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Torre Monmany N, Astete JA, Ramaiah D, Suchitra J, Krauel X, Fillol M, Balasubbaiah Y, Alarcón A, Bassat Q. Extended Perinatal Mortality Audit in a Rural Hospital in India. Am J Perinatol 2023; 40:375-386. [PMID: 33902133 DOI: 10.1055/s-0041-1727220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of the study is to describe the status of perinatal mortality (PM) in an Indian rural hospital. STUDY DESIGN Retrospective analysis of data was compiled from PM meetings (April 2017 to December 2018) following "Making Every Baby Count: audit and review of stillbirths and neonatal deaths (ENAP or Every Newborn Action Plan)." RESULTS The study includes 8,801 livebirths, 105 stillbirths (SBs); 74 antepartum stillbirths [ASBs], 22 intrapartum stillbirths [ISBs], and nine unknown timing stillbirths [USBs]), 39 neonatal deaths or NDs (perinatal death or PDs 144). The higher risks for ASBs were maternal age >34 years, previous history of death, and/or SBs. Almost half of the PDs could be related with antepartum complications. More than half of the ASB were related with preeclampsia/eclampsia and abruptio placentae; one-third of the ISB were related with preeclampsia/eclampsia and gestational hypertension, fetal growth restriction, and placental dysfunction. The main maternal conditions differed between PDs (p = 0.005). The main causes of the ND were infections, congenital malformations, complications of prematurity, intrapartum complications, and unknown. The stillbirth rate was 11.8/1,000 births, neonatal mortality rate 4.4/1,000 livebirths, and perinatal mortality rate 15.8/1,000 births. CONCLUSION This is the first study of its kind in Andhra Pradesh being the first step for the analysis and prevention of PM. KEY POINTS · Many conditions that lead to stillbirths are linked to neonatal deaths and PM has been outside of the global parameters from the last decades.. · This is the first study following International Classification of Disease perinatal mortality codes and the audit of ENAP in Andhra Pradesh.. · Extended PM and mortality are mainly caused by similar preventable and treatable conditions..
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Affiliation(s)
- Núria Torre Monmany
- Department of Paediatrics, Rural Development Trust Children's Hospital, Bathalapalli, Andhra Pradesh, India
- Department of Paediatric Emergency Transport, Sant Joan de Déu Hospital, Barcelona, Spain
| | - Joaquín Américo Astete
- Department of Paediatrics, Rural Development Trust Children's Hospital, Bathalapalli, Andhra Pradesh, India
- Department of Paediatrics, Pediatria dels pirineus, la Seu d'Urgell, Spain
| | - Dasarath Ramaiah
- Department of Paediatrics, Rural Development Trust Children's Hospital, Bathalapalli, Andhra Pradesh, India
| | - Jyothi Suchitra
- Department of Gynecology and Obstetrics, Rural Development Trust Children's Hospital, Bathalapalli, Andhra Pradesh, India
| | - Xavier Krauel
- Department of Paediatrics, Rural Development Trust Children's Hospital, Bathalapalli, Andhra Pradesh, India
- Department of Neonatology, Sant Joan de déu Hospital, Barcelona, Spain
| | - Manolo Fillol
- Department of Gynecology and Obstetrics, Rural Development Trust Children's Hospital, Bathalapalli, Andhra Pradesh, India
- Department of Gynecology, Hospital de la plana, Castellón, Spain
| | - Yadamala Balasubbaiah
- Department of Gynecology and Obstetrics, Rural Development Trust Children's Hospital, Bathalapalli, Andhra Pradesh, India
| | - Ana Alarcón
- Department of Neonatology, Sant Joan de déu Hospital, Barcelona, Spain
| | - Quique Bassat
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Icrea, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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