Measuring maternal, foetal and neonatal mortality: Challenges and solutions

Blencowe, Hannah; Calvert, Clara; Lawn, Joy E; Campbell, Oona M. R.

doi:10.1016/j.bpobgyn.2016.05.006

Cited by 42 publications

(49 citation statements)

References 63 publications

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“…In practice, these statistics likely considerably underestimate the impact of HI given that many countries do not have robust maternal and perinatal mortality and morbidity databases (Blencowe et al . ).…”

Section: The Global Burden Of Hypoxic–ischaemic Brain Injurymentioning

confidence: 97%

“…Further, creating maternal and perinatal mortality and morbidity databases will help determine risk factors and the success of interventions (Blencowe et al . ). Importantly, however, it is the advances we must make in our scientific understanding about the adaptation of the fetus and the neonate to adverse events (both injurious and endogenously protective) that will allow us to unravel the complexity of the pathological causes underpinning perinatal mortality and morbidity.…”

Section: The Global Burden Of Hypoxic–ischaemic Brain Injurymentioning

confidence: 97%

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The fetus at the tipping point: modifying the outcome of fetal asphyxia

Dhillon

Lear

Galinsky

et al. 2018

The Journal of Physiology

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Brain injury around birth is associated with nearly half of all cases of cerebral palsy. Although brain injury is multifactorial, particularly after preterm birth, acute hypoxia-ischaemia is a major contributor to injury. It is now well established that the severity of injury after hypoxia-ischaemia is determined by a dynamic balance between injurious and protective processes. In addition, mothers who are at risk of premature delivery have high rates of diabetes and antepartum infection/inflammation and are almost universally given treatments such as antenatal glucocorticoids and magnesium sulphate to reduce the risk of death and complications after preterm birth. We review evidence that these common factors affect responses to fetal asphyxia, often in unexpected ways. For example, glucocorticoid exposure dramatically increases delayed cell loss after acute hypoxia-ischaemia, largely through secondary hyperglycaemia. This critical new information is important to understand the effects of clinical treatments of women whose fetuses are at risk of perinatal asphyxia.

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Section: The Global Burden Of Hypoxic–ischaemic Brain Injurymentioning

confidence: 97%

Section: The Global Burden Of Hypoxic–ischaemic Brain Injurymentioning

confidence: 97%

The fetus at the tipping point: modifying the outcome of fetal asphyxia

Dhillon

Lear

Galinsky

et al. 2018

The Journal of Physiology

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“…Reducing the NMR is still an important health topic in the developing countries and it is also the 4th objective of the Millennium Development Goals, which drags huge attentions (3,4). Neonatal mortality is defined as the death of newborns in their first 28 days of life or the neonatal period (5,6).…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Related to the Neonatal Mortality in Kurdistan Province, Iran: A Population-Based Case-Control Study

et al. 2017

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Background: Neonatal mortality rate (NMR) is one of the most important health indicators in the world. Objectives: The current study aimed at determining the factors influencing neonatal mortality in Kurdistan province, Northwest of Iran. Methods: The current population-based case-control study was conducted in 2013. Cases were neonates who passed away within their first 28 days of life, in Kurdistan. The controls were selected among neonates who were born in the closest time and place to the case group. Data were collected using a questionnaire through interviews by a trained questioner. Chi-square, Fisher exact test, and logistic regression were used to analyze the data. All analyses were conducted by SPSS version 19. Results: A significant difference was observed between the neonatal mortality and the place of residence, maternal education level, maternal passive smoking, age, neonate birth weight, type of delivery, and nutrition. Maternal passive smoking during the previous year, pregnancy interval of less than 3 years, placental abruption, age, birth weight, malformations, and asphyxia were the most important factors associated with neonatal mortality. Conclusions:To reduce the NMR, in addition to follow-up and application of national guidelines, other necessary factors including the regionalization of the maternal and neonatal cares, planning, and development of programs with the focus on the causes and risk factors of neonatal mortality in Kurdistan province should be considered.

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“…The large disparity in stillbirth rates seen in maternal near‐miss cases across different countries, from 3.8% in Finland to as high as 46% in low‐ to middle‐income countries, is probably attributable to substandard management of complications. However, measurement challenges prevail in low‐resource settings, restricting a direct comparisons of rates across different settings.…”

Section: Introductionmentioning

confidence: 99%

“…in low-to middle-income countries, [10][11][12][13][14] is probably attributable to substandard management of complications. However, measurement challenges prevail in low-resource settings, 15 restricting a direct comparisons of rates across different settings.…”

Section: Introductionmentioning

confidence: 99%

Disentangling the contributions of maternal and fetal factors to estimate stillbirth risks for intrapartum adverse events in Tanzania and Uganda

Hirose

Alwy

Atuhairwe

et al. 2018

Intl J Gynecology & Obste

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Objective To estimate the stillbirth risk associated with intrapartum adverse events, controlling for fetal and maternal factors. Methods The present study was an analysis of cross‐sectional patient‐record and facility‐file data from women with viable fetuses who experienced obstetric adverse events at 23 hospitals and 38 health centers in Tanzania (between December 2015 and October 2016), and 22 hospitals, 16 level‐4 health centers, and five level‐3 health centers in Uganda (between May 2016 and September 2017). Adverse events were categorized in three severity groups (postpartum, intrapartum non‐near‐miss, and intrapartum near‐miss) to calculate stillbirth rates and adjusted prevalence ratios. Results Data from 3816 women in Tanzania and 8305 in Uganda were included. Compared with postpartum adverse events, intrapartum near‐miss was associated with a 3.73‐ and 4.55‐fold higher prevalence of stillbirth in Uganda and Tanzania, respectively. Most women who experienced near‐miss had organ dysfunction on arrival or developed it soon after. The risk of stillbirth was higher among preterm deliveries compared with term deliveries, and was 42% and 59% lower in Tanzania and Uganda, respectively, for cesarean deliveries compared with vaginal deliveries after intrapartum non‐near‐miss adverse events. Conclusion Stillbirth risk increased with severity of complications and was higher among premature deliveries. Survival was higher for cesarean deliveries in intrapartum non‐near‐miss complications, identifying the opportunity to prevent deterioration by timely actions.

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Measuring maternal, foetal and neonatal mortality: Challenges and solutions

Cited by 42 publications

References 63 publications

The fetus at the tipping point: modifying the outcome of fetal asphyxia

The fetus at the tipping point: modifying the outcome of fetal asphyxia

Risk Factors Related to the Neonatal Mortality in Kurdistan Province, Iran: A Population-Based Case-Control Study

Disentangling the contributions of maternal and fetal factors to estimate stillbirth risks for intrapartum adverse events in Tanzania and Uganda

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