Neonatal mortality in the urban and rural China between 1996 and 2013: a retrospective study

Lu, Ruifeng; Li, Xiaohong; Guo, Sufang; Wang, Huiqing; Zhu, Jun; He, Chunhua; Li, Qi; Kang, Lakhwinder Singh; Wang, Yanping; Tang, Jun; Mu, Dezhi

doi:10.1038/pr.2016.6

Cited by 11 publications

(10 citation statements)

References 26 publications

(31 reference statements)

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“… 10 , 11 A retrospective study on the neonatal mortality rates in China from the last two decades revealed that 4/5th of the total mortality was due to premature birth, congenital abnormalities, or pneumonia and that the scenario has improved lately in both urban and rural areas since then. 14 Interhospital variations in prescribing treatments and microbiological diversity may differ among different regions of the country. Hence, a comparative study on the prevalence, microbial profile, prescribing patterns, and hospital diagnosis of different hospitals may be useful for health care professionals and researchers to realize and rectify the gaps in the prevention of the disease and to set novel/updated treatment guidelines.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology, microbiology, and treatment patterns of pediatric patients hospitalized with pneumonia at two hospitals in China: a patient chart review study

Wen¹,

Jia²,

Xue³

et al. 2018

TCRM

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BackgroundThe etiology, epidemiology, treatment patterns, and clinical outcomes of neonatal and pediatric pneumonia patients in China are not well reported. This retrospective chart review study aimed to describe such information among neonatal (0 to 27 days) and pediatric (28 days to <18 years) pneumonia patients in two regions of China.MethodsElectronic medical records of pneumonia hospitalizations (aged <18 years) admitted between 2008 and 2013 from four hospitals under Guangdong Provincial Hospital of Chinese Medicine (Southern China) and between 2010 and 2014 at Peking University People’s Hospital (Beijing, Northern China) were reviewed.ResultsThe average age of neonatal hospitalizations in Beijing (n=92) was 3.5 days. The mean length of hospital stay was 11.2 days, and no deaths occurred. Staphylococcus epidermidis was the most common bacteria found in Beijing patients, whereas Mycoplasma pneumoniae was the most common bacteria found in Guangdong patients. The average age of pediatric hospitalizations was 3.3 (±3.1) and 6.5 (±5.6) years in Guangdong (n=3,046) and Beijing (n=222), respectively. The mean length of hospital stay was 17.4 and 5.8 days, and overall mortality rates were 0.2% and 0.5%.ConclusionThe findings revealed a low level of bacterial isolation and hence microbiological diagnoses. There was a low level of in-hospital mortality due to pneumonia, and the majority of hospitalizations were discharged from hospital, suggesting that current practice was generally effective. Neonatal hospitalizations were greater than pediatric hospitalizations in Beijing along with disparity in bacterial profile when compared with Guangdong, intending a need to improve neonatal pneumonia prophylaxis and selection of appropriate treatment.

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Section: Introductionmentioning

confidence: 99%

Epidemiology, microbiology, and treatment patterns of pediatric patients hospitalized with pneumonia at two hospitals in China: a patient chart review study

Wen¹,

Jia²,

Xue³

et al. 2018

TCRM

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“…The early neonatal mortality rate was surprisingly low, although it was consistent with that found in other studies. 48 While early neonatal mortality rates in the NMNMSS may be biased downward, there is no reason for this to have changed over time. Fourthly, the Robson classification has been recommended as the most appropriate to compare caesarean section rates, 32 49 but we were unable to separate women who had spontaneous labour from those who delivered after induction or had a caesarean section before labour, a critical element in understanding caesarean section rates.…”

Section: Discussionmentioning

confidence: 99%

Relaxation of the one child policy and trends in caesarean section rates and birth outcomes in China between 2012 and 2016: observational study of nearly seven million health facility births

Liang

et al. 2018

BMJ

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170

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ObjectiveTo examine how the relaxation of the one child policy and policies to reduce caesarean section rates might have affected trends over time in caesarean section rates and perinatal and pregnancy related mortality in China.DesignObservational study.SettingChina’s National Maternal Near Miss Surveillance System (NMNMSS).Participants6 838 582 births at 28 completed weeks or more of gestation or birth weight ≥1000 g in 438 hospitals in the NMNMSS between 2012 and 2016.Main outcome measuresObstetric risk was defined using a modified Robson classification. The main outcome measures were changes in parity and age distributions and relative frequency of each Robson group, crude and adjusted trends over time in caesarean section rates within each risk category (using Poisson regression with a robust variance estimator), and trends in perinatal and pregnancy related mortality over time.ResultsCaesarean section rates declined steadily between 2012 and 2016 (crude relative risk 0.91, 95% confidence interval 0.89 to 0.93), reaching an overall hospital based rate of 41.1% in 2016. The relaxation of the one child policy was associated with an increase in the proportion of multiparous births (from 34.1% in 2012 to 46.7% in 2016), and births in women with a uterine scar nearly doubled (from 9.8% to 17.7% of all births). Taking account of these changes, the decline in caesarean sections was amplified over time (adjusted relative risk 0.82, 95% confidence interval 0.81 to 0.84). Caesarean sections declined noticeably in nulliparous women (0.75, 0.73 to 0.77) but also declined in multiparous women without a uterine scar (0.65, 0.62 to 0.77). The decrease in caesarean section rates was most pronounced in hospitals with the highest rates in 2012, consistent with the government’s policy of targeting hospitals with the highest rates. Perinatal mortality declined from 10.1 to 7.2 per 1000 births over the same period (0.87, 0.83 to 0.91), and there was no change in pregnancy related mortality over time.ConclusionsChina is the only country that has succeeded in reverting the rising trends in caesarean sections. China’s success is remarkable given that the changes in obstetric risk associated with the relaxation of the one child policy would have led to an increase in the need for caesarean sections. China’s experience suggests that change is possible when strategies are comprehensive and deal with the system level factors that underpin overuse as well as the various incentives at work during a clinical encounter.

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“…In 2010 hospital-based maternal near miss monitoring which collects in-depth information about maternal severe morbidity, and in 2012 population-based under-5 child nutrition data which on children's growth and anemia, In addition, MCHSS has set up a vertical and hierarchical data quality assurance mechanism to ensure the accuracy of core health indicators. [34][35][36] China has also established other national MCH information systems, such as the monitoring system for MCH Institutions Surveillance System, Major MCH Projects Information System, and Neonatal Disease Screening Information System, which are used to monitor the development of MCH institutions, evaluate the effect of MCH projects, and monitor the progress of intervention services for birth defects.…”

Section: Mch Information Systemmentioning

confidence: 99%

A Lancet Commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China

et al. 2021

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Neonatal mortality in the urban and rural China between 1996 and 2013: a retrospective study

Cited by 11 publications

References 26 publications

Epidemiology, microbiology, and treatment patterns of pediatric patients hospitalized with pneumonia at two hospitals in China: a patient chart review study

Epidemiology, microbiology, and treatment patterns of pediatric patients hospitalized with pneumonia at two hospitals in China: a patient chart review study

Relaxation of the one child policy and trends in caesarean section rates and birth outcomes in China between 2012 and 2016: observational study of nearly seven million health facility births

A Lancet Commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China

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