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Nwokoro UU, Dahiru T, Olorukooba A, Daam CK, Waziri HS, Adebowale A, Waziri NE, Nguku P. Determinants of perinatal mortality in public secondary health facilities, Abuja Municipal Area Council, Federal Capital Territory, Abuja, Nigeria. Pan Afr Med J 2020; 37:114. [PMID: 33425147 PMCID: PMC7755356 DOI: 10.11604/pamj.2020.37.114.17108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 09/08/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction in Nigeria, perinatal mortality rate remains high among births at the health facility. Births occur majorly at the secondary healthcare level in Abuja Municipal Area Council (AMAC) of the Federal Capital Territory (FCT). Identifying factors influencing perinatal deaths in this setting would inform interventions on perinatal deaths reduction. We assessed perinatal mortality and its determinants in public secondary health facilities in AMAC. Methods delivery and neonatal data from two selected public secondary health facilities between 2013 and 2016 were reviewed and we extracted maternal socio-demographics, obstetrics and neonatal data from hospital delivery, newborns´ admissions and discharge registers. Data were analyzed using descriptive statistics and Cox proportional hazard models (α = 5%). Results perinatal mortality rate was 129.5 per 1000 births. Asphyxia 475 (34.0%), neonatal infection 279 (20.0%) and prematurity 242 (17.3%) accounted for majority of the 1,398 perinatal deaths. Unbooked status [aHR = 1.8 (95% CI 1.4 - 2.2)], antepartum haemorrhage [aHR = 2.8 (95% CI 1.2 - 6.7)], previous perinatal death [aHR = 2.3 (95% CI 1.7 - 3.1)] and maternal age ≥ 35 years [aHR= 1.4 (95% CI 1.0 - 1.8)] were associated with increased risk of perinatal death. Conclusion perinatal mortality in the studied hospitals was high. Determinants of perinatal death were unbooked antenatal care (ANC) status, antepartum haemorrhage, previous perinatal death and high maternal age. Reducing perinatal deaths would require improving antenatal care attendance with healthcare staff identifying and targeting women at risk of pregnancy complications.
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Affiliation(s)
| | - Tukur Dahiru
- Department of Community Medicine, Faculty of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Abdulhakeem Olorukooba
- Department of Community Medicine, Faculty of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | | | | | - Ayo Adebowale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | | | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
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Anastasi E, Ekanem E, Hill O, Adebayo Oluwakemi A, Abayomi O, Bernasconi A. Unmasking inequalities: Sub-national maternal and child mortality data from two urban slums in Lagos, Nigeria tells the story. PLoS One 2017; 12:e0177190. [PMID: 28489890 PMCID: PMC5425188 DOI: 10.1371/journal.pone.0177190] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 04/24/2017] [Indexed: 11/26/2022] Open
Abstract
Introduction Nigeria has one of the highest maternal mortality ratios in the world as well as high perinatal mortality. Unfortunately, the country does not have the resources to assess this critical indicator with the conventional health information system and measuring its progress toward the goal of ending preventable maternal deaths is almost impossible. Médecins Sans Frontières (MSF) conducted a cross-sectional study to assess maternal and perinatal mortality in Makoko Riverine and Badia East, two of the most vulnerable slums of Lagos. Materials and methods The study was a cross-sectional, community-based household survey. Nearly 4,000 households were surveyed. The sisterhood method was utilized to estimate maternal mortality and the preceding births technique was used to estimate newborn and child mortality. Questions regarding health seeking behavior were posed to female interviewees and self-reported data were collected. Results Data was collected from 3963 respondents for a total of 7018 sisters ever married. The maternal mortality ratio was calculated at 1,050/100,000 live births (95% CI: 894–1215), and the lifetime risk of maternal death at 1:18. The neonatal mortality rate was extracted from 1967 pregnancies reported and was estimated at 28.4/1,000; infant mortality at 43.8/1,000 and under-five mortality at 103/1,000. Living in Badia, giving birth at home and belonging to the Egun ethnic group were associated with higher perinatal mortality. Half of the last pregnancies were reportedly delivered in private health facilities. Proximity to home was the main influencing factor (32.4%) associated with delivery at the health facility. Discussion The maternal mortality ratio found in these urban slum populations within Lagos is extremely high, compared to the figure estimated for Lagos State of 545 per 100,000 live births. Urgent attention is required to address these neglected and vulnerable neighborhoods. Efforts should be invested in obtaining data from poor, marginalized, and hard-to-reach populations in order to identify pockets of marginalization needing additional resources and tailored approaches to guarantee equitable treatment and timely access to quality health services for vulnerable groups. This study demonstrates the importance of sub-regional, disaggregated data to identify and redress inequities that exist among poor, remote, vulnerable populations—as in the urban slums of Lagos.
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Affiliation(s)
- Erin Anastasi
- United Nations Population Fund, New York, United States of America
- Operational Centre Barcelona, Médecins sans Frontières / Doctors without Borders, Barcelona, Spain
| | - Ekanem Ekanem
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olivia Hill
- Operational Centre Barcelona, Médecins sans Frontières / Doctors without Borders, Barcelona, Spain
| | - Agnes Adebayo Oluwakemi
- Operational Centre Barcelona, Médecins sans Frontières / Doctors without Borders, Barcelona, Spain
| | - Oluwatosin Abayomi
- Operational Centre Barcelona, Médecins sans Frontières / Doctors without Borders, Barcelona, Spain
- Turquoise Zeta Consult, Lagos, Nigeria
| | - Andrea Bernasconi
- Operational Centre Barcelona, Médecins sans Frontières / Doctors without Borders, Barcelona, Spain
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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Akinyemi JO, Bamgboye EA, Ayeni O. Trends in neonatal mortality in Nigeria and effects of bio-demographic and maternal characteristics. BMC Pediatr 2015; 15:36. [PMID: 25886566 PMCID: PMC4395970 DOI: 10.1186/s12887-015-0349-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 03/19/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Nigeria's efforts to reduce under-five mortality has been biased in favour of childhood mortality to the neglect of neonates and as such the literature is short of adequate information on the determinants of neonatal mortality. Whereas studies have shown that about half of infant deaths occur in the neonatal period. Knowledge of the determinants of neonatal mortality are essential for the design of intervention programes that will enhance neonatal survival. Therefore, this study was conducted to investigate the trends and factors associated with neonatal mortality in Nigeria. METHODS This was a retrospective analysis of the reproductive history data collected in the Nigeria Demographic and Health Surveys (NDHS) for 1990, 2003, 2008 and 2013. Neonatal mortality rates were estimated as the probability of dying before 28 completed days using synthetic cohort life table techniques. Univariate and multiple Cox proportional hazards regression models were used to explore the effects of selected maternal and bio-demographic variables on neonatal mortality. The Hazard Ratio (HR) and its 95% Confidence Interval (CI) were estimated to prioritize obtained significant factors. RESULTS Nigeria neonatal mortality rate stagnated at 41 per 1000 live births between 1990 and 2013. There were rural-urban and regional differences with more deaths occurring in rural areas and northern regions. In 1990, antenatal care (HR = 0.76; CI = 0.61-0.95), facility delivery (HR = 0.69; CI = 0.53-0.90) and births interval less than 24 months (HR = 1.67; CI = 1.41-1.98) were significantly associated with neonatal deaths. Factors identified from the 2013 data were antenatal care (HR = 0.76; CI = 0.61-0.95), birth interval less than 24 months (HR = 1.67; CI = 1.41-1.98), delivery at health facility (HR = 0.69; CI = 0.53-0.90), and small birth size (HR = 1.72; CI = 1.39-2.14). CONCLUSION There was little improvement in neonatal survival in Nigeria between 1990 and 2013. Bio-demographic and health care related characteristics are significant determinants of neonatal survival. Family planning should be intensified while government should improve the quality of maternal and child health services to enhance the survival of neonates.
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Affiliation(s)
- Joshua Odunayo Akinyemi
- Department of Epidemiology and Medical Statistics Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Elijah Afolabi Bamgboye
- Department of Epidemiology and Medical Statistics Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Olusola Ayeni
- Department of Epidemiology and Medical Statistics Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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Oluwole AA, Adegbesan-Omilabu MA, Okunade KS. Preterm delivery and low maternal serum cholesterol level: Any correlation? Niger Med J 2014; 55:406-10. [PMID: 25298606 PMCID: PMC4178338 DOI: 10.4103/0300-1652.140381] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The study assessed whether low maternal serum cholesterol during early pregnancy is associated with preterm delivery. PATIENTS AND METHODS It was a prospective observational cohort study involving pregnant women at gestational age of 14-20 weeks over a period of 12 months. Blood samples were obtained to measure total serum cholesterol concentrations and the sera were then analysed enzymatically by the cholesterol oxidase: p-aminophenazone (CHOD PAP) method. RESULTS The study showed an incidence of 5.0% for preterm delivery in the low risk study patients. Preterm birth was 4.83-times more common with low total maternal cholesterol than with midrange total cholesterol (11.8% versus 2.2%, P = 0.024). CONCLUSION Low maternal serum cholesterol (hypocholesterolaemia) is associated with preterm delivery. Optimal maternal serum cholesterol during pregnancy may have merit, therefore pregnant women should be encouraged to follow a healthy, balanced diet.
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Affiliation(s)
- Ayodeji A Oluwole
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria
| | | | - Kehinde S Okunade
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria
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Suleiman MB, Mokuolu OA. Perinatal Mortality in a Northwestern Nigerian City: A Wake up Call. Front Pediatr 2014; 2:105. [PMID: 25340044 PMCID: PMC4189423 DOI: 10.3389/fped.2014.00105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 09/14/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In Nigeria, of the over 900,000 children under the age of 5 years that die every year, perinatal mortality is responsible for a little over 20%. Previous reports are largely from the southern part of the country. This is the first report of perinatal data from the northwest of Nigeria. METHODS A case control study of perinatal deaths in the three major public hospitals in Katsina metropolis was carried out to determine the pattern of perinatal deaths in the metropolis. Data were collected over a 6 week period on maternal socio-demographic, antenatal, and delivery variables. Data were similarly obtained on neonatal profile and morbidities. RESULTS There were 143 perinatal deaths (94 stillbirths and 49 early neonatal deaths) out of 1104 live and stillbirths during the study period. The perinatal mortality rate was thus 130 per 1000 births with a stillbirth rate of 85 per 1000 births and an early neonatal mortality rate of 49 per 1000 live births. Stillbirths during the intrapartum period were twice as frequent as macerated stillbirths (2:1). Maternal factors significantly associated with perinatal deaths included chorioamnionitis, ruptured uterus, multiple gestation, medically induced delivery, prolonged labor, unbooked pregnancies, antepartum hemorrhage, and prolonged rupture of membranes. Antepartum hemorrhage was the strongest determinant of perinatal death. Significant neonatal determinants were multiple gestation, severe birth asphyxia, apnea, and necrotizing enterocolitis. Apnea was the strongest neonatal determinant. The majority (83.2%) of perinatal deaths were due to severe perinatal asphyxia (SPA) (54.5%), normally formed macerated stillbirths (20.3%), and immaturity (8.4%). CONCLUSION In conclusion, Perinatal Mortality in Katsina metropolis in northwest Nigeria is unacceptably high as we approach the timeline for the millennium development goals. Antepartum hemorrhage and SPA are major determinants.
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Affiliation(s)
| | - Olugbenga Ayodeji Mokuolu
- Neonatal Intensive Care Unit, Department of Pediatrics, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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Okeudo C, Ezem B, Ojiyi E. Stillbirth rate in a teaching hospital in South-eastern Nigeria: a silent tragedy. Ann Med Health Sci Res 2013; 2:176-9. [PMID: 23439739 PMCID: PMC3573514 DOI: 10.4103/2141-9248.105667] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Stillbirths often are not seen as a major public health problem, for despite increasing attention and investment on maternal, neonatal, and child health, stillbirths remain invisible. AIM The objective of this study was to determine the stillbirth rate at the Imo State University Teaching Hospital, Orlu. SUBJECTS AND METHODS Analysis of the case records of stillbirths that occurred in the institution over a 5-year period from 1(st) July 2005 to 30(th) June 2010 was made. Data retrieved was analyzed for age of the women, parity, presumptive risk factor for the stillbirth, and booking status of the women. Also, the total births during the period of study were obtained. A P-value of <0.05 is said to be significant at confidence level of 95% (95/100). RESULTS There were a total of 1,142 deliveries within the study period, out of which 206 resulted in stillbirths. This gave an institutional stillbirth rate of 18% (180/1000 deliveries). One-hundred and fifty-five 75.2% (155/206) of the stillbirths were macerated stillbirth. The age range of the women was 15-44 years. The modal age was 31 years. The age group of 26-30 years had the highest prevalence rate of stillbirths of 79 (38.3%, 79/206), while age group of more than 40 years contributed the least with four stillbirths 4 (1.9%, 4/206). CONCLUSION The stillbirth rate at the institution is too high and efforts must be made to reduce it.
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Affiliation(s)
- C Okeudo
- Department of Obstetrics and Gynaecology, Imo State University Teaching Hospital, Orlu, Imo State, Nigeria
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Ezugwu EC, Onah HE, Ezegwui HU, Nnaji C. Stillbirth rate at an emerging tertiary health institution in Enugu, southeast Nigeria. Int J Gynaecol Obstet 2011; 115:164-6. [PMID: 21872234 DOI: 10.1016/j.ijgo.2011.05.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 05/22/2011] [Accepted: 07/26/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the stillbirth rate and factors predisposing to a stillbirth delivery at a teaching hospital in Nigeria, with the aim of identifying solutions. METHOD A descriptive study of all stillbirths delivered at Enugu State University of Science and Technology Teaching Hospital, Parklane, Nigeria between January 1 and December 31, 2009. The sociodemographic characteristics of the mothers were documented and the possible causes of death were analyzed. RESULTS There were 153 stillbirths and 2064 total deliveries, giving a stillbirth rate of 74 per 1000 deliveries. Of the stillbirths, 52.3% were fresh and 47.7% were macerated. Women who had not received prenatal care had a significantly higher stillbirth rate (P<0.05). The most likely cause of a macerated stillbirth was a hypertensive disorder of pregnancy, whereas the likely causes of fresh stillbirths were labor-related. The "3 levels of delay" and injudicious use of oxytocin in labor contributed to the intrapartum stillbirths (P<0.05). CONCLUSION The stillbirth rate recorded in the study institution is unacceptably high. Appropriate prenatal care, timely intervention, and prompt and appropriate intrapartum care are key to achieving a reduction in the stillbirth rate.
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Affiliation(s)
- Euzebus C Ezugwu
- Department of Obstetrics/Gynecology, University of Nigeria Teaching Hospital, Itukku-Ozalla, Enugu, Nigeria.
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Mokuolu OA, Suleiman BM, Adesiyun OO, Adeniyi A. Prevalence and determinants of pre-term deliveries in the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Pediatr Rep 2010; 2:e3. [PMID: 21589839 PMCID: PMC3094003 DOI: 10.4081/pr.2010.e3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2009] [Revised: 02/01/2010] [Accepted: 02/04/2010] [Indexed: 11/23/2022] Open
Abstract
In Nigeria, over 900,000 children under the age of five years die every year. Early neonatal death is responsible for a little over 20% of these deaths. Prematurity remains a significant cause of these early neonatal deaths. In some series, it is reported to be responsible for 60-70% of these deaths. This study aimed to determine the prevalence and determinants of pre-term deliveries at the University of Ilorin Teaching Hospital, Ilorin. This was a prospective cohort study conducted over a 9-month period at the University of Ilorin Teaching Hospital. Records of deliveries and data on maternal socio-biological and antenatal variables were collected during this period in order to determine the prevalence and determinants of pre-term deliveries. Out of the 2,489 deliveries that took place over a 9-month period, there were 293 pre-terms, giving a pre-term delivery rate of 120 per 1,000 deliveries. Of the total deliveries, 1,522 singleton deliveries that satisfied inclusion criteria were recruited; 185 of them were pre-term deliveries giving a case:control ratio of 1:7. Significant determinants of pre-term delivery identified were previous pre-term delivery (P=0.001; OR=3.55; 95% CI=1.71-7.30), antepartum hemorrhage (P=0.000; OR=8.95; 95%CI=4.06-19.78), premature rupture of the membranes (P=0.000; OR=6.48; 95%CI=4.33-9.67), maternal urinary tract infection (P=0.006; OR=5.89; 95%CI=1.16-27.57), pregnancy induced hypertension (P=0.007; OR=3.23; 95%CI=2.09-4.99), type of labor (P=0.000; OR=6.44; 95%CI=4.42-9.38) and booking status (P=0.000; OR=4.67; 95%CI=3.33-6.56). The prevalence of pre-term delivery was 120 per 1,000 live births. Factors significantly associated with pre-term delivery were low socio-economic class, previous pre-term delivery, antepartum hemorrhage, premature rupture of fetal membranes, urinary tract infection, pregnancy induced hypertension, induced labor, and booking elsewhere outside the teaching hospital.
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Affiliation(s)
- Olugbenga A. Mokuolu
- Neonatal Intensive Care Unit, Department of Paediatrics, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - BM Suleiman
- Department of Paediatrics, Federal Medical Centre, Katsina, Nigeria
| | - OO Adesiyun
- Neonatal Intensive Care Unit, Department of Paediatrics, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - A Adeniyi
- Neonatal Intensive Care Unit, Department of Paediatrics, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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Olusanya BO, Afe AJ, Solanke OA. Are risk factors for stillbirths in low-income countries associated with sensorineural hearing loss in survivors? J Matern Fetal Neonatal Med 2009; 22:576-83. [DOI: 10.1080/14767050902906360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Prevailing adverse perinatal conditions in developing countries have been associated with substantial mortality, but little evidence exists on their impact on permanent childhood disabilities and morbidity due to limitations in clinical investigations and medical records. This study aims to identify the possible association between parent-reported adverse perinatal conditions and permanent hearing loss, in order to establish service needs within current maternal and child health programmes. Structured questionnaires were administered to 363 parents of deaf children and 309 parents of normal-hearing children in an inner city area of Lagos, Nigeria. The parents were from all social classes. After a multivariable logistic regression analysis, birth asphyxia [OR 20.45; 95% CI 6.26, 66.85], difficult delivery [OR 8.09; 95% CI 2.76, 23.68], neonatal jaundice [OR 2.45; 95% CI 1.25, 4.79] and neonatal seizures [OR 2.30; 95% CI 1.09, 4.85] were associated with permanent hearing loss. Consanguineous marriages [OR 6.69; 95% CI 2.72, 16.46] and family history of deafness [OR 6.27; 95% CI 2.07, 18.97] also emerged as additional risk factors for permanent hearing loss. In addition, parents of children in state-owned schools for the deaf were significantly more likely to belong to higher social classes compared with normal-hearing children in mainstream state-owned schools. There is a need to incorporate services for the early detection of permanent hearing loss into current maternal and child healthcare programmes in developing countries.
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Affiliation(s)
- Bolajoko O Olusanya
- Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, University College London, 30 Guilford Street, London, UK.
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Abnormal births and other “ill omens”. HUMAN NATURE-AN INTERDISCIPLINARY BIOSOCIAL PERSPECTIVE 1996; 7:381-401. [DOI: 10.1007/bf02732900] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/1995] [Accepted: 12/15/1995] [Indexed: 11/25/2022]
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Ravikumara M, Bhat BV. Early neonatal mortality in an intramural birth cohort at a tertiary care hospital. Indian J Pediatr 1996; 63:785-9. [PMID: 10830061 DOI: 10.1007/bf02730930] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Early neonatal mortality (ENM) occurring among 12,283 consecutive live births over a period of 3 years were analysed. The early neonatal mortality rate (ENMR) was 26.6/1000 live births. Birth weight less than 2,000 gm, lack of antenatal care, male sex, operative vaginal delivery, prematurity and multiple pregnancy were significantly associated with early neonatal deaths. Birth asphyxia was found to be the most important cause of death, followed by hyaline membrane disease and congenital malformations. Majority of the asphyxia related deaths were due to late intrapartum referral of the mothers. Forty-two per cent of early neonatal deaths occurred in babies weighing less than 1,500 gm. Early identification and referral of high risk mothers and health education would significantly reduce the early neonatal deaths.
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Affiliation(s)
- M Ravikumara
- Department of Pediatrics, Jawaharlal Institute of Post-graduate Medical Education and Research, Pondicherry
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Abstract
A comparative study of perinatal mortality patterns over a period was conducted at a teaching hospital of South India. Among the 6,048 babies born from January 1984 to December 1985 (Group A), there were 265 (43.8/1000) still births and 127 (22.0/1000) early neonatal deaths. Three hundred and thirty seven (41/1000) babies were still born and 235 (29.8/1000) early neonatal deaths out of 8,215 deliveries during 1992-93 (Group B). The perinatal mortality rate (PMR) in Groups A and B were 57.9/1000 and 57.7/1000 respectively. Unbooked cases accounted for the majority (> 75%) of perinatal deaths during both the periods. The overall mortality rates in unbooked cases were three to four times higher than booked cases. Among the various causes of still births, antepartum haemorrhage and uterine rupture had increased. Septicaemia was the major cause of early neonatal deaths in Group A, but in Group B birth asphyxia and prematurity were the leading causes. Effective interventions like creating awareness among the target population to utilise maternal and child health services and early referral of high risk cases with improved intranatal and perinatal care can decrease the perinatal mortality.
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Affiliation(s)
- M R Kumar
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry
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