Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan

Jehan, Imtiaz; Harris, Hillary; Salat, Sohail; Zeb, Amna; Mobeen, N; Pasha, Omrana; McClure, Elizabeth M.; Moore, Janet; Wright, Linda L.; Goldenberg, Robert L.

doi:10.2471/blt.08.050963

Cited by 211 publications

(237 citation statements)

References 15 publications

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“…The highest rates of perinatal mortality were confi rmed in other studies conducted in diff erent Brazilian states (8,9,15,17) . These results did not diff er from other studies conducted in La n America, Europe and USA (16,(18)(19)(20) . In the United Kingdom in 2010, the highest rates of neonatal mortality were related to low birth weight and gesta onal age less than 31 weeks (21) .…”

Section: Discussionsupporting

confidence: 30%

“…In the urban area of Pakistan-South Asia, between 2003 and 2005, all of the neonatal deaths (1,280) 73.0% occurred in the early neonatal period due to premature birth, 34% from neonatal asphyxia, and 23% due to neonatal infec ons (18) . In the U.S.A., the rela onship between Apgar score and neonatal mortality of preterm newborns, between 2001 and 2002, showed that the increased risk of neonatal anoxia (score 0-6) occurred among newborns with gesta onal age of 24-28 weeks (average of 6).…”

Section: Discussionmentioning

confidence: 99%

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Fatores determinantes da mortalidade neonatal em um município da Região Sul do Brasil

Ferrari

Bertolozzi

Dalmas

et al. 2013

Rev. esc. enferm. USP

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RESUMO ABSTRACTThis is an ecological quantitative study to identify risk factors that determined neonatal death between the years of 2000 to 2009 in Londrina, Paraná, using data from Birth Cer fi cates, Death Cer fi cates and Infant Death Inves ga on Forms. The variables maternal age, years of educa on, family income, occupa on, marital status, type of delivery, and number of prenatal appointments were not associated to neonatal death. To the contrary, birth weight, gestational age, Apgar score at 1 and 5 minutes, and place of birth were iden fi ed as sta s cally signifi cant variables. More than 73.0% of newborns died within early neonatal period. The predominant basic cause of death was perinatal problems (77.7%), 72.6% of which were preventable, and the majority of which could be reduced with adequate control over pregnancy/ birth. These results highlight the need for investments in prevention of premature delivery by improvement of health care in prenatal and birth periods, in an equanimous, accessible and comprehensive manner in all levels of maternal and child health care. DESCRIPTORS Infant mortality Risk factors Cause of death Neonatal nursing Ecological studies RESUMENInves gación cuan ta va de po ecológico objetivando identificar los factores de riesgo que determinaron el deceso neonatal en el municipio de LondrinaParaná entre 2000 y 2009. Se verificó que la edad materna, escolaridad, renta familiar, ocupación, situación conyugal, tipo de parto y número de consultas prenatales no se asocian al fallecimiento. Mientras tanto, el peso al nacer, la edad gestacional, el índice de Apgar en los minutos 1 y 5 y el lugar del parto sí mostraron significatividad estadística. Más del 73,0% de los recién nacidos fallecieron en el período neonatal precoz. La causa predominante fue afección perinatal (77,7%), considerándose que 72,6% de las muertes fueron evitables, y la mayoría, reducible por control adecuado del embarazo y parto. Tales resultados refuerzan la necesidad de inversiones en prevención del parto prematuro con atención prenatal y al parto equita vo, accesible e integral entre los diferentes niveles de atención de la salud materno-infan l.

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Section: Discussionsupporting

confidence: 30%

Section: Discussionmentioning

confidence: 99%

Fatores determinantes da mortalidade neonatal em um município da Região Sul do Brasil

Ferrari

Bertolozzi

Dalmas

et al. 2013

Rev. esc. enferm. USP

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show abstract

“…Earlier reports indicated that in Pakistan, the mortality rate was 78 (range 78 to 100) per 1,000 live births [19][20], contrary to current study results, may be due to the facility-based approach. A separate study reported early neonatal mortality up to first 7 days of life as 70 neonatal deaths per 1,000 live births, and late perinatal mortality from 8 to 28 days of life was reported as 47 neonatal deaths per 1,000 live births [21]. Neonatal deaths may be averted if healthcare facilities provide evidence-based interventions such as provision of skilled maternal and immediate neonatal care, emergency obstetric care, antibiotics for preterm premature rupture of membranes, and antenatal corticosteroids for preterm labour during the intrapartum period [17].…”

Section: Discussionmentioning

confidence: 99%

Infection remains a leading cause of neonatal mortality among infants delivered at a tertiary hospital in Karachi, Pakistan

Mustufa

Korejo

Shahid

et al. 2014

J Infect Dev Ctries

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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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“…The quality of such care is highly important: training of community health workers without adequate triage and referral is unlikely to reduce the burden of stillbirths and early neonatal mortality. 28 The fact that no diff erences were noted for stillbirths and perinatal deaths between facility-based and community-based births in one urban setting in Pakistan 29 underscores the importance of staff training and high quality of care.…”

Section: Provision Of Basic and Comprehensive Emergency Obstetric Carmentioning

confidence: 99%

Stillbirths: what difference can we make and at what cost?

Bhutta¹,

Yakoob²,

Lawn³

et al. 2011

The Lancet

263

171

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Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan

Cited by 211 publications

References 15 publications

Fatores determinantes da mortalidade neonatal em um município da Região Sul do Brasil

Fatores determinantes da mortalidade neonatal em um município da Região Sul do Brasil

Infection remains a leading cause of neonatal mortality among infants delivered at a tertiary hospital in Karachi, Pakistan

Stillbirths: what difference can we make and at what cost?

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