Neonatal mortality in singleton pregnancies: a 20-year retrospective study from a tertiary perinatal unit in Hong Kong

Fung, Gabriel Pui Cheong; Lau, SL; Hui, Annie SY; Wong, Stan Hok-Wui; Tse, WT; Ng, PC; Sahota, D.S.; Lam, HS; Leung, Thomas

doi:10.12809/hkmj2210357

Cited by 3 publications

(4 citation statements)

References 34 publications

(42 reference statements)

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“…Time of birth in relation to discharge, environmental aspects, resource availability, referral rates and return for follow-up rates have all been identified as possible factors that impact the practicability and efficiency of screening in specific contexts. Ng, Hui, Lam, Goh, and Yeung (2004) report similar findings where newborns were missed in terms of hearing screening because of time of birth and discharge out of normal working hours. However, contrary to these findings, evidence also indicates highest coverage to take place for screening before discharge in non-South African contexts where discharge occurs after six hours post birth (Adelola, Papanikolaou, Gormley, Lang, & Keogh, 2010;Lim & Daniel, 2008).…”

supporting

confidence: 61%

Early Detection and Intervention in Audiology

Beswick¹,

Bornman²,

Casoojee³

et al. 2021

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All images remain the property of the copyright holders. The publishers gratefully acknowledge the publishers, institutions and individuals referenced in captions for the use of images. Every effort has been made to locate the original copyright holders of the images reproduced here; please contact Wits University Press in case of any omissions or errors. This book is freely available through the OAPEN library (www.oapen.org) under a CC-BY-NC-ND 4.0 Creative Commons License (https://creativecommons.org/ licenses/by-nc-nd/4.0/).

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supporting

confidence: 61%

Early Detection and Intervention in Audiology

Beswick¹,

Bornman²,

Casoojee³

et al. 2021

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“…The timing of the screening differed in these studies, with Attias et al (2006) having screened newborns more than 48 hours after birth and Mathur and Dhawan (2007)having conducted screening at 48 hours or less. Similar to the current study, Ng et al (2004) utilized a broad frequency range (1-6 kHz), with results yielding a 3.5% refer rate and a 3.1% false positive rate.…”

Section: Discussionmentioning

confidence: 86%

The Impact of Pass/Refer Criteria in the Use of Otoacoustic Emission Technology for Newborn Hearing Screening

Kanji

Naudé

2021

Am J Audiol

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Purpose The current study aimed to compare the specificity of transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) in isolation and in combination, with varying pass/refer criteria for DPOAE technology. Method A longitudinal, repeated-measures design was employed. The current study sample comprised 91 of the initial 325 participants who returned for the repeat screening and diagnostic audiological assessment within a risk-based newborn hearing screening program. Results TEOAE screening had the highest specificity in comparison to DPOAE screening at the initial and repeat screening, irrespective of differences in DPOAE pass/refer criteria. DPOAE screening had a slightly higher specificity, with a three out of six rather than the four out of six frequency pass criteria. Conclusions Pass/refer criteria alone do not influence referral rates and specificity. Instead, consideration of other factors in combination with these criteria is important. More research is required in terms of the sensitivity and specificity of OAE screening technology using repeated-measures and diagnostic audiological evaluation as the gold standard.

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Section: Introductionmentioning

confidence: 99%

“…Significant birth asphyxia is one of the major causes of stillbirths, neonatal death, infant death and adverse long‐term outcomes such as cerebral palsy and developmental delay. 1 , 2 , 3 , 4 Acute intrapartum hypoxic events such as placental abruption, uterine rupture, cord prolapse, and shoulder dystocia cause anaerobic metabolism, which can lead to rapid deterioration of umbilical cord arterial pH within a short period. 5 , 6 , 7 , 8 The effects of fetal acidosis have been associated with hypoxic ischemic encephalopathy (HIE), the need for cardiopulmonary resuscitation, intubation, seizures, cerebral palsy, developmental delay, and mortality.…”

Section: Introductionmentioning

confidence: 99%

Neonatal outcome of infants with umbilical cord arterial pH less than 7

Lau

Lok²,

Hui

et al. 2022

Acta Obstet Gynecol Scand

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Introduction Umbilical arterial pH of less than 7 is often used as the threshold below which the risks of neonatal death and adverse long‐term neurological outcomes are considered to be higher. Yet within the group with pH <7, the risks have not been further stratified. Here, we aimed to investigate the predictors of adverse long‐term outcomes of this group of infants. Material and methods This was a retrospective study of 248 infants born after 34 weeks of gestation in a tertiary obstetric unit, between 2003 and 2017, with cord arterial pH <7 or base excess ≤−12 mmol/L at birth. The infants were categorized into two groups: (1) intact survivors, or (2) neonatal/infant deaths or cerebral palsy or developmental delay. The umbilical arterial pH and base excess levels, Apgar scores, mode of delivery, gestational age, small for gestational age, birth in the era before the implementation of neonatal hypothermic therapy, and the presence of a known sentinel event, were compared between the groups using univariate analysis followed by multivariate analysis. Results Among the 248 infants, there were 222 intact survivors (89.5%) and 26 infants with poor outcomes (10.5%), including eight deaths (3.2%) and 18 (7.3%) with cerebral palsy and/or developmental delay. Univariate analysis showed that infants with adverse outcomes had significantly lower cord arterial pH (6.85 vs 6.95, with p < 0.001), lower cord arterial base excess (−19.95 vs −15.90 mmol/L, p < 0.001), a higher proportion of having AS at 5 min <7 (65.4% vs 13.1%, p < 0.001), and a higher proportion of having a sentinel event (34.6% vs 16.7%, p = 0.034). Multivariate analysis confirmed cord arterial pH of <6.9 and an Apgar score at 5 min <7 as independent prognostic factors (the adjusted odds ratios were 4.64 and 6.62, respectively). The risk of adverse outcome increased from 4.3% when the arterial pH was between 6.9 and <7, to 30% when the pH was <6.9. Conclusions Infants born with umbilical artery pH <7 still have a high chance of 89.5% to become intact survivors. A cord arterial pH of <6.9 and an Apgar score at 5 min <7 are independent prognostic factors for neonatal/infant death or adverse long‐term neurological outcomes.

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Neonatal mortality in singleton pregnancies: a 20-year retrospective study from a tertiary perinatal unit in Hong Kong

Cited by 3 publications

References 34 publications

Early Detection and Intervention in Audiology

Early Detection and Intervention in Audiology

The Impact of Pass/Refer Criteria in the Use of Otoacoustic Emission Technology for Newborn Hearing Screening

Neonatal outcome of infants with umbilical cord arterial pH less than 7

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