This study assessed causes and factors associated with neonatal mortality in the neonatal intensive care unit (NICU) of Jimma University Medical Center in Ethiopia between 2014-2017. Of the 3,276 neonates admitted, 412 (13.3%) died, equating to a mortality rate of 30 deaths per 1,000 live births. The majority of deceased neonates had low birth weight, prematurity, or respiratory distress syndrome. Residency outside of Jimma city, length of stay under 7 days, low birth weight, prematurity, respiratory distress syndrome, perinatal asphyxia, and congenital malformations were significantly associated with neonatal mortality. Addressing factors like antenatal care and early identification/referral of
A Study to Identify the Post Partum Complications among Post Natal Mothers in...ijtsrd
Complications in early post natal periods may lead many issues such as breast engorgement, perineal pain, constipation, and urine incontinence. Postpartum complications contribute to a lot of maternal morbidity. A Descriptive study was conducted to identify the post partum complications among post natal mothers. The study was conducted on 120 post natal mothers who were selected using convenient sampling technique. The study was explained to participants and consent was taken. Data were collected by using structured knowledge questionnaire and self reported practice check list. Homogeneity was maintained for demographic variables. The result showed Identification of post partum complications shows that that in perineal pain, pain in perineal area 45 . In constipation, difficulty to express stool 33.33 , a sense that everything didn’t come out 33.33 , hard or small stool 20.83 . In breast engorgement, 20.83 mothers reported pain and swelling in breast, hardness in breast 20 and flat nipple 15 . In urine incontinence, intense urge of urine 2.5 . Himani Bora | Kanchan Bala | Laxmi Kumar "A Study to Identify the Post-Partum Complications among Post Natal Mothers in Selected Hospital of Dehradun, Uttarakhand" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33524.pdf Paper Url: https://www.ijtsrd.com/other-scientific-research-area/other/33524/a-study-to-identify-the-postpartum-complications-among-post-natal-mothers-in-selected-hospital-of-dehradun-uttarakhand/himani-bora
In India, roughly one maternal death occurs every five minutes. Maternal mortality is defined as the death of a woman during or within 42 days of pregnancy termination from pregnancy-related causes. The highest maternal mortality rates in 2010 were in Chad, Somalia, Central African Republic, Sierra Leone and Burundi, while the lowest were in Estonia and Singapore. Though India's maternal mortality ratio has declined from 400 in 1997 to 212 per 100,000 live births in 2007-2009, it still has a long way to go to meet its Millennium Development Goal of 109 by 2015. Anemia and unsafe abortion are significant causes of maternal death in India. National initiatives aim to strengthen antenatal, intranatal and
Does Utilization of Antenatal Care Reduces Reproductive Risk? A Case Study o...PRAKASAM C P
This paper examines the utilization of antenatal care and out come of pregnancy and delivery complications (Reproductive risk) among currently married women in Andhra Pradesh, India. Data for this study were collected from DLHS-RCH-3 for Andhra Pradesh. Pregnancy outcome has been collected for all deliveries from the currently married women and the utilisation of ANC, health seeing behavior, pregnancy problems during and problems during delivery which have been considered as reproductive risk and analysed for the last child data. Reproductive history of 19825 deliveries for Andhra Pradesh form data set. Analysis has been carried out in three stages. Initially Pregnancy loss and its ANC and treatment seeking behavior have been analysed. At the second stage pregnancy complications and delivery complications for the last delivery in relation to outcome has been analysed for Andhra Pradesh data. At the third stage interrelation between Pregnancy out come and reproductive risk has been analysed by using logistic regression. Further influence of background variables on reproductive loss and treatment seeking behavior has been analysed. The results revealed that women experience still birth in Andhra Pradesh found to be around 2.9. Further results revealed that women who had utilized antenatal care services found to have less risk in delivering last child than other. Maternal age and husband occupation played significant influence in utilization of health care services leading to safe delivery in these two selected states.
Risk factors and treatment seeking behavior of Tuberculosis In Selected Stat...PRAKASAM C P
This document analyzes risk factors and treatment seeking behavior for tuberculosis (TB) in four Indian states using data from the National Family Health Survey 3 (NFHS-3). The key points are:
1. The prevalence of TB was highest in Tamil Nadu and among males, older age groups, and rural populations.
2. Risk factors for TB included poor housing conditions, cooking with biomass fuels, and behaviors like smoking and drinking. Wealth, education, and urban residence were protective.
3. Treatment seeking varied by state, with households in Andhra Pradesh least likely to use government facilities for TB care. Private providers remained the primary source of care overall.
This document summarizes maternal and child health issues. It defines maternal mortality as death during pregnancy or within 42 days of termination from pregnancy-related causes. The main causes of high maternal mortality in India are anemia, lack of antenatal screening, 30% of women needing emergency care during delivery due to risk factors, and delays in reaching hospitals. It also defines perinatal morbidity and mortality, including neonatal mortality (death in first 28 days) and stillbirths (death after 28 weeks). The major causes of perinatal problems are maternal medical conditions, pregnancy complications, infections, and birth injuries. Developing countries have much higher rates of maternal death, around 1 in 11 women, compared to 1 in 5000 in developed
EFFECTIVENESS OF INTERMITTENT PREVENTIVE TREATMENT IN PREGNANCY WITH SULPHADO...oyepata
EFFECTIVENESS OF INTERMITTENT PREVENTIVE TREATMENT IN PREGNANCY WITH
SULPHADOXINE-PYRIMETHAMINE AGAINST MALARIA IN NORTHERN NIGERIA
Builder MI*1, Anzaku SA2 and Joseph SO1
Study on utilization of antenatal care and outcome of pregnancy in a medical ...Su Dipta
- Antenatal care is important for both mother and baby's health during pregnancy. It involves medical supervision, screening tests, education, and management or referral of any health conditions.
- The document discusses the aims, components, and importance of antenatal care. It also presents data on antenatal care utilization and pregnancy outcomes in West Bengal, India. Key findings include over 50% of women receiving at least 3 antenatal visits and getting recommended tests.
- Ensuring quality antenatal care through multiple visits, screenings and education can help prevent complications and lower maternal and infant mortality rates.
Hospital based study on perinatal mortality in RIMS,Manipuriosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A Study to Identify the Post Partum Complications among Post Natal Mothers in...ijtsrd
Complications in early post natal periods may lead many issues such as breast engorgement, perineal pain, constipation, and urine incontinence. Postpartum complications contribute to a lot of maternal morbidity. A Descriptive study was conducted to identify the post partum complications among post natal mothers. The study was conducted on 120 post natal mothers who were selected using convenient sampling technique. The study was explained to participants and consent was taken. Data were collected by using structured knowledge questionnaire and self reported practice check list. Homogeneity was maintained for demographic variables. The result showed Identification of post partum complications shows that that in perineal pain, pain in perineal area 45 . In constipation, difficulty to express stool 33.33 , a sense that everything didn’t come out 33.33 , hard or small stool 20.83 . In breast engorgement, 20.83 mothers reported pain and swelling in breast, hardness in breast 20 and flat nipple 15 . In urine incontinence, intense urge of urine 2.5 . Himani Bora | Kanchan Bala | Laxmi Kumar "A Study to Identify the Post-Partum Complications among Post Natal Mothers in Selected Hospital of Dehradun, Uttarakhand" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33524.pdf Paper Url: https://www.ijtsrd.com/other-scientific-research-area/other/33524/a-study-to-identify-the-postpartum-complications-among-post-natal-mothers-in-selected-hospital-of-dehradun-uttarakhand/himani-bora
In India, roughly one maternal death occurs every five minutes. Maternal mortality is defined as the death of a woman during or within 42 days of pregnancy termination from pregnancy-related causes. The highest maternal mortality rates in 2010 were in Chad, Somalia, Central African Republic, Sierra Leone and Burundi, while the lowest were in Estonia and Singapore. Though India's maternal mortality ratio has declined from 400 in 1997 to 212 per 100,000 live births in 2007-2009, it still has a long way to go to meet its Millennium Development Goal of 109 by 2015. Anemia and unsafe abortion are significant causes of maternal death in India. National initiatives aim to strengthen antenatal, intranatal and
Does Utilization of Antenatal Care Reduces Reproductive Risk? A Case Study o...PRAKASAM C P
This paper examines the utilization of antenatal care and out come of pregnancy and delivery complications (Reproductive risk) among currently married women in Andhra Pradesh, India. Data for this study were collected from DLHS-RCH-3 for Andhra Pradesh. Pregnancy outcome has been collected for all deliveries from the currently married women and the utilisation of ANC, health seeing behavior, pregnancy problems during and problems during delivery which have been considered as reproductive risk and analysed for the last child data. Reproductive history of 19825 deliveries for Andhra Pradesh form data set. Analysis has been carried out in three stages. Initially Pregnancy loss and its ANC and treatment seeking behavior have been analysed. At the second stage pregnancy complications and delivery complications for the last delivery in relation to outcome has been analysed for Andhra Pradesh data. At the third stage interrelation between Pregnancy out come and reproductive risk has been analysed by using logistic regression. Further influence of background variables on reproductive loss and treatment seeking behavior has been analysed. The results revealed that women experience still birth in Andhra Pradesh found to be around 2.9. Further results revealed that women who had utilized antenatal care services found to have less risk in delivering last child than other. Maternal age and husband occupation played significant influence in utilization of health care services leading to safe delivery in these two selected states.
Risk factors and treatment seeking behavior of Tuberculosis In Selected Stat...PRAKASAM C P
This document analyzes risk factors and treatment seeking behavior for tuberculosis (TB) in four Indian states using data from the National Family Health Survey 3 (NFHS-3). The key points are:
1. The prevalence of TB was highest in Tamil Nadu and among males, older age groups, and rural populations.
2. Risk factors for TB included poor housing conditions, cooking with biomass fuels, and behaviors like smoking and drinking. Wealth, education, and urban residence were protective.
3. Treatment seeking varied by state, with households in Andhra Pradesh least likely to use government facilities for TB care. Private providers remained the primary source of care overall.
This document summarizes maternal and child health issues. It defines maternal mortality as death during pregnancy or within 42 days of termination from pregnancy-related causes. The main causes of high maternal mortality in India are anemia, lack of antenatal screening, 30% of women needing emergency care during delivery due to risk factors, and delays in reaching hospitals. It also defines perinatal morbidity and mortality, including neonatal mortality (death in first 28 days) and stillbirths (death after 28 weeks). The major causes of perinatal problems are maternal medical conditions, pregnancy complications, infections, and birth injuries. Developing countries have much higher rates of maternal death, around 1 in 11 women, compared to 1 in 5000 in developed
EFFECTIVENESS OF INTERMITTENT PREVENTIVE TREATMENT IN PREGNANCY WITH SULPHADO...oyepata
EFFECTIVENESS OF INTERMITTENT PREVENTIVE TREATMENT IN PREGNANCY WITH
SULPHADOXINE-PYRIMETHAMINE AGAINST MALARIA IN NORTHERN NIGERIA
Builder MI*1, Anzaku SA2 and Joseph SO1
Study on utilization of antenatal care and outcome of pregnancy in a medical ...Su Dipta
- Antenatal care is important for both mother and baby's health during pregnancy. It involves medical supervision, screening tests, education, and management or referral of any health conditions.
- The document discusses the aims, components, and importance of antenatal care. It also presents data on antenatal care utilization and pregnancy outcomes in West Bengal, India. Key findings include over 50% of women receiving at least 3 antenatal visits and getting recommended tests.
- Ensuring quality antenatal care through multiple visits, screenings and education can help prevent complications and lower maternal and infant mortality rates.
Hospital based study on perinatal mortality in RIMS,Manipuriosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The document provides information on COVID-19 vaccination for postpartum lactating women. It discusses the vaccines available in India and their effectiveness. Studies have shown that the mRNA vaccines generate robust immunity in pregnant and lactating women similar to non-pregnant women. Vaccine-induced antibodies were found in breastmilk, allowing for immune transfer to infants. Preliminary findings did not reveal any obvious safety signals among vaccinated pregnant individuals. International organizations recommend vaccination for pregnant and lactating individuals when the benefits outweigh the risks.
Dr. Eugene Declercq: "Maternal Mortality as a Public Health Challenge" 10.04.17reportingonhealth
Dr. Eugene Declercq's slides from the webinar "America's High Maternal Mortality and What Can Be Done
For info: https://www.centerforhealthjournalism.org/content/america%E2%80%99s-high-maternal-mortality-what-can-be-done
This document discusses severe maternal morbidity, also known as near-misses, which are life-threatening complications during pregnancy, childbirth, or postpartum that women survive only through medical intervention. It notes that over 50 million women experience maternal health issues annually. The document then provides definitions of near-miss cases and discusses risk factors. It presents statistics on near-miss cases from a private hospital in India compared to a rural hospital, finding higher rates in the rural hospital. The leading causes of near-misses are identified as pre-eclampsia/eclampsia and hemorrhage. The conclusion emphasizes the need for improved management of near-miss cases to reduce maternal mortality.
Indications and Outcomes of Emergency Caesarean Section at St Paul’s Hospital...Crimsonpublishers-IGRWH
Cesarean Section (CS) rates and their indications vary all over the World. Audit of indications and factors affecting infant and maternal outcome remain an important activity in rationalizing the use of this major procedure in obstetrics practice. Cesarean section (CS) carries a higher maternal morbidity and mortality compared to vaginal delivery. Noresearches have been done on this area.
1) Maternal mortality in India remains a significant problem, with 212 deaths per 100,000 live births according to 2009 data.
2) The main medical causes of maternal death are postpartum hemorrhage (24%), hypertension/eclampsia (12%), and infection (15%).
3) Addressing the "three delays" - delay in deciding to seek care, reaching a facility, and receiving care at the facility - is critical to reducing maternal mortality through strategies like community education, improving transportation and emergency services, and upgrading health facilities.
Maternal mortality remains a significant issue worldwide, with over 500,000 deaths annually. Through initiatives like the Confidential Enquiries into Maternal Deaths system, Malaysia has significantly reduced its maternal mortality rate from 540/100,000 live births in 1950 to 28.1/100,000 in 2000. Postpartum hemorrhage is a leading cause of death in Malaysia, while medical conditions, sepsis, and hypertensive disorders also contribute substantially. Recommendations focus on increasing access to emergency care and transportation, improving provider training, and expanding family planning programs.
Accuracy of Combined Maternal Serum Interleukin-8 and Salivary Estriol in Pre...Samir elsayed
This study aimed to assess the accuracy of combined maternal serum interleukin-8 and salivary estriol levels in predicting preterm labor in Egyptian pregnant females. The study found that maternal serum interleukin-8 alone had the highest accuracy at a cut-off of 965 pg/ml, with an overall accuracy of 79%, sensitivity of 92.5%, and specificity of 42.5%. Combined interleukin-8 and estriol had an overall accuracy of 68% and salivary estriol alone had an accuracy of 58%. The study concluded that maternal serum interleukin-8 is a more accurate, effective, and relatively non-invasive strategy for predicting preterm labor compared to salivary estriol alone.
This document summarizes presentations on maternal near miss in Sudan. It defines maternal near miss as a severe life-threatening complication during pregnancy, childbirth, or postpartum that requires urgent intervention to prevent death. The document discusses how analyzing near miss cases can provide insights into health system failures in obstetric care. It notes that the leading causes of near miss in Sudan are hemorrhage, infection, hypertensive disorders, and anemia. The document also outlines Sudan's policy on identifying near miss criteria and qualitative research examining determinants of maternal morbidity and mortality in post-conflict areas.
Dr. Elliott Main: "Reducing Maternal Mortality: Building on the California Ex...reportingonhealth
This document discusses efforts in California to reduce maternal mortality rates through quality improvement initiatives. It notes that California saw a rise in maternal mortality that led to the creation of the California Maternal Quality Care Collaborative (CMQCC) in 2006. The CMQCC works with various partners to implement toolkits and collaboratives focused on the most common causes of mortality and severe morbidity - obstetric hemorrhage and preeclampsia. Through these statewide initiatives, California saw a reduction in its maternal mortality rate compared to the national rate. The document advocates expanding this approach nationally through the Alliance for Innovation on Maternal Health (AIM) partnership.
Maternal and neonatal morbidity and mortalityDipsikhaAryal
The document discusses maternal and neonatal morbidity and mortality from international and national perspectives. Key points include:
- The leading causes of maternal death are hemorrhage, sepsis, abortion complications and hypertensive disorders.
- Globally, maternal mortality has declined 38% from 2000-2017 but still occurs mostly in low-income countries. Nepal's MMR has declined from 539 in 1996 to 239 in 2016.
- Neonatal mortality accounts for 47% of under-5 deaths. The global NMR is 18 per 1000 live births while Nepal's is 21 per 1000 live births.
- Reducing maternal and child mortality is a global development target but progress must still be made to meet goals of MMR 70 by
This document summarizes the results of a 2005 survey of neonatal births in urban China. Some key findings include:
- 8.1% of births were preterm and 0.7% were very low birth weight. Caesarean delivery rate was 49.2%, higher than rates in the US and Asia.
- Factors associated with higher risk of preterm birth included maternal age over 35, assisted reproduction, pregnancy complications like hypertension, and multiple gestations.
- Overall infant outcomes were good, with 4.8% having low Apgar scores at birth, 7.14% requiring neonatal unit admission, and 0.74% mortality.
Relationship of Antenatal Care with the Prevention of Maternal Mortality amon...iosrjce
The document discusses a study that examined the relationship between antenatal care and the prevention of maternal mortality among pregnant women in Bauchi State, Nigeria. The study found:
1) A significant relationship existed between the level of awareness of antenatal care and the prevention of maternal mortality.
2) A significant relationship also existed between the level of utilization of antenatal care services and the prevention of maternal mortality.
3) The study recommended increasing awareness of antenatal care benefits and encouraging regular attendance to allow early detection of risks and reduce maternal mortality.
Maternal mortality refers to deaths due to complications from pregnancy or childbirth. Globally, almost 800 women die daily from preventable causes related to pregnancy and childbirth. The vast majority (99%) of maternal deaths occur in developing countries, particularly in sub-Saharan Africa and South Asia. The three leading causes of maternal death in the United States are postpartum hemorrhage, preeclampsia and eclampsia, and cardiomyopathy. Preventing unwanted pregnancies and ensuring access to skilled care before, during, and after childbirth can significantly reduce maternal mortality worldwide.
Maternal mortality remains a significant global issue, with one woman dying every minute from pregnancy or childbirth complications. This document defines maternal mortality and classifications, and provides data on maternal mortality ratio (MMR) in various regions. Key findings include: the state's MMR declining from 30.8 in 2008 to 21.7 in 2011 but rising again to 26.6 in 2012; the principal causes of death being obstetric embolism, medical disorders during pregnancy, and postpartum hemorrhage; and over 60% of deaths occurring postnatally. Remediable factors contributing to deaths include delays in seeking or receiving care, failure to diagnose or treat appropriately, and inadequate adherence to protocols.
Maternal mortality is defined as the death of a woman during pregnancy or within 42 days of termination of pregnancy from pregnancy-related causes. The three main causes of maternal death globally are hemorrhage, sepsis, and hypertensive disorders. In India, maternal mortality rates are highest in rural areas where access to healthcare is limited. The three delay model explains that maternal deaths are often due to delays in seeking care, reaching care, and receiving adequate care. Reducing maternal mortality requires improving access to emergency obstetric care, family planning services, and addressing social determinants like gender inequality and poverty.
Maternal mortality remains a significant global issue, with nearly 830 women dying daily from preventable causes related to pregnancy and childbirth. The majority (99%) of maternal deaths occur in developing countries, where access to skilled healthcare is limited. Key factors that influence a woman's risk include her location (rural areas pose higher risk), economic status (poorer communities at higher risk), and age (adolescents at highest risk). While the global maternal mortality ratio has declined 44% between 1990-2015, many countries still show no progress. Reliable data remains scarce but interventions like skilled birth attendance and access to family planning can significantly reduce maternal deaths.
Preterm Premature Rupture of Membranes and Neonatal and Maternal Outcomesremedypublications2
The management of Preterm Premature Rupture of Membranes (PPROM) remains
controversial. PPROM may lead significant maternal and neonatal complications.
Methods: Retrospective data of PPROM cases managed in Suleymaniye Maternity Research and
Training Hospital between 2008 and 2012 were collected and analyzed using SPSS.
Infant Mortality Rate, perinatal mortalityRoselin V
This document discusses infant and perinatal mortality. It defines key terms like live birth, fetal death, stillbirth and provides current global and national magnitudes for perinatal mortality rate, neonatal mortality rate and infant mortality rate. The major causes of infant and perinatal deaths are discussed along with the various determinants. Prevention strategies are highlighted including improvements to antenatal, natal and postnatal care. Investigation of infant deaths and methods for surveying to estimate infant mortality rate are also summarized.
- Maternal mortality in Ethiopia is a significant problem, with an estimated 25,000 maternal deaths per year. The major causes of maternal death are similar to other developing countries and include hemorrhage, sepsis, obstructed labor, hypertension, and unsafe abortion.
- There have been some changes in trends over time, with increasing proportions of deaths due to hypertension and hemorrhage, and a declining proportion due to unsafe abortion. Distance to health facilities remains a major factor influencing maternal outcomes.
This presentation is all about the epidemiology of stillbirths, in India. It talks about the different challenges in controlling the stillbirths and the strategies of controlling it. The INAP guideline of Government of India, which is a stepping stone for controlling stillbirths in India, is also discussed here.
This study assessed the prevalence of neonatal sepsis and associated risk factors among neonates admitted to neonatal intensive care units (NICUs) at two hospitals in Ethiopia from February 2016 to February 2017. The overall prevalence of neonatal sepsis was found to be 77.9%. Age of neonates, birth asphyxia, and use of oxygen via mask were significantly associated with increased risk of neonatal sepsis. The study recommends focusing prevention efforts on modifiable risk factors to reduce neonatal sepsis.
This study examined maternal and fetal outcomes in term premature rupture of membranes (PROM) using medical records from a hospital in Ethiopia between 2011-2013. The study found that 22.2% of women experienced unfavorable maternal outcomes like puerperal sepsis. 33.5% of neonates experienced unfavorable outcomes like stillbirth. Factors associated with unfavorable outcomes included residing in a rural area, duration of PROM over 12 hours, latency over 24 hours, and birth weight under 2500g. The study aims to identify factors that can help reduce complications from term PROM and improve outcomes.
The document provides information on COVID-19 vaccination for postpartum lactating women. It discusses the vaccines available in India and their effectiveness. Studies have shown that the mRNA vaccines generate robust immunity in pregnant and lactating women similar to non-pregnant women. Vaccine-induced antibodies were found in breastmilk, allowing for immune transfer to infants. Preliminary findings did not reveal any obvious safety signals among vaccinated pregnant individuals. International organizations recommend vaccination for pregnant and lactating individuals when the benefits outweigh the risks.
Dr. Eugene Declercq: "Maternal Mortality as a Public Health Challenge" 10.04.17reportingonhealth
Dr. Eugene Declercq's slides from the webinar "America's High Maternal Mortality and What Can Be Done
For info: https://www.centerforhealthjournalism.org/content/america%E2%80%99s-high-maternal-mortality-what-can-be-done
This document discusses severe maternal morbidity, also known as near-misses, which are life-threatening complications during pregnancy, childbirth, or postpartum that women survive only through medical intervention. It notes that over 50 million women experience maternal health issues annually. The document then provides definitions of near-miss cases and discusses risk factors. It presents statistics on near-miss cases from a private hospital in India compared to a rural hospital, finding higher rates in the rural hospital. The leading causes of near-misses are identified as pre-eclampsia/eclampsia and hemorrhage. The conclusion emphasizes the need for improved management of near-miss cases to reduce maternal mortality.
Indications and Outcomes of Emergency Caesarean Section at St Paul’s Hospital...Crimsonpublishers-IGRWH
Cesarean Section (CS) rates and their indications vary all over the World. Audit of indications and factors affecting infant and maternal outcome remain an important activity in rationalizing the use of this major procedure in obstetrics practice. Cesarean section (CS) carries a higher maternal morbidity and mortality compared to vaginal delivery. Noresearches have been done on this area.
1) Maternal mortality in India remains a significant problem, with 212 deaths per 100,000 live births according to 2009 data.
2) The main medical causes of maternal death are postpartum hemorrhage (24%), hypertension/eclampsia (12%), and infection (15%).
3) Addressing the "three delays" - delay in deciding to seek care, reaching a facility, and receiving care at the facility - is critical to reducing maternal mortality through strategies like community education, improving transportation and emergency services, and upgrading health facilities.
Maternal mortality remains a significant issue worldwide, with over 500,000 deaths annually. Through initiatives like the Confidential Enquiries into Maternal Deaths system, Malaysia has significantly reduced its maternal mortality rate from 540/100,000 live births in 1950 to 28.1/100,000 in 2000. Postpartum hemorrhage is a leading cause of death in Malaysia, while medical conditions, sepsis, and hypertensive disorders also contribute substantially. Recommendations focus on increasing access to emergency care and transportation, improving provider training, and expanding family planning programs.
Accuracy of Combined Maternal Serum Interleukin-8 and Salivary Estriol in Pre...Samir elsayed
This study aimed to assess the accuracy of combined maternal serum interleukin-8 and salivary estriol levels in predicting preterm labor in Egyptian pregnant females. The study found that maternal serum interleukin-8 alone had the highest accuracy at a cut-off of 965 pg/ml, with an overall accuracy of 79%, sensitivity of 92.5%, and specificity of 42.5%. Combined interleukin-8 and estriol had an overall accuracy of 68% and salivary estriol alone had an accuracy of 58%. The study concluded that maternal serum interleukin-8 is a more accurate, effective, and relatively non-invasive strategy for predicting preterm labor compared to salivary estriol alone.
This document summarizes presentations on maternal near miss in Sudan. It defines maternal near miss as a severe life-threatening complication during pregnancy, childbirth, or postpartum that requires urgent intervention to prevent death. The document discusses how analyzing near miss cases can provide insights into health system failures in obstetric care. It notes that the leading causes of near miss in Sudan are hemorrhage, infection, hypertensive disorders, and anemia. The document also outlines Sudan's policy on identifying near miss criteria and qualitative research examining determinants of maternal morbidity and mortality in post-conflict areas.
Dr. Elliott Main: "Reducing Maternal Mortality: Building on the California Ex...reportingonhealth
This document discusses efforts in California to reduce maternal mortality rates through quality improvement initiatives. It notes that California saw a rise in maternal mortality that led to the creation of the California Maternal Quality Care Collaborative (CMQCC) in 2006. The CMQCC works with various partners to implement toolkits and collaboratives focused on the most common causes of mortality and severe morbidity - obstetric hemorrhage and preeclampsia. Through these statewide initiatives, California saw a reduction in its maternal mortality rate compared to the national rate. The document advocates expanding this approach nationally through the Alliance for Innovation on Maternal Health (AIM) partnership.
Maternal and neonatal morbidity and mortalityDipsikhaAryal
The document discusses maternal and neonatal morbidity and mortality from international and national perspectives. Key points include:
- The leading causes of maternal death are hemorrhage, sepsis, abortion complications and hypertensive disorders.
- Globally, maternal mortality has declined 38% from 2000-2017 but still occurs mostly in low-income countries. Nepal's MMR has declined from 539 in 1996 to 239 in 2016.
- Neonatal mortality accounts for 47% of under-5 deaths. The global NMR is 18 per 1000 live births while Nepal's is 21 per 1000 live births.
- Reducing maternal and child mortality is a global development target but progress must still be made to meet goals of MMR 70 by
This document summarizes the results of a 2005 survey of neonatal births in urban China. Some key findings include:
- 8.1% of births were preterm and 0.7% were very low birth weight. Caesarean delivery rate was 49.2%, higher than rates in the US and Asia.
- Factors associated with higher risk of preterm birth included maternal age over 35, assisted reproduction, pregnancy complications like hypertension, and multiple gestations.
- Overall infant outcomes were good, with 4.8% having low Apgar scores at birth, 7.14% requiring neonatal unit admission, and 0.74% mortality.
Relationship of Antenatal Care with the Prevention of Maternal Mortality amon...iosrjce
The document discusses a study that examined the relationship between antenatal care and the prevention of maternal mortality among pregnant women in Bauchi State, Nigeria. The study found:
1) A significant relationship existed between the level of awareness of antenatal care and the prevention of maternal mortality.
2) A significant relationship also existed between the level of utilization of antenatal care services and the prevention of maternal mortality.
3) The study recommended increasing awareness of antenatal care benefits and encouraging regular attendance to allow early detection of risks and reduce maternal mortality.
Maternal mortality refers to deaths due to complications from pregnancy or childbirth. Globally, almost 800 women die daily from preventable causes related to pregnancy and childbirth. The vast majority (99%) of maternal deaths occur in developing countries, particularly in sub-Saharan Africa and South Asia. The three leading causes of maternal death in the United States are postpartum hemorrhage, preeclampsia and eclampsia, and cardiomyopathy. Preventing unwanted pregnancies and ensuring access to skilled care before, during, and after childbirth can significantly reduce maternal mortality worldwide.
Maternal mortality remains a significant global issue, with one woman dying every minute from pregnancy or childbirth complications. This document defines maternal mortality and classifications, and provides data on maternal mortality ratio (MMR) in various regions. Key findings include: the state's MMR declining from 30.8 in 2008 to 21.7 in 2011 but rising again to 26.6 in 2012; the principal causes of death being obstetric embolism, medical disorders during pregnancy, and postpartum hemorrhage; and over 60% of deaths occurring postnatally. Remediable factors contributing to deaths include delays in seeking or receiving care, failure to diagnose or treat appropriately, and inadequate adherence to protocols.
Maternal mortality is defined as the death of a woman during pregnancy or within 42 days of termination of pregnancy from pregnancy-related causes. The three main causes of maternal death globally are hemorrhage, sepsis, and hypertensive disorders. In India, maternal mortality rates are highest in rural areas where access to healthcare is limited. The three delay model explains that maternal deaths are often due to delays in seeking care, reaching care, and receiving adequate care. Reducing maternal mortality requires improving access to emergency obstetric care, family planning services, and addressing social determinants like gender inequality and poverty.
Maternal mortality remains a significant global issue, with nearly 830 women dying daily from preventable causes related to pregnancy and childbirth. The majority (99%) of maternal deaths occur in developing countries, where access to skilled healthcare is limited. Key factors that influence a woman's risk include her location (rural areas pose higher risk), economic status (poorer communities at higher risk), and age (adolescents at highest risk). While the global maternal mortality ratio has declined 44% between 1990-2015, many countries still show no progress. Reliable data remains scarce but interventions like skilled birth attendance and access to family planning can significantly reduce maternal deaths.
Preterm Premature Rupture of Membranes and Neonatal and Maternal Outcomesremedypublications2
The management of Preterm Premature Rupture of Membranes (PPROM) remains
controversial. PPROM may lead significant maternal and neonatal complications.
Methods: Retrospective data of PPROM cases managed in Suleymaniye Maternity Research and
Training Hospital between 2008 and 2012 were collected and analyzed using SPSS.
Infant Mortality Rate, perinatal mortalityRoselin V
This document discusses infant and perinatal mortality. It defines key terms like live birth, fetal death, stillbirth and provides current global and national magnitudes for perinatal mortality rate, neonatal mortality rate and infant mortality rate. The major causes of infant and perinatal deaths are discussed along with the various determinants. Prevention strategies are highlighted including improvements to antenatal, natal and postnatal care. Investigation of infant deaths and methods for surveying to estimate infant mortality rate are also summarized.
- Maternal mortality in Ethiopia is a significant problem, with an estimated 25,000 maternal deaths per year. The major causes of maternal death are similar to other developing countries and include hemorrhage, sepsis, obstructed labor, hypertension, and unsafe abortion.
- There have been some changes in trends over time, with increasing proportions of deaths due to hypertension and hemorrhage, and a declining proportion due to unsafe abortion. Distance to health facilities remains a major factor influencing maternal outcomes.
This presentation is all about the epidemiology of stillbirths, in India. It talks about the different challenges in controlling the stillbirths and the strategies of controlling it. The INAP guideline of Government of India, which is a stepping stone for controlling stillbirths in India, is also discussed here.
This study assessed the prevalence of neonatal sepsis and associated risk factors among neonates admitted to neonatal intensive care units (NICUs) at two hospitals in Ethiopia from February 2016 to February 2017. The overall prevalence of neonatal sepsis was found to be 77.9%. Age of neonates, birth asphyxia, and use of oxygen via mask were significantly associated with increased risk of neonatal sepsis. The study recommends focusing prevention efforts on modifiable risk factors to reduce neonatal sepsis.
This study examined maternal and fetal outcomes in term premature rupture of membranes (PROM) using medical records from a hospital in Ethiopia between 2011-2013. The study found that 22.2% of women experienced unfavorable maternal outcomes like puerperal sepsis. 33.5% of neonates experienced unfavorable outcomes like stillbirth. Factors associated with unfavorable outcomes included residing in a rural area, duration of PROM over 12 hours, latency over 24 hours, and birth weight under 2500g. The study aims to identify factors that can help reduce complications from term PROM and improve outcomes.
This document provides background information on a proposed research study examining determinants of antenatal corticosteroid utilization among preterm births in Addis Ababa, Ethiopia. It discusses high preterm birth rates globally and in Ethiopia, complications of preterm birth like respiratory distress syndrome, and the recommendation and benefits of antenatal corticosteroid administration. While corticosteroid use is recommended, coverage remains low in low-and middle-income countries. The study aims to assess corticosteroid utilization and associated factors in Addis Ababa hospitals over 4 months in 2016. A literature review found mixed results on corticosteroid trials in developing nations and a range of utilization rates reported in other studies from the
Maternal & Infant Risks Regarding Extreme Age of PregnancyAI Publications
Background: Extremes of maternal age are of considerable clinical and public health concern as it plays an important role in infant and maternal health. This study aims to determine the effect of extreme maternal age at pregnancy on a mother and infant’s health. Methods: The study was a cross-sectional analytical observational study, conducted on a pediatric outpatient clinic at Teaching Hospital, with a purposive sample of 450 mothers. A structured questionnaire was designed, which included socio-demographic data, factors related to pregnancy care, and factors related to the infant. Results: The main maternal health problem during pregnancy was anemia and pregnancy induced hypertension with a statistically significant association between the mother’s age and maternal morbidity. The main causes of baby admission into hospital were diarrhea and acute respiratory diseases, with a statistical significant. Conclusion: There was an agonizing correlation between extreme maternal age and infant health. A serious collaborative effort must be done between social worker in health facilities and community, to rise up awareness about the suitable age of marriage and reproductive health.
Incidence of Neonatal Septicemia in Babies Admitted in Pediatric Ward of KIU...PUBLISHERJOURNAL
This research was done to determine factors that influence the occurrence of neonatal septicemia among babies admitted in Kampala international university teaching hospital. This study was guided by the following objectives: to assess the maternal related factors associated with occurrence of neonatal septicemia among babies admitted in Pediatric ward of Kampala international university teaching hospital; to determine neonatal related factors associated with occurrence of neonatal septicemia among babies admitted in Pediatric ward of Kampala international university teaching hospital and to determine the social-economic factors associated with occurrence of neonatal septicemia among babies admitted in Pediatric ward of Kampala international university teaching hospital. A cross sectional study design was used in this study; A sample of 134 respondents were studied which included neonates/caretakers and health workers; data was collected with the use of observation, interview guide and questionnaires; data analysis and interpretation were done using Statistical package for social sciences (SPSS) to generate descriptive statistics and Chi-square p-values that were used to draw conclusion of the study. The results from this research showed that; - the maternal factors that influenced the occurrence of neonatal septicemia among babies admitted in pediatric ward of Kampala international university teaching hospital were inadequate Antenatal Care (ANC) attendance, prolonged rupture of membrane, bathing neonates with herbal medicines and place of delivery whereby a significant number of mothers delivered from home. On the neonatal factors the researcher found out that birth weight had a significant influence on the occurrence of neonatal septicemia among babies admitted in pediatric ward of Kampala international university teaching hospital. Finally, the study identified the socio-economic factors responsible for the occurrence of neonatal septicemia among babies admitted in pediatric ward of Kampala international university teaching hospital as washing hands before handling the neonates, low level of monthly household income and low level of education among caretakers. Based on the findings of this study, the researcher recommends that the Government through the DHOs offices should embark on health education by educating the pregnant women on the dangers of giving birth from their homes and also being helped by unqualified midwives. Also, the government through district sensitization programs should encourage pregnant women to seek antenatal care at the health facilities where they can be health educated, comprehensively screened and treated of infections to prevent spread of infections to newborns.
Keywords: Pediatric, Septicemia, Pregnant Women, Health Education, Antenatal care.
________________________________________
Dr. Ankit Jain et al conducted a study to evaluate neonatal outcomes in mothers with premature rupture of membranes (PROM) at a tertiary care hospital. They analyzed 85 neonates born to mothers with PROM. Most neonates were born at 35-36 weeks gestation to primigravid mothers aged 21-25 years via normal vaginal delivery. The most common neonatal complications were jaundice, respiratory distress, and hypoglycemia. Over half of neonates were admitted to the NICU. Most had normal CBC and CRP reports, and the majority exhibited no complications. Common issues during hospitalization included decreased activity, fever, and feeding difficulties.
This study analyzed maternal and perinatal outcomes of 150 patients referred to a tertiary hospital in India over 24 months. The most common reasons for referral were previous cesarean section (28.7%) and premature rupture of membranes (16%). Majority of referrals came from private hospitals (48.7%) and primary health centers (44%), indicating gaps in emergency obstetric care. Most common maternal complications were anemia requiring blood transfusion (10%) and cesarean delivery (92.7%). There was 1 maternal death (0.7%) and 12 near miss cases (8%). For neonates, 42.9% had respiratory distress and 42.7% required NICU admission. Neonatal
Focused antenatal and emergecy obstetric carePave Medicine
Focused antenatal care (FANC) aims to provide goal-oriented and timely care during pregnancy through a limited number of focused visits. The document outlines the elements and purposes of FANC, including early detection and management of diseases, individual birth planning, and 4 scheduled antenatal visits. It also discusses emergency obstetric care (EmOC) and the need to address barriers to access such as delays in seeking, reaching, and receiving appropriate care. A study in northern Tanzania found low availability of basic EmOC units, high availability of comprehensive EmOC units, and that 36% of expected deliveries occurred in EmOC facilities, above the minimum threshold of 15%.
Evaluation of factors that contributes to post-partum haemorrhage in Pregnant...PUBLISHERJOURNAL
Postpartum haemorrhage (PPH) is the world’s leading cause of maternal death and accounts for an estimated 127,000 deaths each year. Identification of some of the risk factors such as; previous postpartum haemorrhage, multiple pregnancies, macrosomia, induction of labour, operative vaginal deliveries and cesarean section would help in preventing PPH. The aim of this research was to assess the factors contributing to postpartum haemorrhage (PPH) among pregnant women who attend delivery services in Kampala International University Teaching Hospital (KIU-TH). This study used a cross-sectional descriptive design where by a cross-section of respondents involving 68 respondents were sampled to represent the target population, in these case women who received maternity service from KIU-TH. Only quantitative methods of data collection using questionnaires with closed ended questions were employed for both mothers and health workers. During the study period, 58 women who delivered in the unit and 20 women developed postpartum haemorrhage giving the frequency of postpartum haemorrhage 34.6%. The majority of the women 30% were between 30-34 years of age. Among the women who developed PPH retained placental tissues was the most common cause 50% followed by uterine atony which was 30%. The rest of the causes of PPH were laceration 20%. Postpartum haemorrhage is still a leading but preventable cause of maternal morbidity and mortality in our country due to underutilization of health facilities, the major cause is retained placental tissues followed by uterine atony.
Keywords: post-partum haemorrhage, pregnant women, delivering, Uganda
Evaluation of factors that contributes to post-partum haemorrhage in Pregnant...PUBLISHERJOURNAL
Postpartum haemorrhage (PPH) is the world’s leading cause of maternal death and accounts for an estimated 127,000 deaths each year. Identification of some of the risk factors such as; previous postpartum haemorrhage, multiple pregnancies, macrosomia, induction of labour, operative vaginal deliveries and cesarean section would help in preventing PPH. The aim of this research was to assess the factors contributing to postpartum haemorrhage (PPH) among pregnant women who attend delivery services in Kampala International University Teaching Hospital (KIU-TH). This study used a cross-sectional descriptive design where by a cross-section of respondents involving 68 respondents were sampled to represent the target population, in these case women who received maternity service from KIU-TH. Only quantitative methods of data collection using questionnaires with closed ended questions were employed for both mothers and health workers. During the study period, 58 women who delivered in the unit and 20 women developed postpartum haemorrhage giving the frequency of postpartum haemorrhage 34.6%. The majority of the women 30% were between 30-34 years of age. Among the women who developed PPH retained placental tissues was the most common cause 50% followed by uterine atony which was 30%. The rest of the causes of PPH were laceration 20%. Postpartum haemorrhage is still a leading but preventable cause of maternal morbidity and mortality in our country due to underutilization of health facilities, the major cause is retained placental tissues followed by uterine atony.
Keywords: post-partum haemorrhage, pregnant women, delivering, Uganda
Lscs audit in a tertiary care center in mumbai to study indications and risk...Papri Sarkar
This study analyzed 474 cesarean section cases performed over 6 months at a tertiary hospital in Mumbai, India. The overall cesarean rate was 25.7%, and primary cesarean rate was 23.1%. Previous cesarean section was the leading indication (35.2% of cases), followed by fetal distress (14.9%) and previous 2 cesareans (10.5%). Early perinatal mortality was 1.6% and morbidity from NICU admission was 20.8%. Highest morbidity occurred in babies delivered for fetal distress, multiple pregnancy, and premature rupture of membranes. Careful evaluation of indications and individualization can help reduce early perinatal morbidity and mortality.
This study evaluated the clinical and perinatal outcomes of 100 teenage pregnancies at a tertiary referral center in South India. The study found that teenage pregnancies had higher rates of complications like anemia (43%), preeclampsia (21%), preterm labor (21%), and emergency c-sections (33%) compared to adult pregnancies. Neonatal outcomes were also worse, with 38% of babies being low birth weight (<2.5 kg) and 21% being preterm. The study concluded that teenage pregnancy poses significant health risks to both mother and baby due to the biological immaturity of teenage mothers.
This study investigated risk factors for low birth weight (LBW) in Sudan. Researchers conducted a case-control study of 1,224 deliveries at a hospital in Medani, Sudan between August and October 2009. They found that 12.6% of births were LBW. Lack of antenatal care and maternal anemia were significant risk factors for LBW based on multivariate analysis, with odds ratios of 5.9 and 9.0 respectively. Maternal socio-demographic characteristics and measurements were not associated with LBW. The study concludes that improving antenatal care and nutrition may help prevent LBW.
The study assessed knowledge, attitude, and practices regarding emergency contraception among 366 female students in Mekelle, Northern Ethiopia. The key findings were:
1) About 90.7% of respondents had heard of emergency contraception. Three-fourths (75.7%) had good knowledge and over half (64.9%) had a positive attitude.
2) Older age was significantly associated with greater awareness. Those over 18 were more likely to have good knowledge compared to younger students.
3) Age and ethnicity also influenced attitude - younger students and non-Tigre ethnic groups were less likely to have a positive attitude.
4) While knowledge and attitude were high, the study
The relationship between prenatal self care and adverse birth outcomes in you...iosrjce
Birth outcomes refer to the end result of a pregnancy. The purpose of this study was to examine the
relationship between self care practices during pregnancy and adverse birth outcomes in young women aged 16
to 24 years at a provincial maternity hospital in Zimbabwel. A descriptive corelational design was used. Orem’s
Self Care theory was used to guide the study. Eighty pregnant women were selected using systematic random
sampling and, data was collected using interviews from the 1 March - 31 April 2012. Permission to carry out
the study was obtained from the provincial maternity hospital, the Department of Nursing Science and the
Medical and Research Council of Zimbabwe. Findings revealed such adverse birth outcomes as prematurity
(between 28-32 weeks) 10 (12.5%), still births, 3 (3.75%), low apgar 17 (21.2%) and low birth weight 16 (20%).
Adverse birth outcomes in the mothers included high blood pressure 32 (40%), HIV infection 20 (25%) and post
partum hemorrhage 7 (8.8%) Twenty-four (30%) participants had not booked for antenatal care, 1 (1.8%)
booked for antenatal care at less than 12 weeks while only 1 (1.8%) disclosed her pregnancy at above 29 weeks’
gestation. There was a moderate significant positive correlation between self care practices and adverse birth
outcomes, r=.340. This meant that birth outcomes improved as self care practices increased. Significant R2
. was
.115 meaning self care practices explained 11.5% of the variance observed in birth outcomes. Midwives should
advocate delay in sexual debut in young women to reduce adverse birth outcomes.
[[INOSR ES 11(2)108-121, 2023.Evaluation of Male partner participation in pre...PUBLISHERJOURNAL
Evaluation of Male partner participation in prevention of mother to child transmission of HIV/AIDs at Hoima Referral hospital
Sebwami Richard
School of Allied Health Sciences, Kampala International University Uganda.
________________________________________
ABSTRACT
The purpose of the study was to assess the knowledge and attitude, the level of male involvement and factors associated with male involvement in the prevention of mother-to-child transmission of HIV in Hoima municipality. This study was a descriptive cross section in which quantitative method of data collection was employed in collection of data from respondents. Questionnaires were distributed to participants to assess the knowledge and attitude, the level of male involvement and factors associated with male involvement in prevention of mother-to-child transmission of HIV (PMTCT) in Hoima municipality. Sample size of 200 participants were used, this included the Male partners who hard escorted their pregnant partners to the antenatal clinic aged between 20-50years.The predominant religion were Catholics 59% and seventh day Adventists. Regarding educational levels, majority of respondents had completed secondary level and above (61%) and the predominant ages were between 20-29 years. The study revealed that very few males partner were involved in the PMTCT program especially during HIV counseling and testing (HCT) because of being at old age group above 30years couples, couples not living together, high number of wife’s pregnancies four and above, having no knowledge on methods of MTCT, and husbands failure to discuss HCT with their wives. From the findings, majority of the respondents have ever had about the male involvement in the PMTCT but there was still low male involvement in PMTCT programs at antenatal clinics. There is a need to do an in-depth assessment of women’s experiences when tested HIV-positive in the presence of their partners at the ANC, as well as to develop strategies to improve male involvement. The study again recommends formative research on the use of incentives to promote male involvement in the PMTCT program and the government should train more of the health promoters and the Village Health Teams in order to reach even those that are deep in the village that are not having easy access to the health facility.
Keywords: HIV, Hoima municipality, Male partner, counseling
Developing normal placental growth curves using 2 d ultrasound in a zimbabwe ...TÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
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tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
- The study assessed the prevalence of vitamin-A deficiency and its determinants among 681 preschool children in Dembia District, Ethiopia.
- The overall prevalence of xerophthalmia (a clinical sign of vitamin-A deficiency) was found to be 8.6%.
- Factors significantly associated with vitamin-A deficiency included non-attendance at antenatal care clinics, being male, and being between 49-59 months of age.
This document provides an introduction to the Rashtriya Bal Swasthya Karyakram (RBSK) program in India, which aims to screen over 270 million children aged 0-18 for defects, diseases, deficiencies, and developmental delays. It does this through mobile health teams that screen children in anganwadis and schools. Children identified with issues are referred to primary or community health centers, or district early intervention centers for further examination and treatment if needed. The district early intervention centers are located in district hospitals and have medical professionals and facilities to assess children for conditions like hearing, vision, motor and cognitive impairments. The goal of the program is to identify health issues in children early and ensure they receive
Ijsrp p8825 Caregiver factors influencing seeking of Early Infant Diagnosis (...Elizabeth kiilu
Caregiver factors influencing seeking of Early Infant Diagnosis (EID) of HIV services in selected hospitals in Nairobi County, Kenya:A qualitative Study
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
2. nearly half (47%) of the under five deaths occurred in the
first month of life. In other words, the probability of dying
in the first 28 days of life was estimated at 18 deaths per
1,000 live births globally.2
Over the last two decades, the world has made substantial
progress in the reduction of mortality among children.
Globally, the neonatal mortality rate fell by 51% which
means 37 deaths per 1,000 live births in 1990 to 18 in
2017. However, the change in neonatal mortality is not as
significant as the change in children aged 1–59 months
(63%).2
Africa contributed to one third of the world’s neo-
natal mortality burden. In this region about 75% of deaths
occurred during the first week of life almost half being within
the first 24 hrs. Among (Sustainable Developmental Goals
(SDG) regions, Sub-Saharan Africa had the highest neonatal
mortality rate in 2017 at 27 deaths per 1000 live births.2–4
According to the Ethiopian Demographic Health Survey
(EDHS) 2016, the under-5, infant and neonatal mortality rate is
67, 48 and 29 deaths per 1,000 live births respectively. In other
words, in Ethiopia 1 in every 35 children dies within the first
month, 1 in every 21 children dies before celebrating the first
birthday, and 1 of every 15 children dies before reaching the
fifth birthday. Childhood mortality has declined substantially
since 2000. Neonatal mortality declined from 49 deaths per
1,000 live births in 2000 to 29 deaths per 1,000 births in 2016,
areduction of41% overthe past16 years. However, the change
in neonatal mortality is not as significant as the change in post-
neonatal and child mortality.5
In Ethiopia, the main causes of
neonatal deaths were birth asphyxia, prematurity and sepsis.6–9
Knowing the disease patterns and causes in the Neonatal
Intensive Care Unit (NICU) and the disease-wise mortality
rate can inform the requisite efforts to reduce morbidity and
mortality. Therefore, the aim of this study was to assess the
causes and factors associated with neonatal mortality among
neonates admitted to the Neonatal Intensive Care Unit
(NICU) of Jimma University Medical Center.
Materials and methods
Study design and period
An institutional based retrospective cross-sectional study
was conducted from February 12, to 23, 2018 using the
medical records of neonates admitted to Neonatal ICU of
Jimma University Medical Center (JUMC).
Study setting and period
The study was carried out at Neonatal ICU of Jimma
University Medical Center, located in Jimma town. The town
is located 357 km towards the southwest of Addis Ababa, the
capital of Ethiopia. JUMC is the only tertiary and referral
teaching hospital in the south western part of the country, and
currently provides different services for approximately
18 million people in the catchment area. The neonatal ICU is
one of the ICU services that the hospital is currently running.
The unit has 20 neonatal beds and 14 Kangaroo mother care
(KMC) beds. the unit also has 2 incubators,10 radiant warmers,
4 continuous positive airway pressure (CPAP), phototherapy
and oxygen concentrator machines. Additionally, there is pulse
oximetry, glucometer and neonatal resuscitation equipment.
Advanced procedures such as exchange transfusions and
Lumber punctures are performed at the center. The unit is
staffed with pediatricians, pediatric residents and neonatal
nurses and located adjacent to the labour ward to receive high-
risk newborns from this unit. Furthermore, the unit also
receives neonates referred from other health facilities and
homes. The maternal services including antenatal care follow
up, delivery services, early detection and treatment of high-risk
pregnant mothers are currently run by the center. According to
Jimma town municipality reports during the last three years,
there were 19,250 institutional delivery cases in Jimma town,
from which 13,568 mothers give birth at JUMC, which
resulted in 13,705 total live births.
Study population
The study populations were all neonates admitted to the
Neonatal Intensive Care Unit (NICU) of JUMC from
September 11, 2014 to September 10, 2017.
Inclusion and exclusion criteria
Medical records of neonates with a missing diagnosis of
admission and missing clinical outcomes, other than death
and improved discharge were excluded from the study
(Figure 1).
Sample size
All available medical records of neonates that fulfilled the
inclusion criteria were included in the study.
Data collection procedures
Data were extracted by reviewing medical records of new-
borns using a structured checklist adapted from the previous
related study.8
The checklist contained variables including
age, sex, address of parents, gestational age, birth weight,
length of stay, causes of admission, causes of death and
medical outcomes. The quality of the data collected was
guaranteed by pretesting using the medical records of 5%
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submit your manuscript | www.dovepress.com
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Pediatric Health, Medicine and Therapeutics 2019:10
40
3. of the newborns before actual data collection. The data were
collected by professional nurses and training was given to the
data collectors on how to collect data from the records to
augment data accuracy and validity. The data collection was
closely supervised by the supervisors to check for its com-
pleteness and clarity before data entry.
Data analysis
The Collected data were cleaned, coded and entered into
Epidata 3.1 and exported, to SPSS for windows version
23.0 for cleaning and analyses, data were summarized, by
using simple frequency tables, graphs, and charts.
Bivariate analysis of candidate associated factors for mul-
tivariate analysis at the p-value of <0.25 and multivariate
analysis was employed, in order to assess the relative
effect of independent variables on dependent variables
and statistically significant association was declared at
the p-value of less than 0.05.
Operational definitions
Neonatal conditions were divided into five major cate-
gories, four adapted from the Global Burden of Diseases
(GBD 2017) classification catalog, and one category, Low
Birth Weight (LBW) added from the National strategy for
newborn and child survival in Ethiopia.35,36
The presenta-
tion conditions included under these five categories is
presented in the Table 1. Specific neonatal conditions
Total admission
3276 cases
Total included
3093 neonates
Excluded records
183 cases
Leave against medical advice
110 cases
Incomplete records
67 cases
Referred
6 cases
Figure 1 Flow chart of the inclusion and exclusion criteria.
Table 1 Major categories of neonatal diseases and definitions
Categories Definitions Conditions included
Birth asphyxia & other perina-
tal complications
Any of the following conditions identified to occur in a newborn
during the perinatal period.
-Birth asphyxia
-Birth trauma
-Hypoglycemia/Hypothermia
-Meconium aspiration syndrome(MAS)
-Pathological jaundice
Neonatal sepsis & Infections Any neonatal conditions identified as neonatal sepsis and other
neonatal infections.
-EONS
-LONS
-Any other infectionsa
Preterm birth complication Any complications occurred in preterm newborns which
attributed to prematurity
-Prematurity
- Respiratory complication
-Metabolic complications (Hypoglycemia/
Hypothermia)
- Infections and Sepsis
- Other complications related to preterm
birth
Low birth weight Any child with birth weight is less than 2,500 g or recorded as
LBW.
-Low birth weight (EVLBWa
, LBW
LBW)
Other neonatal condition All neonatal conditions other than those listed in the above
categories.
eg Congenital malformations, baby of high
risk mothers, anemia,
Circumcision site bleeding, baby admitted for
observation and etc.
Note: a
Any other infection; includes any infections other than EONS and LONS.
Abbreviations: EONS, early onset neonatal sepsis; LONS, late onset neonatal sepsis; EVLBW, extremely very low birth weight; VLBW, very low birth weight; LBW, low
birth weight; JUMC, Jimma University Medical Center.
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41
4. with high frequency were selected and used for multi-
variate analysis. In JUMC, the causes of neonatal admis-
sions and deaths were recorded based on clinical
presentation and supportive laboratory results. In this
study any neonatal conditions or diagnosis identified or
recorded for deceased neonates were considered as causes
of death and its contributing factors. In other words,
causes of deaths were defined as the underlying neonatal
factors or conditions, which presented in the admitted or
deceased neonate. Variables such as birth weight; gesta-
tional age and maturity were classified based on WHO
classification criteria.1
The gestational age was estimated
using Maternal Report of the Last Normal Menstrual
Period(LNMP) and confirmed by ultrasound for those
mother who gave birth at the center while the Ballard
score was used to estimate the gestational age of the new-
born delivered outside the center and newborn delivered to
those mothers who did not remember or know the date of
their last normal menstrual period. The neonatal mortality
rate was number of deaths during the first 28 completed
days of life per 1,000 live births in a given period.
Ethical considerations
Ethical clearance to conduct the study was obtained from the
institutional review board of the Institute of Health, Faculty
of Health Sciences, Jimma University. Further permission
was obtained from the medical director of JUMC and the
department head of pediatrics and gynecology for the utiliza-
tion of medical records. We guaranteed confidentiality by
excluding names or any other personal identifiers from data-
collection sheets and reports. The identifier for each eligible
subject was replaced by a code and no master code exists that
allows the research data to be linked with the identifiers.
Results
The total number of neonates admitted to the NICU during
the period under the study was 3,276, of which 110 neo-
nates left against medical advice, 67 neonates had deficient
records and 6 neonates were referred to other facilities
and were excluded from the study. A total of 3,093 neonates
with improved/death hospital outcomes were included for
further analysis.
Socio-demographic characteristics
The present study shows that, more than half, 1837(59.4%) of
the neonates were males, while 1256(40.6%), were females
giving a male to female ratio of 1.46:1. The majority, 2349
(76.0%) of the newborns admitted within 24 hrs of life while
135(4.3%) were admitted within 8–21 days of life. The mean
age at admission was 1.84(SD±2.4) days. With regard to the
residential addresses of parents, the majority 2135(69%) came
from places outside Jimma town, while 958(31%) of them
were from Jimma town. For the period under the study it was
observed that the magnitude of admissions increased from 453
(14.6%) admissions during 2014/15 to 1085(35.1%) during
the year 2016/2017. The highest admission of neonates was
observed in 2015 which accounted for half (50%) of the total
neonatal admissions studied (Table 2). Less than one third, 864
(27.9%) of the neonates were preterm whereas 2229(72.1%)
were term neonates. Regarding gestational ages of the neo-
nates, the majority 222(71.9%)had a gestational age between
37–42 weeks. The birth weight of the newborns studied were
comprised of, nearly one third 1108(35.8%) within the Low
Birth Weight (LBW) range. Amongst these 29(1.0%), and 236
(7.6%) had extremely or very low birth weights, respectively.
Seventy two percent of the neonates were discharged within
7 days of admission, and the median length of stay was 5 days.
Out of 3093 neonates admitted 412 died, giving a death rate of
13.3%. In other words, there were 30 deaths per 1,000 live
births at the JUMC for the period under the study. The mor-
tality rate was higher among neonates of extremely low birth
weight, gestational age <28 weeks, very low birth weight and
preterm which accounted 27/29(93%), 23/25(92%), 124/236
(52.5%) and 230/864(26.6%) respectively (Table 2).
Causes of neonatal admission and death
Nearly half (1,488, 48.1%) of admissions were due to birth
asphyxia & other perinatal complications. Of these 138
died, accounting for 4.5% of total neonatal mortality.In
contrast low birth weight newborns, accounted for 1108
(35.8%) of admissions and contributed to 249(8.1%)of
neonatal deaths. Furthermore, neonatal sepsis and infec-
tions were the third causes of a visit to the neonatal ICU,
accounting for 919(29.7%) and 129(4.2%) neonatal admis-
sions and deaths, respectively (Table 3).
Top causes of neonatal admission and
death
All available admission diagnoses were extracted to eval-
uate the proportional cause of admission and death among
neonates., Low birth weight, neonatal sepsis, and
hypothermia were the top three conditions that accounted
for 1108(35.8%), 884(28.6%), and 809(26.2%) of neonatal
ICU admissions, respectively. Furthermore, 157(5.1%),
112(3.6%), and 86(2%) of the neonates were admitted
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5. due to meningitis, sub-glial haemorrhage, and macroso-
mia, respectively (Table 4).
With respect to the top ten leading causes of deaths, out of
1,108 neonates admitted with Low birth weight, 249(60.4%)
died. Among premature neonates,230(55. %)of them died.
Total neonates with sepsis were 884 and 129(31.3%) died.
Hypothermia accounted for 809 (28.6%) admissions and169
(41%) deaths. Moreover, Respiratory Distress Syndrome
(RDS), 169(41.0%) was the fourth ranked cause observed
among the deceased neonates; whereas hypoglycaemia, 49
(11.9%), congenital malformations 33(8%), and pathologic
jaundice, 31(7.5%) were the least ranked three conditions
respectively (Table 4).
Multivariate analysis of socio
demographic characteristics of neonate
admitted to the NICU of JUMC
Using Multivariate analysis, to test the association of socio
demographic variables with neonatal mortalities, four vari-
ables were found to be significantly associated with neonatal
death. These variables were address of parents, the length of
stay, gestational ages, and birth weight and maturity levels.
neonates who came from addresses outside the city had a 1.89
times higher increased risk of mortality (AOR 1.89, 95%
CI1.4–2.5) compared to their counterparts resident in the
city. Neonates who stayed for less than one week in the
NICU had 3.9 fold higher odds of neonatal mortality (AOR
3.9, 95%CI2.8–5.50), compared to those who stayed for more
than one week. The risk of mortality decreased as the gesta-
tional age increased. The highest risk was observed in those
neonates delivered before 28 weeks of gestation (AOR 19.2,
95%CI 3.9–90.9). The same was true for the birth weight; the
Table 2 Demographic characteristics of neonates admitted to
JUMC
Characteristics Frequency Percent Mean
±SD
Sex Male 1,837 59.4%
Female 1,256 40.6%
Total 3,093 100%
Age <24 hrs 2,349 76.0%
2–7 days 609 19.7%
≥8–14 days 135 4.3%
Total 3,093 100% 1.84
±2.4
Parents’
residency
From Jimma 958 31.0%
Out of
Jimma
2,135 69.0%
Total 3,093 100%
Year of visit 2014/2015 453 14.6%
2015/2016 1,555 50.3%
2016/2017 1,085 35.1%
Total 3,093 100%
Gestational
age
<28 weeks 25 0.8%
28 –
<32 weeks
219 7.1%
32 –
<37 weeks
620 20.0%
37 –
<42 weeks
2,222 71.9%
>42 weeks 7 0.2%
Total 3,093 100%
Maturity Preterm 864 27.9%
Term 2,229 72.1%
Total 3,093 100%
Birth weight EVLBW 29 1.0%
VLBW 236 7.6%
LBW 843 27.3%
NBW 1,864 60.3%
Macrosomia 121 3.9%
Total 3,093 100%
Length of say <7 Days 2,231 72.1%
>7 Days 862 27.8%
Total 3,093 100%
Median 5
Hospital
Outcomes
Died 412 13.3%
Improved 2,681 86.7%
Total 3,093 100%
Abbreviations: EVLBW, extremely very low birth weight; VLBW, very low birth
weight; LBW, low birth weight; NBW, normal birth weight; JUMC, Jimma University
Medical Center.
Table 3 Aggregated categories of causes of admission and death
by outcomes among neonates admitted to Neonatal ICU of
JUMC
Categoriesa
Outcomes at
discharge
Total
Death Improved
No
(%)
No(%) No(%)
All causes 412
(13.3)
2681(86.7) 3093(100)
Birth asphyxia & other peri-
natal complications
138
(4.5)
1350(43.6) 1488
(48.1)
Low birth weight 249
(8.1)
859(27.8) 1108
(35.8)
Neonatal sepsis and
infections
129
(4.2)
790(25.5) 919(29.7)
Preterm birth complications 222
(7.2)
561(18.1) 783(25.3)
Other neonatal conditions 87(2.8) 481(15.6) 568(18.4)
Note: a
One neonate can be categorized in more than one categories
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43
6. risk of mortality decreased as the birth weight increased and
the highest risk was seen in a neonate who had birth weight
less 1,000 g (AOR 44.8, 9%CI9.43–200). The odds of neona-
tal death in preterm birth was two times higher compared to
term births as shown in Table 5.
Multivariate and univariate analysis of
factors associated with neonatal
mortalities
Univariate logistic regression analysis was performed sepa-
rately for each neonatal condition and any risk factors that
showed significant association (P<0.25) with the outcome
were selected for multivariate analysis. While testing the
association of causes of neonatal admissions with the neonatal
mortality using binary logistic regressions seven variables
were significantly associated with neonatal mortalities.
Neonatal sepsis, hypothermia and meconium aspiration
syndrome(MAS) were not significantly associated with mor-
tality in univariate analysis. In multivariate analysis, only five
variables were found to be the significant predictors of the
neonatal mortalities. The odds of neonatal mortalities among
preterm neonates were 2.2 times higher than that of term
Table 4 Top ten leading causes of admissions and mortalities among neonates admitted to JUMC
Ranks Causes of admission (n=3093) No(%) Ranks Causes of death (n=412) No(%)
1 Low birth weight 1108(35.8) 1 Low birth weight 249(60.4)
2 Neonatal Sepsis 884(28.6) 2 Prematurity 230(55.8)
3 Hypothermia 809(26.2) 3 RDS 169(41.0)
4 Hypoglycemia 548(17.7) 4 Neonatal sepsis 129(31.3)
5 RDS 413(13.4) 5 Hypothermia 120(29.1)
6 PNA 286(9.2) 6 PNA and birth trauma 108(26.2)
7 Baby of a high-risk mother 172(5.6) 7 MAS 53(12.9)
8 Meningitis 157(5.1) 8 Hypoglycemia 49(11.9)
9 Sub-glial Hemorrhage 112(3.6) 9 Congenital malformation 33(8.0)
10 Macrosomia 86(2) 10 Pathologic Jaundice 31(7.5)
Abbreviations: RDS, respiratory distress syndrome; MAS, meconium aspiration syndrome; PNA, perinatal asphyxia; JUMC, Jimma University Medical Center.
Table 5 Multivariate analysis of socio demographic characteristics of neonate admitted to the NICU of JUMC
Variables Died Survived COR(CI,95) AOR(CI,95) P-value
No(%) No(%)
Sex Male 236(7.6) 1601(51.8) 1 1
Female 176(5.7) 1080(34.9) 1.11(0.90, 1.36) 0.99(0.78, 1.26) 0.934
Age <24 hrs 337(10.9) 2011(65.0) 1.26(0.74, 2.15) 0.62(0.35, 1.10) 0.101
2–7 days 59(1.9) 550(17.8) 0.80(0.45, 1.45) 0.58(0.31, 1.07) 0.081
≥8 days 16(0.5) 120(3.9) 1 1
Address Out of Jimma 326(10.5) 1809(58.5) 1.83(1.422, 2.35) 1.89(1.43, 2.51)
From Jimma 86(2.8) 872(28.2) 1 1 0.000
Length of stay <7 Days 346(11.2) 1885(60.9) 2.21(1.68, 2.92) 3.93(2.82, 5.50)
>7 Days 66(2.1) 796(25.7) 1 1 0.000
Gestational age <28 weeks 23(0.7) 2(0.1) 129.7(30.3, 554.3) 19.16(3.9, 90.9) 0.000
>42 weeks 1(0.0) 6(0.2) 1.88(0.23, 15.70) 3.58(0.39, 33.3) 0.260
28 - <32 weeks 93(3.0) 126(4.1) 8.33(6.12, 11.33) 3.06(1.79, 5.26) 0.000
32 - <37 weeks 114(3.7) 506(16.4) 2.54(1.97, 3.27) 1.89(1.23, 2.92) 0.004
37 - <42 weeks 181(5.9) 2041(66.0) 1 1
Birth weight <1,000 g 27(0.9) 2(0.1) 142.8(33.7, 606) 44.84(9.43, 200) 0.000
<2,500 g 98(3.2) 745(24.1) 1.39(1.07, 1.81) 0.88(0.59, 1.33) 0.541
>4,000 g 2(0.1) 119(3.9) 0.18(0.04, 0.73) 0.16(0.04, 0.66) 0.011
2,500–4,000 g 161(5.2) 1703(55.1) 1 1
<1,500 g 124(4.0) 112(3.6) 11.71(8.66, 15.85) 6.87(4.05, 11.6) 0.000
Maturity Preterm 230(7.4) 634(20.5) 4.08(3.30, 5.05) 2.11(1.39, 3.23)
Term 182(5.9) 2047(66.2) 1 1 0.001
Note: Preterm: those who delivered before 37 weeks of Gestation, Term:those delivered at above 37 weeks of gestation.
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7. neonates (AOR 2.2, 95%CI 1.41, 3.42). Neonates who had
a history of birth asphyxia had five fold higher odds of death
(AOR4.9, 95%CI 3.6, 7.34) and low birth weight had 1.54
times increased risk of mortality (AOR 1.54, 95%CI 1.06,
2.25). The odds of death among newborns who had a history
of congenital malformations and RDS were four times that of
neonates who did not have the conditions (AOR 4, 95%CI
2.55–2.68) and (AOR 4.15,95%CI 2.9–5.66) respectively
(Table 6).
Discussion
According to the Ethiopian demographic health survey
(EDHS) 2016, in Ethiopia 1 in every 35 children dies
within the first month of birth.5
The present study assessed
causes and factors associated with neonatal mortality
among neonates admitted to NICU of Jimma University
Medical Center.
The present study reported that low birth weight
35.8%, neonatal sepsis 28.6% and hypothermia 26.2%
were found to be the three predominant causes of
neonatal admissions. The proportions of these causes
of admission vary across different studies conducted in
Ethiopia.8–11
Similar to this study neonatal sepsis and
low birth weight were found to be within the top three
leading causes of neonatal admissions in other several
studies conducted outside Ethiopia.12–17
This implies
that major causes of neonatal admissions were attribu-
ted to avoidable and curable neonatal conditions and
would be preventable if detected early and proper care
were in place.
In the present study, the overall neonatal mortality
rate was 12.6% (30 deaths per 1,000 live births). This
finding is inconsistent with several studies carried out
in different parts of Ethiopia. The current finding is
slightly lower than the studies conducted in northwes-
tern parts of Ethiopian and significantly lower than the
study carried out in Addis Ababa which was 14.3%,
15.9%, and 23.2% respectively. Similarly, the finding
in this study is significantly lower than the neonatal
mortality rate reported by WHO in 2018 which is 40%
and also lower compared to studies conducted in
Eritrea 8.2%, Pakistan 6.8%, South Africa 3.8% and
India 7.16%. Commonly, the mortality rates of the
newborn in NICU fluctuate between 3.1% and 29% in
Table 6 Multivariate and Univariate analysis of factors associated with Neonatal mortalities among neonate admitted to JUMC
Variables Died Survived COR(CI,95) AOR(CI,95) P-value
No(%) No(%)
Prematurity Yes 230(7.4) 634(20.5) 4(3.29,5.05) 2.2(1.41,3.42) 0.000
No 182(5.9) 2047(66.2) 1 1
Neonatal sepsis and Infection Yes 129(4.2) 790(25.5) 1.1 (0.87,1.36)
No 283(9.1) 1891(61.1) 1
Birth asphyxia and birth trauma Yes 108(3.5) 348(11.3) 2.4(1.86,3.04) 4.95(3.6,7.34) 0.000
No 304(9.8) 2333(75.4) 1 1
Low birth weight Yes 249(8.1) 859(27.8) 3.24(2.6,4.01) 1.54(1.06,2.25) 0.025
No 163(5.3) 1822(58.9) 1 1
Hypothermia Yes 120(3.9) 689(22.3) 1.2(0.94,1.49) 0.97(0.74–1.27) 0.816
No 292(9.4) 1992(64.4) 1 1
Hypoglycemia Yes 49(1.6) 499(16.1) 0.59(0.43,0.80) 0.81(0.57–1.15) 0.231
No 363(11.7) 2182(70.5) 1 1
Congenital malformation Yes 33(1.1) 122(3.9) 1.8(1.23,2.7) 4(2.55–2.68) 0.000
No 379(12.3) 2559(82.7) 1 1
MAS Yes 53(1.7) 322(10.4) 1.1(0.79,1.48)
No 359(11.6) 2359(76.3) 1
Pathologic Jaundice Yes 31(1.0) 300(9.7) 0.65(0.44–0.95) 0.82(0.54–1.25) 0.357
No 381(12.3) 2381(77) 1
RDS Yes 169(5.5) 252(8.1) 6.7(5.29–8.48) 4.15(2.9–5.66) 0.000
No 243(7.9) 2429(78.5) 1
Others conditions Yes 54(1.7) 359(11.6) 0.98(0.72–1.32)
No 358(11.6) 2322(75.1) 1
Abbreviations: RDS, respiratory distress syndrome; MAS, meconium aspiration syndromes; JUMC, Jimma University Medical Center.
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8. the world.8,11–20–22
The discrepancy observed between
the mortality rates estimated by several centers and
countries might be due to the difference in the distri-
bution of skilled human resources, quality of care
delivered by the centers, equipment availability, and
socioeconomic status, as well as geographical
locations.
The major causes of neonatal mortality in the current
study were low birth weight 8%, prematurity, 7.4%, RDS
5.4%. Case fatality for neonatal sepsis was 4.2%. The
similar causes of neonatal mortalities were reported in
several studies conducted in other centers and
countries.8–11,15,16,23–27
Most of the neonatal problems
would be avoidable if proper antenatal care implementa-
tion and on time linkage of high risk pregnant women to
health institutions were in place,28
This implies that
antenatal care services in the area were not satisfactory
in anticipating and linking high risk pregnant women to
health institutions where an appropriate neonatal care ser-
vice was available.
In multivariate analysis of neonatal conditions prema-
turity, low birth weight, birth asphyxia, congenital malfor-
mations and respiratory distress syndrome were identified
as predictors of neonatal mortalities. Similarly significant
associations have been observed in a study conducted in
Gondar, Addis Ababa, Iran, Brazil and other several
studies.8,9,24,26,29–32
These indicated that most of the neo-
natal deaths are due to preventable causes of death that
could be addressed by anticipating risky pregnancies and
the provision of proper and on time interventions.
Furthermore, the multivariate analysis of socio
demographic factors has also found that those neonates
who came from centers outside the city had increased
risk of mortality. This is comparable with a similar
finding from another study carried out in our
country.26
This may be related to delay in making
a decision to seek care and delay in reaching care
due to the availability of and cost of transportations
which would affect the on time arrival of laboring
mothers to the hospitals and lack of pre hospital emer-
gency care. Since most mothers and newborns are
referred to the center after they had already developed
complications, this could contribute significantly to
loss of life during neonatal periods.
Our finding in the present study also indicated that
neonatal mortality was also related to the length of hospital
stay, gestational age and birth weights of the newborn. This
finding is in line with other studies.33,34
The lower the
gestational and birth weight the higher chance of death
and this is due to the fact that underweight and preterm
newborn had immaturity of immune systems and other
body defense mechanisms which control newborn disease
susceptibility.1
This implies that anticipating high risk new-
born babies and early treatment would reduce the deaths of
such physiologically and anatomically vulnerable neonates.
Other possible explanations for this might also be due to
delay in receiving adequate health care due to poor facilities
and lack of medical supplies in low income countries.
The strengths of this study include the fact that it used
large sample sizes and statistical analyses appropriate to
the study design and with the results matching the method
described. Limitations include the use of medical records
of newborns and since the study is institutionally based,
the results might lack generalizability to the entire popula-
tion in the catchment area. This study was mainly focused
on neonatal factors that could be related to neonatal mor-
talities, for this reason other possible factors not adjusted
for during the current study may influence observed asso-
ciations. In all cross-sectional studies, we can infer asso-
ciation but not causation from our results.
In conclusion, this study found that babies born outside
the city, gestational ages, the length of stay in the ICU,
prematurity, low birth weight, RDS, and congenital mal-
formations all had a significant association with neonatal
mortality. Therefore, it is recommended that early detec-
tion and anticipating high risk pregnancies and high-risk
newborns and provision of timely and appropriate inter-
vention could reduce neonatal mortalities. Furthermore, it
is important that further community based interventional
studies be conducted on a larger scale to broaden the
understanding obtained from this initial study.
Acknowledgments
Professor Gillian Murphy, Emeritus Professor senior visi-
tor, Departments of Oncology, University of Cambridge,
CRUK Cambridge Institute.
Disclosure
The authors report no conflicts of interest in this work.
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