A Selected Review of the Mortality Rates of Neonatal Intensive Care Units

Chow, Selina; Chow, Ronald; Popovic, Mila; Lam, Michael; Popović, Marko; Merrick, Joav; Margalit, Ruth Naomi Stashefsky; Lam, Henry; Milakovic, Milica; Chow, Edward; Popović, Jelena

doi:10.3389/fpubh.2015.00225

Cited by 61 publications

(63 citation statements)

References 34 publications

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“…The VLBW survival in our unit was significantly less than that reported in the VON [www.vtoxford.org] for the same period (69.1% vs. 85.6%). Neonatal mortality rates among different neonatal units are highly variable, but the rates reported in the present study are within the reported range for developing nations [3]. The current neonatal survival rates are better than those reported from NICUs in The Gambia [4] and Ethiopia [15], but worse than those reported from a NICU in Thailand [16].…”

Section: Discussionsupporting

confidence: 46%

“…This is particularly true when using data from a high-income country to address problems experienced in low-to middle-income countries (LMICS). A recent review of the mortality rates in neonatal intensive care units showed that the rate varied considerably between different countries [3]; the mortality rate was generally high, but greater in developing than developed countries. Issues such as the lack of antenatal care and inadequate health facilities are the causes of neonatal mortality in LMICS.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Survival to Discharge of Newborns in a Middle-Income Country

Ballot¹,

Chirwa²

2016

Epidemiology of Communicable and Non-Communicable Diseases - Attributes of Lifestyle and Nature on Humankind

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Clinical and mortality audit is an essential part of quality improvement in health care; information obtained in this process is used to develop targeted interventions to improve outcome. This study aimed to determine predictors of short-term survival in neonates. An existing neonatal database was reviewed. A total of 5018 neonates > 400 g admitted to a tertiary hospital (Johannesburg South Africa) between 1 January 2013 and 31 December 2015 were analysed. Mean birth weight was 2148 g (standard deviation [SD]: 972) and mean gestational age was 34.2 weeks (SD: 4.8). Overall survival was 85.6% (4294/5018). The most common causes of death were prematurity (46.2%), hypoxia (19.5%) and infection (17.2). The strongest predictors of survival were birth weight (OR 1.0; 95% confidence intervals (CI): 1.0-1.01) and gestational age (OR = 1.1, 95% CI: 1.05-1.17). Other predictors of survival included metabolic acidosis (OR = 0.14, 95% CI: 0.09-0.20), hyperglycemia (OR = 0.31, 95% CI: 0.23-0.41), mechanical ventilation (OR = 0.35, 95% CI: 0.28-0.46), major birth defect (OR = 0.12, 95% CI: 0.08-0.18), resuscitation at birth (OR = 0.39, 95% CI: 0.31-0.49) and Caesarean section (OR = 1.8, 95% CI: 1.44-2.25). In conclusion, resources need to be focused on improved care of VLBW infants.

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Section: Discussionsupporting

confidence: 46%

Section: Introductionmentioning

confidence: 99%

Factors Associated with Survival to Discharge of Newborns in a Middle-Income Country

Ballot¹,

Chirwa²

2016

Epidemiology of Communicable and Non-Communicable Diseases - Attributes of Lifestyle and Nature on Humankind

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“…Those who had neonatal sepsis were nearly two times increase risk of mortality as compared to those who did not have sepsis. This finding is supported by a result in developed and developing country [19] [48] [7], [49] , [50] [51], ( [52], [53]. The possible reason might be due to newborns have many physiologic challenges when adapting to the extrauterine environment which might contributed to common problem like immature immunity, RDS., neurologic, cardiovascular, hematologic, nutritional, gastrointestinal and poor thermoregulation which farther increase risk of sepsis and mortality.…”

Section: Discussionmentioning

confidence: 53%

“…Globally, the neonatal mortality rate (NMR) is declined from 49 % to 19%, but slower than under five mortality rate (dropped by 60%) .Of all death of under-five , 40% were attributed with new born death [5] in which close to 1 and 2 million deaths occur on the day of birth, and in the first week of life respectively [6]. A review of 20 studies also indicated that the total NMR greatly varied between developed (4 to 46% ) and developing (0.2 to 64.4%) countries [7]. Despite this, NMR shares the highest proportion of under-five mortality worldwide.…”

Section: Introductionmentioning

confidence: 99%

The magnitude of neonatal mortality and its predictors in Ethiopia: a systematic review and meta-analysis

Asmare

Shibabaw

Akalu

et al. 2019

Preprint

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AbstractsBackground: Although neonatal death is a global burden, it is the highest in Sub Saharan Africa countries such as Ethiopia. This study was aimed to provide pooled national prevalence and predictors of neonatal mortality in Ethiopia. Objective:To assess the pooled prevalence and predictors of neonatal mortality in Ethiopia.Search Strategy: global databases were systematically explored. Systematically searched using the following databases: Boolean operator, Cochrane library, PubMed, EMBASE, HINARI, and Google Scholar. Selection, screening, reviewing and data extraction was done by two reviewers independently using Microsoft excel spread sheet. The modified Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute Prevalence Critical Appraisal tools were used to assess the quality of evidence Selection criteria: All studies conducted in Ethiopia and reporting the prevalence and predictors of neonatal mortality were included Data Collection and Analysis: Data were extracted using a Microsoft Excel spreadsheet software and imported into STATA Version 14 s for further analysis. The pooled effect size with 95% confidence interval of neonatal mortality rate was determined using a weighted inverse variance random-effects model. Publication bias was checked using funnel plots, Egger's and bagger's regression test. Heterogeneity also checked by Higgins's method. A random effects meta-analysis model was computed to estimate the pooled effect size (i.e. prevalence and odds ratio). Moreover, subgroup analysis based on region, sample size and study design were done. Results:After reviewing 88 studies, 12 studies fulfilled the inclusion criteria and were included in the meta-analysis. The pooled national prevalence of neonatal mortality in Ethiopia was 16.3% (95% CI: 11.9, 20.7, I 2 =88.6%). The subgroup analysis indicated that the highest prevalence was observed in Amhara region with a prevalence of 20.3% (95% CI: 9.6, 31.1, I 2 =98.8) followed by Oromia, 18.8% (95%CI: 11.9,49.4, I 2 =99.5). Gestational age AOR,1.14 (95% CI: 0.94 ,1.3), neonatal sepsis (OR:1.2(95% CI: 0.8, 1.5), respiratory distros (OR: 1.2(95% CI: 0.8, 1.5) and place of residency (OR:1.93 (95% CI:1.1,2.7) were the most important predictor.Conclusions: neonatal mortality in Ethiopia was significantly decreased than the national report.There was evidence that neonatal sepsis, gestational age, respiratory distress were the significant predictors. We strongly recommended that health care workers should give a priority for the identified predictors.

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“…1 There is significant reduction in under five mortality rates but newborn mortality have reduced much slowly. [2][3][4] Prematurity, birth asphyxia and infections are three important causes of neonatal deaths.…”

Section: Introductionmentioning

confidence: 99%

Morbidities and Outcome of a Neonatal Intensive Care in Western Nepal

Adhikari

Rao

Ganesh

et al. 2017

J Nepal Health Res Council

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Background: Neonatal mortality rate of developing countries is declining over decades. In the recent years increasing number of preterm and high risk neonates have facilities for tertiary care treatment. The aim of the study was to assess the morbidities and outcome of neonatal intensive care admissions.Methods: It was a retrospective observational study carried out in neonatal intensive care unit of the Manipal Teaching Hospital, Pokhara, Nepal from January 2014 to December 2015. Neonatal details including place of delivery, birth weight, gestation, diagnosis at admission, hospital course and final outcome were recorded in predesigned proforma. Risk of mortality was calculated using odds ratio and 95% confidence interval. Results: There were total 1708 admission during study period and inborn as well as out born neonates were equally admitted. Neonatal hyperbilirubinemia (37.1%), neonatal sepsis 532 (31.2%), prematurity, 314 (18.4%) perinatal asphyxia 112 (6.6%), meconium aspiration syndrome 79 (4.6%) and intrauterine growth restriction 49 (2.8%) were main indications for hospitalization. A total of 1410 (82.6%) the patients were discharged after treatment, 167 (9.7) left against medical advice, 115 (6.7%) died in hospital and 16 (1%) cases were referred. Preterm neonates had twice the risk of mortality than term neonates (OR =2.1664). Birth weight < 2500 grams had three times more risk of neonatal mortality than normal birth weight (OR =3.0783).Conclusions: Neonatal hyperbilirubinemia, prematurity and neonatal sepsis were common morbidities inneonatal intensive care unit.

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A Selected Review of the Mortality Rates of Neonatal Intensive Care Units

Cited by 61 publications

References 34 publications

Factors Associated with Survival to Discharge of Newborns in a Middle-Income Country

Factors Associated with Survival to Discharge of Newborns in a Middle-Income Country

The magnitude of neonatal mortality and its predictors in Ethiopia: a systematic review and meta-analysis

Morbidities and Outcome of a Neonatal Intensive Care in Western Nepal

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