist in the rapid identification and management of risk factors for early neonatal deaths. Keywords: Early neonatal death; Parity; Low birth weight; Maternal characteristics; Overweight.

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Fissha Adem, Yonas, Yosef Haile et Moges Milashu. « Time to death and its predictors among early neonatal patients in neonatal intensive care unit of Dessie referral hospital, South Wollo Zone, Northeast Ethiopia ». Journal of Pediatrics & ; Neonatal Care 12, n^o 3 (9 septembre 2022) : 143–49. http://dx.doi.org/10.15406/jpnc.2022.12.00471.

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Background: Early neonatal death is a serious concern, both in the developing and developed worlds. Early neonatal death remains a health problem and is the biggest component of the neonatal mortality rate. Therefore, substantial reduction in early neonatal mortality is a crucial pre-requisite for achieving further gains in child survival in the country. However, the distribution of deaths in the community within the first week is poorly understood. Therefore, this study was conducted to assess time to death and its predictors among early neonates in the neonatal intensive care unit of Dessie Referral Hospital. Method: A retrospective cohort study was conducted in the early neonatal patient in Dessie referral hospital on the total sample size of 416 selected patients by using a simple random sampling technique. Data were collected by document review. Life table used to estimate the probability of survival, log-rank test to compare survival in two or more groups and the Cox proportional hazard model was used to determine factors associated with time to death of early neonate. The hazard ratio with 95% confidence level was used to declare statistical significant association. Result: A total of 416 early neonates were included in the study. There were 224(53.8%) male neonates. The overall early neonatal mortalities were 47(11.3%), of which 23.41% of them died on the first day of age. early neonatal mortality was associated with neonatal sepsis (AHR=3.349,95% CI,1.842-6.089), low birth weight of neonates (AHR=3.563%,95% CI,1.925-6.595), unable to breastfeeding during delivery (AHR=4.094,95% CI,1.603-10.452), neonatal respiratory distress (AHR=4.018,95% CI,1.733-9.371), perinatal asphyxia (AHR =2.540,95% CI,1.186-5.847). Conclusion: The causes of early neonatal death described in this study were preventable. Managing low birth weight, initiating exclusive breastfeeding, refining quality of service, and confirming the continuity of care are recommended to increase the survival of neonates.

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Asghar, Rai Muhammad, Muddasir Sharif, Khalid Saheel, Rai Rijjal Ashraf et Abid Hussain. « An Analysis of Five years Neonatal Mortality in NICU of a Tertiary Care Hospital of Rawalpindi 2014-2019 ». Journal of Rawalpindi Medical College 24, n^o 4 (30 décembre 2020) : 328–33. http://dx.doi.org/10.37939/jrmc.v24i4.1394.

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Objective: This study was done to find out the main causes and magnitude of neonatal mortality in the neonatal intensive care unit (NICU) of Benazir Bhutto Hospital, Rawalpindi over a period of five years.Material and Methods: A hospital-based cross-sectional study was done from June 2014 to July 2019. The registration book of admitted neonates was reviewed by using a checklist to collect data. Data was analyzed in SPSS 24 for descriptive and bi-variate analysis applying the chi-square test and presented in text, frequencies, tables, and percentages.Results: The study assessed a total of 24,459 neonates admitted to the NICU at Benazir Bhutto Hospital over a span of five years (June 2014 to July 2019). The mean birth weight was 2432 grams ± 740 g (range: Between 800 and 6000 g). Male neonates accounted for 59.8% with male to female ratio of 1.5:1. 67.5% male neonates and 32.5% female neonates expired. Overall 19,832 neonates (81.1%) were discharged, while 4636 (18.9%) died, making a Neonatal Mortality Rate of 18.9% (189 per 1000 admissions). 86.21% of these deaths were early neonatal that occurred in the first week of life. The causes of death were pre-maturity/ low birth weight (LBW), suspected sepsis, birth asphyxia, neonatal jaundice, and meconium aspiration syndrome, accounting for 32%, 31%, 30%, 4%, and 3% respectively.Conclusion: In our NICU the neonatal mortality is high with prematurity/low birth weight (LBW), birth asphyxia (BA), neonatal jaundice (NNJ), and meconium aspiration syndrome (MAS) accounting for most of the deaths. These deaths are largely preventable with better antenatal, perinatal, and neonatal care.

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Asghar, Rai Muhammad, Muddasir Sharif, Khalid Saheel, Rai Rijjal Ashraf et Abid Hussain. « An Analysis of Five years Neonatal Mortality in NICU of a Tertiary Care Hospital of Rawalpindi 2014-2019 ». Journal of Rawalpindi Medical College 24, n^o 4 (30 décembre 2020) : 328–33. http://dx.doi.org/10.37939/jrmc.v24i4.1394.

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Objective: This study was done to find out the main causes and magnitude of neonatal mortality in the neonatal intensive care unit (NICU) of Benazir Bhutto Hospital, Rawalpindi over a period of five years.Material and Methods: A hospital-based cross-sectional study was done from June 2014 to July 2019. The registration book of admitted neonates was reviewed by using a checklist to collect data. Data was analyzed in SPSS 24 for descriptive and bi-variate analysis applying the chi-square test and presented in text, frequencies, tables, and percentages.Results: The study assessed a total of 24,459 neonates admitted to the NICU at Benazir Bhutto Hospital over a span of five years (June 2014 to July 2019). The mean birth weight was 2432 grams ± 740 g (range: Between 800 and 6000 g). Male neonates accounted for 59.8% with male to female ratio of 1.5:1. 67.5% male neonates and 32.5% female neonates expired. Overall 19,832 neonates (81.1%) were discharged, while 4636 (18.9%) died, making a Neonatal Mortality Rate of 18.9% (189 per 1000 admissions). 86.21% of these deaths were early neonatal that occurred in the first week of life. The causes of death were pre-maturity/ low birth weight (LBW), suspected sepsis, birth asphyxia, neonatal jaundice, and meconium aspiration syndrome, accounting for 32%, 31%, 30%, 4%, and 3% respectively.Conclusion: In our NICU the neonatal mortality is high with prematurity/low birth weight (LBW), birth asphyxia (BA), neonatal jaundice (NNJ), and meconium aspiration syndrome (MAS) accounting for most of the deaths. These deaths are largely preventable with better antenatal, perinatal, and neonatal care.

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Muthukumaran, N. « Mortality profile of neonatal deaths and deaths due to neonatal sepsis in a tertiary care center in southern India : a retrospective study ». International Journal of Contemporary Pediatrics 5, n^o 4 (22 juin 2018) : 1583. http://dx.doi.org/10.18203/2349-3291.ijcp20182569.

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Background: The Neonatal mortality rate is an important indicator for newborn care and directly reflects prenatal, intranatal, and postnatal care. Objective: Primary objective was to analyse the neonatal mortality profile, incidence of neonatal sepsis among neonatal deaths and the pattern of antimicrobial resistance.Methods: This was a retrospective descriptive study done in a tertiary care regional center. All neonatal deaths from January 2017 to December 2017 were reviewed and primary causes of deaths, incidence of sepsis among neonatal deaths and pattern of antimicrobial resistance were analyzed.Results: Common causes of neonatal deaths were respiratory distress syndrome (27.4%), asphyxia (23.3%), sepsis (20.1%), congenital malformations, extreme preterm, meconium aspiration syndrome. Case fatality rate was high in extreme preterm neonates (96.8%), followed by respiratory distress syndrome (35.9%), asphyxia (33%), meconium aspiration syndrome (29.4%), congenital malformations (28.8%), and sepsis (22.6%). In present study incidence of neonatal sepsis among total neonatal deaths was about 20.1%. Coagulase negative staphylococcus(CONS) (38.6%) and Klebsiella pneumoniae (32.7%) were the predominant organisms isolated. Highest case fatality rate was associated with Pseudomonas sepsis (80%), K. pneumoniae sepsis (64.8%), followed by Escherichia coli sepsis (57%) and non fermenting Gram negative bacilli (55.6%).Conclusions: Sepsis still remains one of the leading cause of death in developing countries. Coagulase negative staphylococcus (CONS) and Klebsiella pneumoniae were the most common organism. 15 % enterococci and 9.7 % of CONS were resistant to vancomycin. 24 % of K. pneumoniae and 16.6% non fermenting Gram negative bacilli were resistant to amikacin. Multidrug resistance is an emerging problem.

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Simkiss, D. « Reducing neonatal deaths ». Journal of Tropical Pediatrics 56, n^o 6 (25 novembre 2010) : 371–72. http://dx.doi.org/10.1093/tropej/fmq114.

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Alam, Rafiul, Md Shamsur Rahman, Eshrat Jahan, Farhana Afroze et Mohammad Tajul Islam. « Causes and determinants of neonatal deaths : Evidence from a secondary care hospital in Bangladesh ». Bangladesh Journal of Child Health 43, n^o 3 (7 octobre 2020) : 138–44. http://dx.doi.org/10.3329/bjch.v43i3.49569.

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Background: Neonatal death is a major barrier to improve child survival in Bangladesh. This study assessed the patterns of neonatal admissions, causes of deaths and associated risk factors to prioritize and design interventions to improve quality of services. Materials & Methods: This study was conducted at the Satkhira District Hospital, a secondary health care facility in Bangladesh. From January to December 2014 hospital records of neonatal admissions and outcomes were reviewed and analyzed. Risk factors were determined by logistic regression analysis. Results: A total of 2,632 neonates were admitted during the period. More than one-third had admission bodyweight below 2500 grams. The leading causes of admissions were perinatal asphyxia (39.6%), prematurity/low-birth weight (LBW) (16.3%), pneumonia (11.9%) and sepsis (10.0%). The overall neonatal case fatality rate (CFR) was 11.7%. The main causes of neonatal deaths were perinatal asphyxia (41.6%) and prematurity/ LBW (35.8%). Most of the deaths (74.3%) occurred on first day of life. Significant risk factors for death were body weight on admission <1500 grams (OR: 17.08; 95% CI: 7.22 - 40.44; p<0.001), first day of life (OR: 7.99; 95% CI: 2.86 -22.27; p<0.001). Conclusions: The main causes of neonatal deaths were perinatal asphyxia and prematurity/LBW and most of the deaths occurred on first day of life. Bangladesh J Child Health 2019; VOL 43 (3) :138-144

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Riyanti, Riyanti, et Legawati Legawati. « Determinan Kematian Neonatal di RSUD Sultan Imanudin Pangkalan Bun ». Jurnal Surya Medika 3, n^o 2 (1 février 2018) : 115–21. http://dx.doi.org/10.33084/jsm.v3i2.109.

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Efforts to reduce neonatal mortality are done through various efforts in every healthcare setting. Neonatal deaths are caused by various factors, either directly or indirectly. This study aims to determine the cause of neonatal death. The approach used in this research is analytic observational and Cross-Sectional design. The population in this study is all neonatal deaths in RSUD Sultan Imanudin Pangkalan Bun. The sample of research is 103 people. Univariate analyzes were performed with frequency distribution, for bivariate analysis of factors Age of mother, education, occupation, parity, place of birth, the status of the referral, birth attendant and cause of death using chi-square (x2). The results showed that neonatal mortality occurred in the early neonate group 82 people (79.6%). Bivariate analysis showed that parity and cause factor (p = 0,001) showed significant influence on neonatal mortality. Conclusions of the study resulted in parity and direct or indirect causes of neonatal death.

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Parashar, Anupam, Deepesh Barall, Anmol Gupta, Tripti Chauhan, Devender Kumar, Arvind Kumar, Sanjay Kumar, Gopal Ashish Sharma et Sunita Kumari. « Verbal autopsy to determine the timing and causes of infant deaths in the northern state of India ». International Journal of Contemporary Pediatrics 4, n^o 2 (22 février 2017) : 591. http://dx.doi.org/10.18203/2349-3291.ijcp20170715.

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Background: Data on timing and probable causes of infant deaths are very important for the design of intervention to reduce mortality because of very limited study in the state. This study was undertaken to determine the timing and causes of infant deaths in our state using verbal autopsy. The suggestions and recommendations can be used to strengthen and improve the existing facilities and services for the better outcome of life in the early childhood.Methods: A cross sectional study was conducted in 180 selected clusters by WHO cluster sampling method, using validated verbal autopsy tool for timing and causes of infant deaths.Results: Verbal autopsy was done for 45 infant deaths. 37.8% infant deaths were early neonatal, 15.5% in late neonatal and 46.7% in post neonatal period with mean age of 5.79±6.35 days in neonatal period while it was 5.07±3.38 months in post neonatal period. Of all the infants 57.78% were females. The major causes of death were severe infection (15.5%) in neonates, pneumonia (13.3%) in post neonates followed by LBW with prematurity (11.1%) and diarrhea (11.1%). No specific cause could be determined in 13.3% cases.Conclusions: The major causes of infant deaths are preventable. It emphasizes for the robust reporting mechanism to determine the exact causes of all infant mortality, strengthening of comprehensive health care delivery and ensuring the accessibility to the health care services to have a healthy infanthood.

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Cole, Susan K. « Accuracy of death certificates in Neonatal deaths ». Journal of Public Health 11, n^o 1 (février 1989) : 1–8. http://dx.doi.org/10.1093/oxfordjournals.pubmed.a042440.

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Azize, Pary M., Layla A. Muhammad et Nasren A. Kareem. « The causes of early neonatal death in Sulaimani Intensive Care Unite at Maternity Teaching Hospital between Jan 2016 - Feb 2017 ». Kurdistan Journal of Applied Research 2, n^o 2 (30 juin 2017) : 121–27. http://dx.doi.org/10.24017/science.2017.2.17.

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Early neonatal death refers to all deaths of liveborn infants occurring on or before the first seven days of life. There is a shortage of research on the specific causes of early neonatal death. This study has been conducted in order to assess causes of early neonatal death in Sulaimani's Neonatal Intensive Care Unit at Maternity Teaching Hospital. Information was obtained retrospectively from the patients’ medical records, including (Mother and neonate socio-demographic, Maternal, Fetal and labor causes of death). Generally, this study found that in 2016 out of total 18.573 recorded delivery, 168 early neonatal deaths were analyzed from January 2016 to February 2017. However, this number was declined in comparison to the data of 2015, which estimated around 244 early deaths out of 21.142 total births. The mean age of mothers was ranged (28.22 ±7.69), 73.2% of neonate mothers were multi gravid with 67.3% of them delivered through normal vaginal, The majority of early neonate death was happening in the mean expected date delivery of (28.64 ± 2.90) weeks, with mostly weighing 700- 1.10 gm. Regarding the maternal causes, more than a quarter of the mother had Preeclamptic toxemia followed by (25% antepartum hemorrhage, 22.6% diabetes, respectively), In terms of the fetal causes, more than three-quarter of neonate were dead because of prematurity and the majority 85.2% were deceased because of the respiratory distress syndrome. Almost no labor causes. The study also found that there is a significant association between gravidity, mode of delivery and maternal cause in p value < 0.05. However, that relationship was not found to fetal cause. Moreover, there is also no significant relationship between fetal cause and (Age of mother, Expected date delivery and fetal weight) in p-value > 0.05 accept the gender of the neonate. In conclusion, some factors affecting early neonatal death have been identified in this study special care is essential for these children in order to reduce their mortality rates.

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Shanmugam, Ramya S., Arun Karthik, Muthukumaran N. et Chinnathambi Kamalarathanam. « Mortality profile of extreme to very preterm infants in an extramural tertiary care neonatal unit of a teaching hospital in Southern India : a retrospective study ». International Journal of Contemporary Pediatrics 7, n^o 4 (21 mars 2020) : 776. http://dx.doi.org/10.18203/2349-3291.ijcp20201097.

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Background: Neonatal deaths account for 47% of all deaths in children younger than 5 years globally. More than a third of deaths are due to preterm related complications. Understanding the factors contributing to preterm deaths and pattern of mortality is needed to implement interventions that are essential in improving neonatal survival.Methods: This was a retrospective study done in neonatal intensive care unit, Institute of Child Health (ICH) and Hospital for Children, Chennai, a tertiary care regional center. All preterm (<32 weeks) deaths registered in the neonatal medical records from 1st of January 2018 to 31st of December 2018 were analysed. Primary causes of deaths were analysed by two consultants. When there were more than one cause contributing to responsible for death the most significant problem was taken as the cause of death.Results: Overall neonatal mortality was 312 (14.2%) of 2189 neonates. Out of 148 admissions in the study population mortality was 74.2% (26 of 35) for extreme preterm (<28 weeks) infants and 42.7% (48 of 113) for very preterm (28 to 32 weeks) infants. Predominant causes of death were sepsis 44.5% (33), prematurity-related complications 37.8% (28) followed by congenital anomalies 12.1% (9) and miscellaneous causes 2.7% (2). Respiratory Distress Syndrome (RDS) and Intra Ventricular Haemorrhage (IVH) attributed to 75% (21/ 28) of deaths among prematurity-related complications.Conclusions: This study identified sepsis; prematurity related complications were the predominant causes of mortality in the extreme to very preterm population. Understanding the specific causes of preterm mortality would help to implement interventions to promote their survival.

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Ibrahim, Riyadh Mraweh, et Bushra Jabbar Hashem. « The outcome of newborn admitted in neonatal care unit, center teaching hospital of pediatric , Baghdad Al-krakh, 2015 ». AL-Kindy College Medical Journal 15, n^o 1 (12 septembre 2019) : 43–51. http://dx.doi.org/10.47723/kcmj.v15i1.77.

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Background: Neonatal period is a very vulnerable period of life due to many problems, In spite of advances in perinatal and neonatal care still, the mortality rate of neonate high especially in developing country The World Health Organization estimates that globally four million neonatal deaths per year, Developing countries account for around 99% of the neonatal mortality in the world, In Iraq. Neonatal mortality rate about 19 per 1000 live births which represent 56% of child death below 5 years age in 2012. The hospital in the study represents the larger pediatric hospital in Iraq. It contains 400 children's beds and 24 neonatal incubators. Aims of the study: are to determine the institutional new-born case fatality rate and the cause of death in the neonatal care unit. Method; The study is cross-section study of the population sample of neonatal care unit of central teaching hospital of pediatric in Baghdad Al-krakh health directorate Result: Study appear total neonate admission during 2015 was 1977 neonates mortality rate 9% Four main causes of death were Respiratory related condition, Bacterial sepsis, Disorder related to short gestational and low birth weight not relayed to elsewhere classification and congenital malformation 37.5%, 33.3%, 7.1% and 7.1% respectively while the main primary cause of morbidity were Neonatal jaundice, Respiratory related condition, Bacterial sepsis and 37.5%, 35.2%. 14.1% respectively Conclusions: The majority of morbidity and mortality can prevent by appropriate intervention

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Gannon, Hannah, Gwendoline Chimhini, Mario Cortina-Borja, Tarisai Chiyaka, Marcia Mangiza, Felicity Fitzgerald, Michelle Heys, Samuel R. Neal et Simbarashe Chimhuya. « Risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in Zimbabwe over a 12-month period ». PLOS Global Public Health 2, n^o 12 (20 décembre 2022) : e0000911. http://dx.doi.org/10.1371/journal.pgph.0000911.

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Neonatal encephalopathy (NE) accounts for ~23% of the 2.4 million annual global neonatal deaths. Approximately 99% of global neonatal deaths occur in low-resource settings, however, accurate data from these low-resource settings are scarce. We reviewed risk factors of neonatal mortality in neonates admitted with neonatal encephalopathy from a tertiary neonatal unit in Zimbabwe. A retrospective review of risk factors of short-term neonatal encephalopathy mortality was conducted at Sally Mugabe Central Hospital (SMCH) (November 2018 –October 2019). Data were gathered using a tablet-based data capture and quality improvement newborn care application (Neotree). Analyses were performed on data from all admitted neonates with a diagnosis of neonatal encephalopathy, incorporating maternal, intrapartum, and neonatal risk predictors of the primary outcome: mortality. 494/2894 neonates had neonatal encephalopathy on admission and were included. Of these, 94 died giving a neonatal encephalopathy-case fatality rate (CFR) of 190 per 1000 admitted neonates. Caesarean section (odds ratio (OR) 2.95(95% confidence interval (CI) 1.39–6.25), convulsions (OR 7.13 (1.41–36.1)), lethargy (OR 3.13 (1.24–7.91)), Thompson score “11–14” (OR 2.98 (1.08–8.22)) or “15–22” (OR 17.61 (1.74–178.0)) were significantly associated with neonatal death. No maternal risk factors were associated with mortality. Nearly 1 in 5 neonates diagnosed with neonatal encephalopathy died before discharge, similar to other low-resource settings but more than in typical high-resource centres. The Thompson score, a validated, sensitive and specific tool for diagnosing neonates with neonatal encephalopathy was an appropriate predictive clinical scoring system to identify at risk neonates in this setting. On univariable analysis time-period, specifically a period of staff shortages due to industrial action, had a significant impact on neonatal encephalopathy mortality. Emergency caesarean section was associated with increased mortality, suggesting perinatal care is likely to be a key moment for future interventions.

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Mittal, Dr Ujjwal, Dr Vivek Parasher, Dr Rahul Khatri, Dr Samarth Yadav et Dr Sayan Das. « The pattern of admission and their related outcomes in NICU of a tertiary care teaching hospital, Udaipur, Rajasthan, India ». Pediatric Review : International Journal of Pediatric Research 8, n^o 1 (28 février 2021) : 16–22. http://dx.doi.org/10.17511/ijpr.2021.i01.03.

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Introduction: To achieve MDG4 (Millennium Developmental Goals-4), a substantial reduction inearly neonatal deaths will be required. The first steps in improving early neonatal survival are todocument the number and rate of deaths and identify their common causes. As per the NationalFamily Health Survey-3 report, the current neonatal mortality rate (NMR) in India is 39 per 1000 livebirths, neonatal deaths account for nearly 77% of all infant deaths (57/1000) and nearly half ofunder-five child deaths (74/1000). This study was undertaken to study the disease pattern andoutcome of neonates admitted to the neonatal intensive care unit (NICU) of a tertiary care teachinghospital located in Udaipur, Rajasthan. Material and methods: The age, sex, gestational age, andmorbidity and mortality profile of all NICU admissions in 5 years was determined and the differencebetween Inborn (those born in the Teaching Hospital) and Out born was calculated. Morbidity riskfactors to reduce NMR in Udaipur were determined. Results: A total of 2648 neonates wereadmitted to NICU during the study period, out of which none were excluded from the study. Theratio of Male to Female admitted was 1.30:1. The major causes of morbidity were MeconiumAspiration Syndrome (16.16%), Respiratory Distress Syndrome(10.12%), Cong. HeartDefects(8.76%), Neonatal Sepsis(4.83%) and Hypoxic-Ischemic Encephalopathy(5.66%). In thisstudy, the overall mortality rate was 9.96%. Most of the Deaths were due to MAS(25.75%),RDS(15.90%), Neonatal Sepsis(10.22%), and HIE(12.87%). Neonates with birth weight <1000ghad poor outcomes compared to neonates with birth weight >2500g. Conclusion: This studyidentified Prematurity, Extremely low birth weight, MAS, and Neonatal Sepsis as major causes ofMorbidity and MAS, RDS as the major contributors to neonatal mortality. Improving antenatal care,maternal health, and timely referral of high-risk cases to tertiary care hospitals will help to improveneonatal outcomes.

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Mustufa, Muhammad Ayaz, Razia Korejo, Anjum Shahid et Sadia Nasim. « Infection remains a leading cause of neonatal mortality among infants delivered at a tertiary hospital in Karachi, Pakistan ». Journal of Infection in Developing Countries 8, n^o 11 (13 novembre 2014) : 1470–75. http://dx.doi.org/10.3855/jidc.3569.

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Introduction: The current cohort study was conducted to determine the frequency and compare the mortality rate with associated characteristics among low birth weight and normal birth weight infants during the neonatal period at a tertiary healthcare facility, Karachi. Methodology: Close-ended structured questionnaires were used to collect information from the parents of 500 registered neonates at the time of birth. Follow-ups by phone on the 28th day of life were done to determine the mortality among low birth weight and normal birth weight babies during the neonatal period. Results: The neonatal mortality rate ranged from as low as 2.4% in the normal birth weight and 16.4% in the low birth weight categories to as high as 96% in the very low birth weight category. Respiratory distress syndrome (24.2%) and sepsis (18.2%) were reported as the leading causes of neonatal deaths. The babies’ lengths of stay ranged from 2 to 24 hours, and around 90% of neonatal deaths were reported in the first seven days of life. More than 6% of neonates died at home, and 7.6% of the deceased babies did not visit any healthcare facility or doctor before their death. In the 12–15 hours before their deaths, 13.6% of the deceased babies had been unattended. Around 90% of the deceased babies were referred from a doctor or healthcare facility. Conclusions: The present estimates of neonatal mortality are very high among low birth weight and very low birth weight categories. Infectious diseases, including respiratory distress syndrome (24.2%) and sepsis (18.2%), were leading causes of neonatal deaths.

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Mehkarkar, Nitin, et Vijay Baburao Sonawane. « A study of early neonatal mortality in a tertiary hospital of Maharashtra, India ». International Journal of Contemporary Pediatrics 5, n^o 5 (24 août 2018) : 1869. http://dx.doi.org/10.18203/2349-3291.ijcp20183522.

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Background: India has a high Neonatal Mortality Rate (NMR) of 31 per 1000 live births and rural being 34 whereas urban being 17 (2011). Two thirds of the newborn deaths usually occur in the first week of life. Newborn survival has become an important issue to improve the overall health care goals. This study is carried out to identify primary causes of early neonatal deaths and to ascertain the factors affecting early neonatal mortality.Methods: This is a prospective study of all the early neonatal deaths in tertiary hospital of Maharashtra over two years. Details of each early neonatal death were filled in the standard perinatal death proforma.Results: Out of the 2073 total births, there were 75 early neonatal deaths (END) which is nearly 36.18 per 1000 live births. The important causes of END were severe birth asphyxia, respiratory distress syndrome and septicemia. About 50% of deaths were observed in mothers with age < 20 years, 25% deaths observed in mothers of age group 20-29 years, and similar percentage is with age >30 years. Most of the early neonatal deaths were due to Birth asphyxia and RDS was the second most important cause of early neonatal deaths. 70% of ENDs were among LBW babies. Prevention of premature delivery, proper management of very low birth weight babies and early detection and appropriate management of perinatal hypoxia have become important interventional strategies in reducing early neonatal deaths.Conclusions: Early Neonatal Mortality (ENM) at Tertiary Hospital is fairly high. In present study, early neonatal death rate of 36.18 per 1000 live births is observed which significantly higher than reported in literature.

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Madhi, Shabir A., Jayani Pathirana, Vicky Baillie, Alane Izu, Quique Bassat, Dianna M. Blau, Robert F. Breiman et al. « Unraveling Specific Causes of Neonatal Mortality Using Minimally Invasive Tissue Sampling : An Observational Study ». Clinical Infectious Diseases 69, Supplement_4 (9 octobre 2019) : S351—S360. http://dx.doi.org/10.1093/cid/ciz574.

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Abstract Background Postmortem minimally invasive tissue sampling (MITS) is a potential alternative to the gold standard complete diagnostic autopsy for identifying specific causes of childhood deaths. We investigated the utility of MITS, interpreted with available clinical data, for attributing underlying and immediate causes of neonatal deaths. Methods This prospective, observational pilot study enrolled neonatal deaths at Chris Hani Baragwanath Academic Hospital in Soweto, South Africa. The MITS included needle core-biopsy sampling for histopathology of brain, lung, and liver tissue. Microbiological culture and/or molecular tests were performed on lung, liver, blood, cerebrospinal fluid, and stool samples. The “underlying” and “immediate” causes of death (CoD) were determined for each case by an international panel of 12–15 medical specialists. Results We enrolled 153 neonatal deaths, 106 aged 3–28 days. Leading underlying CoD included “complications of prematurity” (52.9%), “complications of intrapartum events” (15.0%), “congenital malformations” (13.1%), and “infection related” (9.8%). Overall, infections were the immediate or underlying CoD in 57.5% (n = 88) of all neonatal deaths, including the immediate CoD in 70.4% (58/81) of neonates with “complications of prematurity” as the underlying cause. Overall, 74.4% of 90 infection-related deaths were hospital acquired, mainly due to multidrug-resistant Acinetobacter baumannii (52.2%), Klebsiella pneumoniae (22.4%), and Staphylococcus aureus (20.9%). Streptococcus agalactiae was the most common pathogen (5/15 [33.3%]) among deaths with “infections” as the underlying cause. Conclusions MITS has potential to address the knowledge gap on specific causes of neonatal mortality. In our setting, this included the hitherto underrecognized dominant role of hospital-acquired multidrug-resistant bacterial infections as the leading immediate cause of neonatal deaths.

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Tesfay, Neamin, Rozina Tariku, Alemu Zenebe, Zewdnesh Dejene et Fitsum Woldeyohannes. « Cause and risk factors of early neonatal death in Ethiopia ». PLOS ONE 17, n^o 9 (29 septembre 2022) : e0275475. http://dx.doi.org/10.1371/journal.pone.0275475.

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Background Globally, three fourth of neonatal deaths occur during the early neonatal period, this makes it a critical time to reduce the burden of neonatal death. The survival status of a newborn is determined by the individual (neonatal and maternal), and facility-level factors. Several studies were conducted in Ethiopia to assess early neonatal death; however, most of the studies had limited participants and did not well address the two main determinant factors covered in this study. In response to this gap, this study attempted to examine factors related to early neonatal death based on perinatal death surveillance data in consideration of all the possible determinants of early neonatal death. Methods The national perinatal death surveillance data were used for this study. A total of 3814 reviewed perinatal deaths were included in the study. Bayesian multilevel parametric survival analysis was employed to identify factors affecting the survival of newborns during the early neonatal period. Adjusted time ratio (ATR) with 95% Bayesian credible intervals (CrI) was reported and log-likelihood was used for model comparison. Statistical significance was declared based on the non-inclusion of 1.0 in the 95% CrI. Result More than half (52.4%) of early neonatal deaths occurred within the first two days of birth. Per the final model, as gestational age increases by a week the risk of dying during the early neonatal period is reduced by 6% [ATR = 0.94,95%CrI:(0.93–0.96)]. There was an increased risk of death during the early neonatal period among neonates deceased due to birth injury as compared to neonates who died due to infection [ATR = 2.05,95%CrI:(1.30–3.32)]; however, perinates who died due to complication of an intrapartum event had a lower risk of death than perinates who died due to infection [ATR = 0.87,95%CrI:(0.83–0.90)]. As the score of delay one and delay three increases by one unit, the newborn’s likelihood of surviving during the early neonatal period is reduced by 4% [ATR = 1.04,95%CrI:(1.01–1.07)] and 21% [ATR = 1.21,95%CrI:(1.15–1.27)] respectively. Neonates born from mothers living in a rural area had a higher risk of dying during the early neonatal period than their counterparts living in an urban area [ATR = 3.53,95%CrI:(3.34–3.69)]. As compared to neonates treated in a primary health facility, being treated in secondary [ATR = 1.14,95%CrI:(1.02–1.27)] and tertiary level of care [ATR = 1.15,95%CrI:(1.04–1.25)] results in a higher risk of death during the early neonatal period. Conclusion The survival of a newborn during the early neonatal period is determined by both individual (gestational age, cause of death, and delay one) and facility (residence, type of health facility and delay three) level factors. Thus, to have a positive early neonatal outcome, a tailored intervention is needed for the three major causes of death (i.e Infection, birth injury, and complications of the intrapartum period). Furthermore, promoting maternal health, improving the health-seeking behaviour of mothers, strengthening facility readiness, and narrowing down inequalities in service provision are recommended to improve the newborn’s outcomes during the early neonatal period.

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Mdoe, Paschal, Sifaeli Katengu, Godfrey Guga, Vickfarajaeli Daudi, Ibrahim Ernest Kiligo, Joshua Gidabayda, Catherine Massay, Felix Mkini et Estomih Mduma. « Perinatal mortality audit in a rural referral hospital in Tanzania to inform future interventions : A descriptive study ». PLOS ONE 17, n^o 3 (11 mars 2022) : e0264904. http://dx.doi.org/10.1371/journal.pone.0264904.

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Background Clear evidence exists that perinatal audit and feedback can lead to important improvements in practice. The death audit can lead to the identification of existing potential delays which are the decision to seek medical care, reaching an appropriate facility, and receiving timely adequate care at the facility. Such an audit potentially initiates a positive discussion, which may foster the implementation of changes that aims at saving more lives. Objective To review the perinatal deaths case notes and identify potential gaps in care provision and health-seeking behavior to foster best practice. Methods The stillbirths and neonatal death case notes that occurred between January 2019 and May 2020 at the hospital were reviewed using an adapted WHO checklist. The completed review case notes were entered into an electronic system and a quality control check-up was done. Data were analysed descriptively, and findings were presented in tables. Results There were 4,898 births, and 1,175 neonatal admissions, out of these there were 135 recorded stillbirths (2.8%) and 201(4.1% of the total hospital births) early neonatal deaths. Out of the 1,175 neonates, 635 (54%) were born within the hospital and 540 (46%) were admitted from other facilities and home deliveries. In total 86 stillbirths and 140 early neonatal deaths case notes were retrieved and audited. Out of 86 stillbirths’ case notes audited, 30 (34.9%) seemed to have died during labor, and of these 5 had audible fetal heart rate during admission. Apgar scores less than 7 at 5 minutes, prematurity, and meconium aspiration were the top three recorded causes of neonatal deaths. Inadequate/late antenatal care visits and home delivery were the maternal factors likely to have contributed to perinatal deaths. Inadequate labor monitoring (12%) and documentation (62%) were among the providers’ factors likely to have contributed to perinatal deaths. Conclusion This audit shows that there are high rates of preventable intrapartum stillbirths and early neonatal deaths. Both women and providers’ factors were found to have contributed to the stillbirths and neonatal deaths. There is a need to encourage women to adequately attend antenatal care, utilize health facilities during birth, and improve maternity and neonatal care at the health facilities.

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Muzammil, K., JV Singh et R. Shankar. « Verbal autopsy of neonatal deaths in Khatauli Block of District Muzaffarnagar, Uttar Pradesh, India ». Nepal Journal of Epidemiology 4, n^o 5 (31 décembre 2014) : 423–27. http://dx.doi.org/10.3126/nje.v4i5.12019.

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BackgroundVerbal autopsy is a method of inquiry to ascertain the likely cause of death in populations where vital registration of deaths is incomplete and unreliable. Over 75% of deaths in India occur at homes; more than half of these do not have a certified cause. Further, most of the deaths in the rural areas of India occur at home and that is why a medical certification by a qualified practitioner is not possible. Keeping these facts in mind, this study was designed having objectives as to find out the causes of neonatal deaths through verbal autopsy and its feasibility to be used by health workers.Material & Methods:This cross-sectional epidemiological study was conducted in randomly selected rural areas of Khatauli Block of District Muzaffarnagar, Uttar Pradesh, India. Verbal autopsy data was collected by a team of health workers adequately trained for the same well in advance. Data related to reported neonatal deaths in the study area in the specified period of time was collected on structured & pre-tested questionnaire used as study tool by interviewing the parents, relatives or neighbours of the deceased. Data thus collected was verified twice by the coordinator and principal investigator respectively and analyzed by using Epi info statistical package.Results:A total of 24 perinatal deaths were reported, out of which 7 (29.2%) were stillbirth and 17 (70.8%) were neonatal deaths. ANC was received by 14 mothers (58.3%). Half of the deliveries were conducted by untrained Dai. About 20 deliveries (83.3%) were at home and 10 (58.8%) of the deceased were early neonates. The cause of deaths found by means of verbal autopsies were mainly: pneumonia - 4 (23.5%), diarrhoea - 2 (11.8%) neonatal jaundice - 03 (17.6%) etc.Conclusion:Pneumonia, diarrhoea & neonatal jaundice alone constitute about 53% of the total neonatal deaths. The use of the verbal autopsy tool by health workers to find out the cause of neonatal deaths is very much feasible.DOI: http://dx.doi.org/10.3126/nje.v4i5.12019 Nepal Journal of Epidemiology 2014; 4(5):423-27

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Heráclio, Isabela de Lucena, Maysa Almeida da Silva, Mirella Bezerra Rodrigues Vilela, Conceição Maria de Oliveira, Paulo Germano de Frias et Cristine Vieira do Bonfim. « Epidemiological investigation of perinatal deaths in Recife-Pernambuco : a quality assessment ». Revista Brasileira de Enfermagem 71, n^o 5 (octobre 2018) : 2519–26. http://dx.doi.org/10.1590/0034-7167-2017-0916.

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ABSTRACT Objective: to evaluate the completeness of perinatal death investigation sheets, stratified by age components. Method: descriptive study carried out in Recife, PE, in 2014. Among 308 perinatal deaths, 46 were excluded from this study due to association with congenital malformations, and 7 due to missing investigation sheets. Analysis included 255 deaths (160 fetal deaths, and 95 preterm neonatal deaths). The degree of completeness of 98 variables was calculated. They were aggregated into six blocks: identification, prenatal care, birth care, family characteristics, occurrence of death and conclusions and recommendations. Results: the median rate of completeness for perinatal death investigation sheets was 85.7% (82.8% for records of fetal deaths and 89.5% for records of preterm neonatal deaths). The best-filled information block was “identification” (96.1%), as well as its components: fetal (94.7%) and preterm neonatal (97.9%). The worst was “prenatal care” (69.8%), along with its components: fetal (73.8%) and preterm neonatal (67.4%). Conclusion: investigation sheets had good completeness; there were differences between variables and components of perinatal death.

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Tiedje, Linda Beth. « Neonatal Survival 1:4 Million Neonatal Deaths ». MCN, The American Journal of Maternal/Child Nursing 32, n^o 6 (novembre 2007) : 386. http://dx.doi.org/10.1097/01.nmc.0000298141.77902.5a.

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Madewell, Zachary J., Cynthia G. Whitney, Sithembiso Velaphi, Portia Mutevedzi, Sana Mahtab, Shabir A. Madhi, Ashleigh Fritz et al. « Prioritizing Health Care Strategies to Reduce Childhood Mortality ». JAMA Network Open 5, n^o 10 (21 octobre 2022) : e2237689. http://dx.doi.org/10.1001/jamanetworkopen.2022.37689.

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ImportanceAlthough child mortality trends have decreased worldwide, deaths among children younger than 5 years of age remain high and disproportionately circumscribed to sub-Saharan Africa and Southern Asia. Tailored and innovative approaches are needed to increase access, coverage, and quality of child health care services to reduce mortality, but an understanding of health system deficiencies that may have the greatest impact on mortality among children younger than 5 years is lacking.ObjectiveTo investigate which health care and public health improvements could have prevented the most stillbirths and deaths in children younger than 5 years using data from the Child Health and Mortality Prevention Surveillance (CHAMPS) network.Design, Setting, and ParticipantsThis cross-sectional study used longitudinal, population-based, and mortality surveillance data collected by CHAMPS to understand preventable causes of death. Overall, 3390 eligible deaths across all 7 CHAMPS sites (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) between December 9, 2016, and December 31, 2021 (1190 stillbirths, 1340 neonatal deaths, 860 infant and child deaths), were included. Deaths were investigated using minimally invasive tissue sampling (MITS), a postmortem approach using biopsy needles for sampling key organs and fluids.Main Outcomes and MeasuresFor each death, an expert multidisciplinary panel reviewed case data to determine the plausible pathway and causes of death. If the death was deemed preventable, the panel identified which of 10 predetermined health system gaps could have prevented the death. The health system improvements that could have prevented the most deaths were evaluated for each age group: stillbirths, neonatal deaths (aged &lt;28 days), and infant and child deaths (aged 1 month to &lt;5 years).ResultsOf 3390 deaths, 1505 (44.4%) were female and 1880 (55.5%) were male; sex was not recorded for 5 deaths. Of all deaths, 3045 (89.8%) occurred in a healthcare facility and 344 (11.9%) in the community. Overall, 2607 (76.9%) were deemed potentially preventable: 883 of 1190 stillbirths (74.2%), 1010 of 1340 neonatal deaths (75.4%), and 714 of 860 infant and child deaths (83.0%). Recommended measures to prevent deaths were improvements in antenatal and obstetric care (recommended for 588 of 1190 stillbirths [49.4%], 496 of 1340 neonatal deaths [37.0%]), clinical management and quality of care (stillbirths, 280 [23.5%]; neonates, 498 [37.2%]; infants and children, 393 of 860 [45.7%]), health-seeking behavior (infants and children, 237 [27.6%]), and health education (infants and children, 262 [30.5%]).Conclusions and RelevanceIn this cross-sectional study, interventions prioritizing antenatal, intrapartum, and postnatal care could have prevented the most deaths among children younger than 5 years because 75% of deaths among children younger than 5 were stillbirths and neonatal deaths. Measures to reduce mortality in this population should prioritize improving existing systems, such as better access to antenatal care, implementation of standardized clinical protocols, and public education campaigns.

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S., Gunasekhar Raju, et Somasekhara Rao S. « A study of neonatal morbidity and mortality in government general hospital, Srikakulam Andhra Pradesh, India ». International Journal of Contemporary Pediatrics 6, n^o 4 (27 juin 2019) : 1485. http://dx.doi.org/10.18203/2349-3291.ijcp20192573.

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Background: Four million newborn babies die in the neonatal period, India 1.2 million neonatal deaths every year. India contributes for a quarter of global neonatal deaths and thus faces the biggest newborn health challenge of any country in the world. The aims of the study were done with the objective to conclude the morbidity and mortality pattern of neonates admitted to a neonatal intensive care unit (NICU).Methods: Hospital based prospective study was conducted at NICU Government Medical Collage, Srikakulam, Andhra Pradesh, India. Neonates from admission to discharge flowed, LAMA or death collecting the data by using a predesigned standardized preform.Results: Neonates were admitted in the NICU during period April 2014 to March 2019. The data analysis for the morbidity showed that the neonatal jaundice (NNJ) were 765(10.57%) , septicemia were 1110 (15.34%), prematurity were 593 (8.19%), birth asphyxia were 963 (13.30%), respiratory distress syndrome (RDS) were 184 (2.54%),hypoxic ischemic encephalopathy (HIE) were 984 (8.46%), meconium aspiration syndrome (MAS)were 612 (8.46%),transient tachypnea of neonate (TTN) were 634 (8.76%), low birth weight (LBW) were 418 (5.77%), intra uterine growth retardation (IUGR) were 179 (2.47%), congenital anomalies were 131 (1.81%), meningitis were 83 (1.15%), seizure disorder were 49 (0.68%) and others. The disease wise mortality among the neonates admitted to NICU was studied and were found that prematurity 212 (35.75%), septicemia were 74 (6.67%), birth asphyxia were 91 (21.70%), meconium aspiration syndrome were 70 (11.44%) and respiratory distress syndrome were 66 (35.87%), low birth weight were 102 (24.40%) congenital anomalies were 31 (23.66%) the top major contributors to the neonatal mortality.Conclusions: The commonest causes of admission were neonatal jaundice (NNJ), sepsis, prematurity, meconium aspiration syndrome, birth asphyxia, low birth weight, congenital anomalies. The most common cause of case fatality was prematurity, meconium aspiration syndrome, birth asphyxia, low birth weight, congenital anomalies in NICU in a tertiary care teaching hospital, government medical college, Srikakulam, Andhra Pradesh, India.

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Rai, Sanjay Kumar, Shashi Kant, Rahul Srivastava, Priti Gupta, Puneet Misra, Chandrakant Sambhaji Pandav et Arvind Kumar Singh. « Causes of and contributors to infant mortality in a rural community of North India : evidence from verbal and social autopsy ». BMJ Open 7, n^o 8 (août 2017) : e012856. http://dx.doi.org/10.1136/bmjopen-2016-012856.

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ObjectiveTo identify the medical causes of death and contribution of non-biological factors towards infant mortality by a retrospective analysis of routinely collected data using verbal and social autopsy tools.SettingThe study site was Health and Demographic Surveillance System (HDSS), Ballabgarh, North IndiaParticipantsAll infant deaths during the years 2008–2012 were included for verbal autopsy and infant deaths from July 2012 to December 2012 were included for social autopsy.Outcome measuresCause of death ascertained by a validated verbal autopsy tool and level of delay based on a three-delay model using the INDEPTH social autopsy tool were the main outcome measures. The level of delay was defined as follows: level 1, delay in identification of danger signs and decision making to seek care; level 2, delay in reaching a health facility from home; level 3, delay in getting healthcare at the health facility.ResultsThe infant mortality rate during the study period was 46.5/1000 live births. Neonatal deaths contributed to 54.3% of infant deaths and 39% occurred on the first day of life. Birth asphyxia (31.5%) followed by low birth weight (LBW)/prematurity (26.5%) were the most common causes of neonatal death, while infection (57.8%) was the most common cause of post-neonatal death. Care-seeking was delayed among 50% of neonatal deaths and 41.2% of post-neonatal deaths. Delay at level 1 was most common and occurred in 32.4% of neonatal deaths and 29.4% of post-neonatal deaths. Deaths due to LBW/prematurity were mostly followed by delay at level 1.ConclusionA high proportion of preventable infant mortality still exists in an area which is under continuous health and demographic surveillance. There is a need to enhance home-based preventive care to enable the mother to identify and respond to danger signs. Verbal autopsy and social autopsy could be routinely done to guide policy interventions aimed at reduction of infant mortality.

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Eshete, Akine, Abebe Alemu et Taddes Alemu Zerfu. « Magnitude and Risk of Dying among Low Birth Weight Neonates in Rural Ethiopia : A Community-Based Cross-Sectional Study ». International Journal of Pediatrics 2019 (16 mai 2019) : 1–8. http://dx.doi.org/10.1155/2019/9034952.

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Background. Even if remarkable progress has been made in reducing preventable child deaths worldwide, neonatal mortality reduction has remained unsatisfactory. Low birth weight (LBW) is the major risk factor for child deaths during the neonatal period, yet only 5% of babies are weighed at birth in Ethiopia. The aim of the present study was to determine the magnitude and risk of dying among low birth weight neonates in rural Gedeo, Southern Ethiopia. Methods. Community-based mixed-method approach design was employed between September and October 2016 to identify and enroll study participants in rural Gedeo, Southern Ethiopia. Records of 17,503 live birth babies, of whom 2,065 (11.8%) had LBW, born in the last 12 months were screened to identify 885 (42.8%) biological mother–LBW neonate pairs from eight health centers. The study subjects were randomly selected using a multistage stratified cluster sampling technique. Cox proportional hazards regression model was used to predict maternal and neonatal risk factors associated with the risk of neonatal death. Results. The overall neonatal mortality rate (NMR) among LBW infants was 110 per 1000 live births (95% confidence interval: 75 –228). Close to half, 374 (42.3%), of the LBW neonates died during the first week of life. The estimated hazard ratios of mortality were higher among neonates whose mothers did not attend antenatal care (ANC) (HR=1.58, 95 % CI: 1.02-2.43), gave birth by assisted or cesarean delivery (HR=1.81 and 3.72; 95% CI: 1.10 - 3.02 and 2.11-6.55), and experienced some form of illness during pregnancy (HH=3.34, 95 % CI: 2.11-5.29), respectively. Similarly, neonates born with very low (<2000gm) birth weight and born prematurely (before 37 weeks of gestation) carried a higher (HR= 1.90 and 1.47; 95 % CI: 1.22 - 2.96 and 1.07-2.28) risk of death. On the other hand, maternal formal education was found to be the single protective factor (HR= 0.65,95 % CI: 0.43-0.99). Conclusion. Nearly one in every ten (11%) of neonates die before celebrating their firth month of life, mainly during the first week in rural Ethiopia. The risk of dying from LBW during the neonatal period is almost fourfold of the current estimated national NMR. Maternal obstetric characteristics and fetal maturity were predictors of mortality.

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Dessu, Samuel, Aklilu Habte, Tamirat Melis et Mesfin Gebremedhin. « Survival Status and Predictors of Mortality among Newborns Admitted with Neonatal Sepsis at Public Hospitals in Ethiopia ». International Journal of Pediatrics 2020 (22 septembre 2020) : 1–10. http://dx.doi.org/10.1155/2020/8327028.

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Background. One-fourth of neonatal death is due to neonatal sepsis and nearly 98% of these deaths are occurring at low- and middle-income countries. In Ethiopia, forty percent of under-five mortality occurs during the neonatal period, of which neonatal sepsis accounts for 30-35% of neonatal deaths next to prematurity and its complications. On the other side, among the survived neonates with neonatal sepsis, there exist as vulnerable to short and long-term neurological and developmental morbidity impacting the overall productivity of the child as adult. Methods. A longitudinal prospective cohort study was conducted among selected 289 neonates with neonatal sepsis who were admitted in the neonatal intensive care unit at public hospitals in Ethiopia from 1st March 2018 to 31st December 2019. Data were entered into Epi data version 3.02 and exported to SPSS V 25 for analysis. The Kaplan-Meier survival curve together with log-rank test was used to estimate the survival time of the neonates. Variables which had p value < 0.05 in multivariable analysis using the cox proportional hazard model were declared as statistically significant predictors of mortality. Results. The study was conducted with a total of 289 neonates admitted with neonatal sepsis. The cumulative proportion of surviving at the end of the fourth day was 99.5%, and it was 98.2% at the end of the fifth day. In addition, it was 96.6%, 93.5%, and 91.1% at the end of the sixth, seventh, and eighth day, respectively. The incidence of mortality was 8.65 per 100 neonates admitted with neonatal sepsis. Having a history of intrapartum fever (AHR: 14.5; 95% CI: 4.25, 49.5), history of chorioamnionitis (AHR: 5.7; 95% CI: 2.29, 13.98), induced labor (AHR: 7; 95% CI: 2.32, 21.08), and not initiating exclusive breastfeeding within one hour (AHR: 3.4; 95% CI: 1.34, 12.63) were the independent predictors of mortality. Conclusion. The survival status of neonates among neonates admitted with neonatal sepsis was high at the early admission days and high cumulative proportion of death as the admission period increased. The risk of mortality was high among the neonates with early onset of neonatal sepsis as compared with late onset of neonatal sepsis and history of intrapartum fever, history of diagnosed chorioamnionitis, onset of labor, and EBF initiation within one hour were the independent predictors of mortality among neonates admitted with neonatal sepsis.

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Rasheed, Hiba A., Huda Al Jadiry et Eman A. Al-Kaseer. « Neonatal mortality rates at Al-Sadar city 2015 – 2019 ». Technium BioChemMed 3, n^o 2 (15 juin 2022) : 74–80. http://dx.doi.org/10.47577/biochemmed.v3i2.6430.

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Neonatal mortality is an index for newborn care and maternal health care. It is a useful indicator for obstetrical and neonatal healthcare services quality and availability. It is influenced by environmental, economic and social factors. Therefore, it is a measure of socio-economic status and health system. The study was a cross sectional one. It was conducted at Al Resafa side in Baghdad city. The requested data were reviewed from medical records (sex, cause of death, etc.). Chi-square was used to show the impact of dependent variables (death causes) on the independent variables (sex, and type of neonatal death). P value < 0.05 was considered statistically significant. The results showed number of neonatal deaths per 1000 livebirths ranged from 19.30-19.08 per 1000 livebirths between 2015 - 2019 respectively. Males had the highest neonatal deaths through studied years (54.8%, 54.5%, 56.4%, 57.2%, and 59 respectively). Prematurity (487, 32.1%), and respiratory distress syndrome (387, 25.5%) were significantly the common causes of early neonatal deaths. Sepsis (216, 30.1%), and respiratory distress syndrome (149, 20.8%) were significantly the main late neonatal deaths causes (kh 2= 429.582, p value = 0.001). Both males and females mainly died from prematurity (340, 285; 27%, 29.2% respectively). The distribution of causes of neonatal death were significantly varied between sexes (kh2= 20.782, p value= 0.001). In conclusions, neonatal mortality rate is high in the studied period. Two thirds of neonatal death occurred early.

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Pandita, Kawal Krishen. « Distance from referral hospital as a risk factor for mortality and length of stay of neonates admitted in a tertiary care hospital ». International Journal Of Community Medicine And Public Health 6, n^o 11 (24 octobre 2019) : 4912. http://dx.doi.org/10.18203/2394-6040.ijcmph20195079.

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Background: Around 66% of infant and over 50% of under-five mortality occurs in newborn period. 99% of neonatal deaths occur in low and middle income countries. Most of these deaths can be prevented by suitable interventions at various levels. The premise of the study is that the neonates who require long transportation (>1 hour) have higher chances of mortality or prolonged stay in the hospital.Methods: A retrospective retrieval of data and prospective interview was conducted in G.B Pant children’s hospital Srinagar, an associated hospital of Govt. Medical College Srinagar in North India.Results: During the period of study 1431 neonates from twelve districts of the state were referred to the hospital for treatment, out of whom, 102 (7.13%) could not be saved. Neonatal death rate was found highest (11.11%) in neonates referred from districts of category-III (>100 kms from the referral hospital), followed by category-II (50-100 kms from the referral hospital) and category-I (>50 kms from the referral hospital). Average length of stay was observed longest for the neonates referred from districts of category-III followed by category-II and category-I.Conclusions: Several other studies found that transfer of sick neonates from another health facility were associated with relatively higher probability of morbidity and mortality after controlling for other predictors. Distance no doubt is a risk factor for neonatal outcome of referred neonates as we have observed in our study. To minimize neonatal deaths it is necessary to strengthen the perinatal services sick newborn care unit {(SNCUs) in district Hospitals)}.

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He, Mai, Alison R. Migliori, Patricia Lauro, C. James Sung et Halit Pinar. « Perinatal Mortality Associated with Positive Postmortem Cultures for Common Oral Flora ». Infectious Diseases in Obstetrics and Gynecology 2017 (2017) : 1–9. http://dx.doi.org/10.1155/2017/9027918.

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Introduction. To investigate whether maternal oral flora might be involved in intrauterine infection and subsequent stillbirth or neonatal death and could therefore be detected in fetal and neonatal postmortem bacterial cultures.Methods. This retrospective study of postmortem examinations from 1/1/2000 to 12/31/2010 was searched for bacterial cultures positive for common oral flora from heart blood or lung tissue. Maternal age, gestational age, age at neonatal death, and placental and fetal/neonatal histopathological findings were collected.Results. During the study period 1197 postmortem examinations (861 stillbirths and 336 neonatal deaths) were performed in our hospital with gestational ages ranging from 13 to 40+ weeks. Cultures positive for oral flora were identified in 24 autopsies including 20 pure and 8 mixed growths (26/227, 11.5%), found in 16 stillbirths and 8 neonates. Microscopic examinations of these 16 stillbirths revealed 8 with features of infection and inflammation in fetus and placenta. The 7 neonatal deaths within 72 hours after birth grew 6 pure isolates and 1 mixed, and 6 correlated with fetal and placental inflammation.Conclusions. Pure isolates of oral flora with histological evidence of inflammation/infection in the placenta and fetus or infant suggest a strong association between maternal periodontal conditions and perinatal death.

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Bhuiyan, Md M., et M. S. Mohammad. « Outcomes of Neonates with Perinatal Asphyxia at a Tertiary Academic Hospital ». Journal of Medical Science & ; Research 24, Number 1 (1 janvier 2015) : 8–12. http://dx.doi.org/10.47648/jmsr.2015.v2401.02.

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Perinatal asphyxia causes about 0.92 million newborn death annually world wide and it is about 21% of the neonatal mortality in Bangladesh which is second to death due to severe infections and its related death. The Retrospective observational study was done to evaluate the outcome of perinatal asphyxia in Neonatal Intensive Care Unit (NICU) of Holy Family Red Crescent Medical College Hospital.from October 2013 to December 2014. Total 327 asphyxiated neonates full filling the inclusion criteria admitted in NICU (both in born & out born, term and preterm). Out of these 59% male patients and 41 % female term, 22% of the asphyxiated patient term unit and 77% preterm. Total deaths among these were 27. Out of these 2 deaths belongs to term units also had some associated neonatal infections and 25 deaths belongs to preterm who had also some other complications related to prematurity. The study results show that predictors of survival were mode of delivery, place of birth and resuscitation at birth. Elective caesarean section was associated with improved outcomes. The study confirms that perinatal asphyxia remains a significant problem at HFRCMCH. The high overall survival and survival after NICU admission provide a benchmark for further care.

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GHOSH, ROHINI, et ARUN KUMAR SHARMA. « INTRA- AND INTER-HOUSEHOLD DIFFERENCES IN ANTENATAL CARE, DELIVERY PRACTICES AND POSTNATAL CARE BETWEEN LAST NEONATAL DEATHS AND LAST SURVIVING CHILDREN IN A PERI-URBAN AREA OF INDIA ». Journal of Biosocial Science 42, n^o 4 (5 mars 2010) : 511–30. http://dx.doi.org/10.1017/s0021932010000040.

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SummaryNearly a quarter of the world's neonatal deaths take place in India. The state of Uttar Pradesh alone accounts for one-quarter of all neonatal deaths in the country. In this study 892 married women aged less than 50 years living in a peri-urban area of Kanpur city in Uttar Pradesh were interviewed. In all, 109 women reported neonatal deaths. Characteristics of the last neonatal deaths of these 109 women were compared with those of the last surviving children. Also, characteristics of women who had a neonatal death were compared with those of 783 women who had no neonatal death. It was found that as compared with neonatal deaths, the last surviving children of the 109 women had: (a) significantly better antenatal tests during pregnancy, intake of iron/folic acid tablets and higher percentage of tetanus toxoid immunization; (b) safer delivery practices such as a higher percentage of institutional delivery, sterilization of instruments and application of antiseptic after removal of umbilical cord; (c) postnatal care, such as application of antiseptic to the navel and postnatal checkups; and (d) higher maternal age and greater birth spacing. Likewise, better antenatal care and safer delivery practices and postnatal care were observed among the 783 women with no neonatal deaths, when compared with women who had experienced neonatal death. The complexities of inter- and intra-household differences in health care are discussed. The paper concludes that to improve child survival general education and awareness regarding safe delivery should be increased. Continuing cultural stigmas and misconceptions about birth practices before, during and after childbirth should be an important part of the awareness campaigns.

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Adatara, Peter, Agani Afaya, Solomon Mohammed Salia, Richard Adongo Afaya, Kennedy Diema Konlan, Eric Agyabeng-Fandoh, Ethel Agbinku, Esther Aku Ayandayo et Irene Gifty Boahene. « Risk Factors Associated with Neonatal Sepsis : A Case Study at a Specialist Hospital in Ghana ». Scientific World Journal 2019 (1 janvier 2019) : 1–8. http://dx.doi.org/10.1155/2019/9369051.

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Worldwide, neonatal sepsis accounts for an estimated 26% of under-five deaths, with sub-Saharan Africa having the highest mortality rates. Though worldwide neonatal deaths have decreased by over 3.6 million per year since 2000, neonatal sepsis remains a notable hindrance to the progress in the decline of cause-specific mortality rates especially in sub-Saharan Africa. This study aimed at examining the risk factors of neonatal sepsis at the Trauma and Specialist Hospital, Winneba. The study was an unmatched case control retrospective study. Cases were neonates who had sepsis with their index mothers and controls were neonates who did not have sepsis with their index mothers. Neonatal and maternal medical records were retrieved from January to December 2017. Data abstraction lasted for one month and 2650 folders for the neonates and their index mothers were retrieved. Nine hundred (900) neonatal folders were considered valid for the study and likewise for the maternal folders. One hundred and three (103) folders were considered cases while 797 were considered as controls. Data were entered using the Statistical Package for Social Sciences Version 22. Logistic regression was used to determine the risk of neonatal sepsis. Maternal factors that predicted the occurrence of sepsis among neonates were parity (p<0.027), mode of delivery (p<0.001), bleeding disorder (p<0.001), and PROM (p<0.001). Neonatal risk factors which predicted the occurrence of sepsis were APGAR score in the first and fifth minute (p<0.001), resuscitation at birth (p<0.004), duration of stay in the facility (p<0.001), and neonatal age on admission (p<0.001). The study found both maternal and neonatal factors to have a strong association with the risk of developing neonatal sepsis. Encouraging maternal antenatal care utilization would help identify the risk factors during prenatal and postnatal care and appropriate interventions implemented to reduce the likelihood of the neonate developing sepsis.

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D., Anuradha, Rajesh Kumar S., Aravind M. A., Jayakumar M. et J. Ganesh J. « A profile on the spectrum of neonatal mortality and morbidity pattern of extramural neonates in the Specialised Neonatal Care Unit (SNCU) in a tertiary care hospital ». International Journal of Contemporary Pediatrics 5, n^o 2 (22 février 2018) : 427. http://dx.doi.org/10.18203/2349-3291.ijcp20180529.

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Background: Every year, nearly four million newborn babies die in the first month of life. India carries the single largest share (around 25-30%) of neonatal deaths in the world. Neonatal deaths constitute two thirds of infant deaths in India. 45% of the deaths occur within the first two days of life. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively at the appropriate time. It was further estimated that health facility-based interventions can reduce neonatal mortality by 23-50% in different settings. Facility-based newborn care, thus, has a significant potential for improving the survival of newborns in India. This research has been planned with an aim to study the profile of pattern of admissions in a SNCU and their outcomes following admission and management in the unit.Methods: All babies referred for neonatal problems (less than 28 days) and admitted in NICU will be included. Both term and preterm babies will be considered. The criteria for admission includes various causes like low birth weight, preterm, birth asphyxia, respiratory distress, hyperbilirubinemia, congenital anomalies, risk factors (maternal, neonatal, prenatal), infections and outcome will be analysed.Results: Among the 2927 admissions term babies and boys outnumbered. The common causes for admission were birth asphyxia, respiratory distress, low birthweight and preterm. Most babies had an uncomplicated stay. The mortality in the extramural neonates was due to neonatal sepsis, extreme preterm and congenital malformations.Conclusions: Intensive and interventional management, along with good neonatal monitoring and care can reduce the mortality and improve the survival of low birth weight babies and other treatable problems. Thus, a combined effort of management by pediatricians, nursing care, neonatal intensive care unit can improve the survival rates of neonates.

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Sheikh, Daud Abdi. « Morbidity, Mortality Patterns and Factors Associated With Mortality among Neonates Admitted in Wajir County Referral Hospital ». Journal of Medicine, Nursing & ; Public Health 5, n^o 3 (10 novembre 2022) : 83–109. http://dx.doi.org/10.53819/81018102t2106.

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Background: Neonatal morbidity and mortality is a global burden despite management measures that has been developed. Approximately 75% of all newborn deaths occur in the first week of life. In 2018 alone, around 2.5 million neonates died globally as a result of preventable causes such as prematurity, complications at birth, infections, and congenital abnormalities. Objective: The objective of the study was to determine neonatal morbidity and mortality patterns, and factors associated with mortality among neonates admitted in Wajir County Referral Hospital. Methodology: A hospital-based retrospective cross-sectional study was conducted among all neonates admitted to the New Born Unit of the WCRH from 01 January 2019 to 31 December 2020. A consecutive sampling technique based on the inclusion criteria was used. A data abstraction tool was used to extract data from the medical records of neonates admitted to the New Born Unit of the hospital. Results: A total of 615 neonates were included in the study. There were 336 (54.6%) male and 279 (45.4%) female neonates. Almost all the deliveries 566 (92.0%) were performed at the health facility with a minority of about 49 (8%) delivered at home. The home deliveries and referrals admissions from tertiary hospitals together were 66 (10.7%). Neonatal morbidity included birth asphyxia 335 (54.5%), neonatal sepsis 144 (23.4%), 57 (9.3%) meconium aspiration syndrome and 52 (8.5%) low birth weight/preterm. Overall mortality in 2019 at the health facility was 45 (12.97%) and in 2020, 35 (13.06%) presenting no significant difference. The deaths that occurred in the first 24 hours of life was 36 (45%). Bivariate and multivariate analysis produced a significant association between the factors associated with neonatal mortality. The multivariate analysis with day of admission (OR 2.872, 95% CI 1.293, 6.375), Sex, (OR 1.02, 95% CI 1.0.627, 1.66) and Birth weight, (OR 0.936, 95% CI 0.423, 2.068) at p<0.05. The logistic regression model was statistically significant, χ2(7) = 20.770, p <0.001. The model explained 27% (Nagelkerke R2) of the variance in discharge outcome and correctly classified 87% of cases. The male gender were 1.02 times more likely to die than females while the place of delivery was 0.572 times likely to result in death. Conclusions: Birth asphyxia was found to be the leading cause of admission, followed by neonatal sepsis and meconium aspiration syndrome respectively. The leading cause of death was birth asphyxia and neonatal sepsis. The mortality rate at the facility was 13%. Neonatal fatality of the newborns admitted to NBU is high in Wajir County. Since majority of the deaths are from preventable causes, this offers chances to improve newborn survival. Key Words: Morbidity, Mortality, Neonates, Asphyxia

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Suzuki, Ayako, Mitsuaki Matsui, Rathavy Tung et Azusa Iwamoto. « "Why did our baby die soon after birth?"—Lessons on neonatal death in rural Cambodia from the perspective of caregivers ». PLOS ONE 16, n^o 6 (7 juin 2021) : e0252663. http://dx.doi.org/10.1371/journal.pone.0252663.

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Introduction Neonatal deaths represent around half the deaths of children less than five-years old in Cambodia. The process from live birth to neonatal death has not been well described. This study aimed to identify problems in health care service which hamper the reduction of preventable neonatal deaths in rural Cambodia. Methods This study adopted a method of qualitative case study design using narrative data from the verbal autopsy standard. Eighty and forty villages were randomly selected from Kampong Cham and Svay Rieng provinces, respectively. All households in the target villages were visited between January and February 2017. Family caregivers were asked to describe their experiences on births and neonatal deaths between 2015 and 2016. Information on the process from birth to death was extracted with open coding, categorized, and summarized into several groups which represent potential problems in health services. Results Among a total of 4,142 children born in 2015 and 2016, 35 neonatal deaths were identified. Of these deaths, 74% occurred within one week of birth, and 57% were due to low-birth weight. Narrative data showed that three factors should be improved, 1) the unavailability of a health-care professional, 2) barriers in the referral system, and 3) lack of knowledge and skill to manage major causes of neonatal deaths. Conclusion The current health system has limitations to achieve further reduction of neonatal deaths in rural Cambodia. The mere deployment of midwives at fixed service points such as health centers could not solve the problems occurring in rural communities. Community engagement revisiting the principle of primary health care, as well as health system transformation, is the key to the solution and potential breakthrough for the future.

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Sindan, Namrata, Sandeep Shrestha, Bishnu Dutta Acharya, Purnima Rai, Nirajana Kayastha, Adheesh Bhandari et Namita Sindan. « Status of Perinatal Mortality in Karnali Academy of Health Sciences, Jumla Nepal ». Journal of Karnali Academy of Health Sciences 2, n^o 2 (7 août 2019) : 120–25. http://dx.doi.org/10.3126/jkahs.v2i2.25178.

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Introduction: Perinatal mortality rate is sensitive indicator of quality of obstetric and pediatric health services. It also helps us to evaluate efficiency of health care provided by a particular hospital. The aim of this study was to evaluate the cause of perinatal death in a tertiary care medical centre, which may help to reduce the incidence of perinatal death and improve the quality of care. Methods: The two-year retrospective study of perinatal deaths was done at Karnali Academy of Health Sciences (KAHS), Jumla from March 2017 to April 2019. Data was collected from monthly perinatal audit and annual mortality reviews. Registers in the maternity ward, sick Neonate Care Unit, and files of dead newborns kept in the record section of the hospital were studied and reviewed. Results: A total of 1354 deliveries were conducted in the 24 months period at KAHS with perinatal mortality rate of 36.08 per 1000 total birth and early neonatal death rate of 12.8 per 1000 live birth. The Perinatal mortality was higher in low birth weight and premature baby. The cause of stillbirth and early Neonatal death were identified. Most of the early neonatal death was due to Prematurity (41.17%) followed by Birth Asphyxia and Neonatal Sepsis. Conclusion: Prematurity and its related complication were the most common cause of early neonatal death followed by birth Asphyxia and Neonatal Sepsis. There is need to improve antenatal, early identification of high-risk pregnancy as well as Neonatal Intensive Care Unit (NICU) to further reduce deaths due to prematurity and birth asphyxia.

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Basaula, Yuba Nidhi, Radha Kumari Paudel et Ram Hari Chapagain. « Trends and Determinants of Perinatal Mortality in a Tertiary Care Hospital of Nepal ». Medical Journal of Shree Birendra Hospital 20, n^o 1 (2 février 2021) : 77–82. http://dx.doi.org/10.3126/mjsbh.v20i1.29133.

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Introduction: Perinatal mortality rate (PMR) in Nepal is still very high. In major hospitals of Nepal, it is still ranging from 20 to 30 per thousand births. This study was carried out to review the different aspects of PMR and classifying them and identify the causes of perinatal and neonatal deaths and assessing the need for improvement in quality of pregnancy and newborn care. Methods: It was a retrospective study carried out in Bharatpur Hospital, Chitawan, Nepal. Data of all stillbirths from 22 weeks of pregnancy and neonatal deaths up to seven days of life was taken from monthly perinatal audit and annual mortality review. The data was taken from July 2017 to Jun 2019. All the perinatal deaths were then classified. Results: Over a two year period, there were total 25,977 births and total death was 369. Thus perinatal mortality rate was 12.3 per thousand births. Still births (fresh and macerated) contributed almost 82.4% of the perinatal deaths and neonatal death contributed 17.6% of total deaths. Deaths related to unexplained intrauterine fetal death (IUFD) showed an increasing trend and have increased by more than 20% in past two years from 39.1% to 60.8%. Deaths due to perinatal asphyxia, neonatal sepsis, respiratory distress syndrome and extreme prematurity were increased. Conclusions: PMR over the two years has shown increasing trend at our institute. There is need to improve antenatal, obstetric as well as intra-partum services to further reduce the still birth as well as deaths due to prematurity, RDS, neonatal sepsis and perinatal asphyxia.

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Ugbem, Theophilius, Ima-Obong Ekanem, Ima-Abasi Bassey, Martin Nnoli, Godwin Ebughe, Ogban Omoronyia et David Ushie. « Neonatal Deaths and Autopsy Rates in a Nigerian Tertiary Hospital : A 10-Year Trend Analysis in University of Calabar Teaching Hospital, Calabar, Nigeria ». Recent Advances in Biology and Medicine 03 (2017) : 131. http://dx.doi.org/10.18639/rabm.2017.03.513787.

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The pains and challenges of pregnancy and delivery are made worse when the resultant neonate dies. Fortunately, many of these neonatal deaths can be prevented if autopsies are routinely conducted to ascertain the immediate and remote causes of death toward subsequent prevention. Unfortunately, there is paucity of studies on neonatal autopsy rates (NARs) in many developing countries, with few reports indicating unacceptably low rates. This study was therefore aimed at assessing the trend in neonatal deaths and autopsy rates in Calabar, Nigeria. Trend analysis of retrospective data obtained from medical records of neonatal deaths and deliveries was conducted. Neonatal mortality rate (NMR) and NAR were obtained for each of the years within 2004-2013. Ethical approval was obtained from the ethical committee of University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. In the 10-year study period, there were 22,916 deliveries with a male:female ratio of 1:0.95. There were 1136 neonatal deaths, yielding a total NMR of 49.6 per 1000 live births (ranging from 26.7 in 2011 to 93.7 in 2004). Bimodal peak in NMR was found at 2008 and 2012. Eighty six neonatal autopsies were conducted within the study period yielding a mean autopsy rate of 7.57%, ranging from 0% in 2008 to 25.0% in 2013. This study found unacceptably high NMR and low NAR in the study setting. There was, however, gradual decrease in mortality and increase in autopsy rates through the study period. It is essential to redouble the efforts at improving public health education and awareness on the relevance of autopsy toward improved health service delivery. Similar studies are recommended in other similar and dissimilar settings.

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