Rates and determinants of neonatal mortality in two rural sub-districts of Sylhet, Bangladesh

Kibria, Gulam Muhammed Al; Khanam, Rasheda; Mitra, Dipak Kumar; Mahmud, Arif; Begum, Nazma; Moin, Syed Mamun Ibne; Saha, Samir K.; Baqui, Abdullah H

doi:10.1371/journal.pone.0206795

Cited by 31 publications

(40 citation statements)

References 44 publications

(73 reference statements)

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“…Prior studies that assessed socio-demographic factors for NNM, have not established a signi cant association between NNM and maternal education [7,15,18,26,41]. However, a universal association between maternal education and neonatal mortality, especially in the low-income countries, has been demonstrated [39,59,61,62], and supports current study's ndings. In addition, educated mothers are more likely to come from a higher socioeconomic status [59], have a better knowledge of healthy behaviours, have a more informed approach to self-care, make better health-related choices, and utilize the healthcare system appropriately [31,63].…”

Section: Discussionsupporting

confidence: 84%

“…Advanced maternal age [15] and under age (<18 years) [27] was signi cantly associated with NNM. Similarly, signi cant association has been reported between advanced maternal age [38,39,69] or younger age (< 20 years) [57,58,62], and adverse neonatal outcomes. Secondary analysis of the WHO multi-country survey on maternal and newborn health ndings showed that advanced maternal age signi cantly increased the risk of stillbirths and perinatal mortalities [77].…”

Section: Discussionmentioning

confidence: 83%

“…There was two-fold increase in stillbirth risk among women with more than one complications in Gambia [45]. Similarly, maternal obstetric complications have been shown to play a role in the underlying causes of neonatal deaths [39,70]. Therefore, early screening for poor obstetric conditions during the antenatal period and the appropriate management of intrapartum complications is crucial to ensure a reduction in the number of NNM cases.…”

Section: Discussionmentioning

confidence: 99%

“…This elucidates the likelihood of NNM affecting nulliparous women [20,32]. Prior studies have shown that rst-born infants are at higher risk of neonatal mortality than second-or third-born infants [37,39]. However, in some studies, parity was not shown to be associated with neonatal mortality [40].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

Rajbanshi

Hussain

2020

Preprint

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Background: Unlike the infant mortality rate, the rate of neonatal mortality has not declined and remains a major health challenge in the low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than the neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods: A hospital-based cross-sectional study was conducted at Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and number of gestational weeks were enrolled. The key inclusion criterion was the pragmatic and management markers of NNM, and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression analysis was performed using SPSS® version 24.0.Results: One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (AOR): 4.51, 95% confidence interval (CI): 2.07–9.84), maternal secondary (AOR: 0.46, 95% CI: 0.24–0.88) and tertiary education (AOR: 0.18, 95% CI: 0.05–0.56), multiparity (AOR: 0.52, 95% CI: 0.39–0.86), and caesarean section (AOR: 0.48, 95% CI: 0.19–0.99) were associated with NNM. Conclusions: The prevalence of NNM in Nepal was 7.9%. Mothers’ obstetric factors, maternal complications and education were associated with NNM. Referral hospitals should have safer access to caesarean section and be prepared to offer NICU intervention to save mothers and their newborns.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

Rajbanshi

Hussain

2020

Preprint

View full text Add to dashboard Cite

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“…This elucidates the likelihood of NNM affecting nulliparous women [32,38]. Prior studies have shown that first-born infants are at higher risk of neonatal mortality than the second-or thirdborn infants [43,45]. However, in some studies, parity was not shown to have an association with neonatal mortality [46].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

Rajbanshi

Hussain

2021

Preprint

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Background: Unlike the infant mortality rate, the rate of neonatal mortality has not significantly declined and remains a major health challenge in the low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods: A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and number of gestational weeks were enrolled. The key inclusion criterion was the pragmatic and management markers of NNM, and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0.Results: One thousand respondents were recruited. Prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI): 2.07–9.84), no education (aOR 2.16; 95% CI 1.12–4.14), multiparity (aOR 0.52; 95% CI 0.32–0.86), and caesarean section (aOR 0.44: 95% CI 0.19–0.99) were associated with NNM. Conclusions: Prevalence of NNM in Nepal was 7.9%. Mothers’ obstetric factors, maternal complications and education were associated with NNM. Women in referral hospitals should have safer access to caesarean section and be prepared for NICU intervention to save mothers and their newborns.

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Neonatal mortality and its predictors among neonates in Jabitehnan district, Northwest Ethiopia: A single‐arm retrospective cohort study

Dessie,

Nigatu,

Yadita

et al. 2023

Health Science Reports

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Background and AimsNeonatal period is the most vulnerable time in which children face the greatest risk of death. Worldwide, each year, millions of newborns died in the first month of life. Sub‐Saharan Africa, Ethiopia, in particular, is largely affected. However, there is a dearth of information regarding the survival status of neonates and determinants of their mortality in the study area. Therefore, this study was aimed at investigating neonatal mortality and its predictors in Jabitehnan district, Northwest Ethiopia.MethodA single‐arm community‐based retrospective cohort study was conducted in March 2021 among 952 neonates born between August 2020 and February 2021. Data were collected by a semi‐structured questionnaire, and a multistage stratified sampling technique was employed to select one urban and 10 rural kebeles from the district. Then, the total sample size was proportionally allocated to these selected kebeles. Neonatal death was ascertained by community diagnosis. Kaplan–Meier curve was used to estimate survival time. Cox regression was used to identify factors, the hazard ratio was estimated, and a p‐value < 0.05 was considered statistically significant.ResultsThe neonatal mortality rate was 44 (95% confidence interval [CI]: 33–60) per 1000 live births; and the incidence rate was 1.64 (95% CI: 1.21–2.23) per 1000 neonate days. Three‐quarters of deaths occurred in the first week of life. Medium household wealth index (adjusted hazard ratio [AHR] = 3.54; 95 CI: 1.21–10.35), increased number of pregnancies (AHR = 1.22; 95%CI: 1.01–1.47), being male (AHR = 2.45, 95% CI: 1.12–5.35) and not starting breastfeeding in the first hour of life (AHR = 4.00; 95% CI: 1.52–11.10) were found to be predictors of neonatal mortality.ConclusionNeonatal mortality was high compared to the national target. Wealth, number of pregnancies, sex of the neonate, and breastfeeding initiation were factors associated with neonatal death. Hence, strengthening interventions such as providing sexual education in the population, considering households with a medium wealth index in the exemption service, and counseling mothers about early breastfeeding initiation would improve neonatal survival.

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Rates and determinants of neonatal mortality in two rural sub-districts of Sylhet, Bangladesh

Cited by 31 publications

References 44 publications

Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

Neonatal mortality and its predictors among neonates in Jabitehnan district, Northwest Ethiopia: A single‐arm retrospective cohort study

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