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Results for “Maternal Mortality--changes”

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PubMed1989

Effect of the administration of oral poliovirus vaccine on infantile diarrhoea mortality.

Infectious diarrhoea is one leading cause of infantile mortality in developing countries. Rotaviruses and other enteroviruses have an important role in diarrhoea but, currently, there are no vaccines available to immunize infants. The use of oral poliovirus vaccine (OPV) over two decades has shown that, besides protecting effectively against poliomyelitis, it can interfere with intestinal infection by other enteroviruses. This interference by the vaccine viruses could explain two epidemiological observations showing that repeated and massive administration of OPV was followed by a statistically significant decrease of infantile diarrhoea mortality. OPV administration could have two objectives: to prevent poliomyelitis and to reduce infantile diarrhoea of viral aetiology.

Developing Countries↗
PubMed1983

Perinatal mortality: changes in the diagnostic panorama 1974-1980.

During the period 1974-1980, all late abortions (greater than 19 completed gestational weeks) (LA), late fetal deaths (LFD) and early neonatal deaths (END) were surveyed in a continuous material of 17813 births with an ascertained gestational age established by early ultrasound fetometry. There was no maternal death during the period. The total perinatal mortality (PM) was 0.98% with an END rate of 0.51%. In about 45% of LFD no diagnosis was found. Intrapartum death was extremely rare as was END caused by asphyxia or infection. In END, death from immaturity constituted the major group in the beginning of the period, while after 1977 lethal malformations was the dominating diagnosis. There was a continuous decrease in Idiopathic Respiratory Distress Syndrome (IRDS) as a cause of END. The proportion of END in extremely premature children showed a constant decrease in the beginning of the period. No difference in sex was found in END except for lethal malformations where there was a significant male preponderance. As a consequence of a more active obstetrical care, some fetuses who would previously have been classified as LA were probably delivered liveborn, extremely premature and appeared as END. The question of where to set the limits for what should be included in PM is thus highly relevant.

Abortion, Spontaneous↗
PubMed1991

Sexual contact patterns between men and women and the spread of HIV-1 in urban centres in Africa.

A simple model of the transmission of HIV-1 by heterosexual contact and from mother to unborn infant is developed to assess the influence of patterns of mixing between low and high sexual activity classes of the two sexes on the pattern of spread of the virus and the demographic impact of AIDS. Numerical studies of model behaviour are based, where possible, on parameter estimates derived from epidemiological studies of HIV-1 spread in Africa. Analyses reveal that the assumed pattern of mixing, ranging from assortative (like with like) through random (proportional) to disassortative (like with unlike), has a very major impact on the predicted spread of the virus and the concomitant demographic impact of AIDS. Patterns of strong assortative mixing are predicted to generate the least spread and demographic impact, by comparison with proportional or disassortative mixing. Analyses also reveal that the rules governing behaviour changes, once AIDS-induced mortality changes the structure of the population (i.e. the numbers in the low and high sexual activity classes of the two sexes), have a very significant influence on the course of the epidemic. Where possible, predicted patterns are compared with observed trends in Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Trends in neonatal mortality in Benin City, Nigeria.

A total of 18,334 live births and 376 neonatal deaths at the University of Benin Teaching Hospital were analyzed. The neonatal mortality rate has declined significantly from 49.5/1000 in 1974 to 16.4/1000 live births in 1981. The decrease mainly resulted from the reduction of mortality of full size infants (greater than 2500 g) and deaths resulting from perinatal asphyxia. Further reduction may be anticipated if careful attention is paid to the management of breech delivery and if a more intensive care for low birth weight infants is provided.

Age Factors↗
PubMed1988

Neonatal vital statistics: a 5-year review in Saudi Arabia.

Neonatal mortality and causes of death at King Fahd Hospital of the University in Al Khobar, Saudi Arabia from June 1981 to May 1986 were analysed. The overall neonatal mortality rate declined from 15.6 to 8.1/1000 live births (LB), and after excluding lethal malformations mortality fell from 14.0 to 5.6/1000 LB. The reduction in mortality was most marked in infants weighing 1500 g or less, among whom mortality fell from 92.3 to 33% (P less than 0.001) during the 5-year period. Further, when annual variation in the very low birthweight rate was eliminated, a reduction in the mortality risk ratio from 1.47 to 0.81 was demonstrated. These significant reductions in mortality appear to be related to the establishment of neonatal intensive care. Major identified causes of death amenable to modern perinatal care were hyaline membrane disease, birth asphyxia, meconium aspiration and septicaemia.

Asphyxia Neonatorum↗
PubMedDate not supplied

Women's status and infant mortality in rural Colombia.

This paper investigates the effects of maternal demographic characteristics and social and economic statuses on infant mortality in rural Colombia. Demographic characteristics include the age of the mother, parity and length of preceding interbirth interval, and sex of infant. Measures of women's status at the time of birth include education, wage labor and occupation, economic stratum, place of residence, and whether the mother is living with a husband. The life history data for the study (involving 4,928 births) were collected in 1986 from a representative sample of two cohorts of women resident in rural central Colombia. Overall differentials in infant mortality by measures of women's status are small and are in good part associated with the differing reproductive behaviors of the women and variations in breastfeeding practices. The sharp declines in infant mortality recorded in rural Colombia in recent years appear less related to improved status of women than to reductions in fertility that enhance infant survivorship and to public health interventions shared by all segments of the population.

Adult↗
PubMed1991

Perinatal mortality statistics in Harare 1980-1989.

Perinatal and neonatal mortality rates, in the Greater Harare Maternity Unit, which showed a modest decline from 1980 to 1985, have rise dramatically since then. Half of the rise in neonatal mortality rate is due to increased numbers and an increased mortality rate in babies of birth weight less than 1001g. There is also an increase in the numbers of deaths of large babies. There is a strong case for a broad-based on-going enquiry into the reasons for such changes.

Birth Rate↗
PubMed1991

A study of 8 year neonatal deaths (1982-1989) of Toa Payoh Hospital.

A study of 233 neonatal deaths out of 30910 livebirths over an 8 year period in the Toa Payoh Hospital is done. The Hospital has since ceased providing obstetric and neonatal intensive services from April 1990 due to restructuring of hospital care. The Neonatal Mortality Rates (NNMR) from 1982-1989 ranged from 6.52 to 9.55 and there was no significant fall in trend (p = 0.13). One hundred and thirteen (48.5%) neonates who died were below 1500gm (VLBW). Various causes of neonatal deaths were examined and there was a decline in respiratory distress syndrome (RDS) death rates (p less than 0.0002). Deaths due to asphyxia (p greater than 0.05) and infections (p greater than 0.05) have not declined significantly over the same period. It is also observed that less VLBW babies died over this 8 year period and the VLBW mortality rates (p less than 0.02) have declined. However, the congenital malformation mortality has also not declined significantly (p = 0.92) though early study (1972-1981) showed an increasing trend of malformation deaths among total neonatal deaths (p less than 0.02). Improvement in VLBW and RDS management has not contributed to a significant decline in NNMR. It is observed that more VLBW babies were born during this 8 year period (p = 0.01) especially so in the less than 1000 gm group (p = 0.0005) and the survival of VLBW babies has improved (45.5% to 75.8% alive) as a result of advances in neonatal intensive care. The reasons for increase in incidence of VLBW births in the past few years are not known.(ABSTRACT TRUNCATED AT 250 WORDS)

Cause of Death↗
PubMedDate not supplied

[Fertility and health in Mexico].

Fertility, health, and family planning are not independent factors, but rather involve a series of biological and social mechanisms in close interaction with one another. The impact that a high fertility rate has on health is reflected mainly in a rise in the rates of maternal and child mortality. Similarly, fertility has a greater negative effect upon the health of groups characterized by high reproductive risk, high parity, short intergenesic intervals, and unwanted pregnancies. On the other hand, family planning -and specifically the use of contraceptive methods-helps to achieve a lowering of the fertility rate and also has a positive effect on maternal-child health. This situation can be observed in the case of Mexico, where fertility rates and tendencies, as well as maternal and child mortality, have been reduced during the past decade.

Family Planning Services↗
PubMed1987

Reducing infant mortality in rural America: evaluation of the Rural Infant Care Program.

The Rural Infant Care Program (RICP), initiated in 1979, was developed to improve perinatal health care in ten rural sites with histories of high infant mortality rates. Time-series regression models indicate that neonatal mortality rates were reduced, following program initiation, by 2.6 per 1,000 live births (p = .0002); black neonatal mortality rates were reduced by an estimated 4.5 per 1,000 (p = .0004). Three sets of comparison areas exhibited no significant changes in rates. Postneonatal mortality rates did not increase in the target areas following initiation of RICP, indicating that deaths were not merely being postponed. Nine of ten individual sites showed reductions in infant mortality following program initiation. Birthweight-specific mortality data indicated that the decline was due mainly to reductions in neonatal mortality among low-birthweight infants. No reductions in the incidence of low birthweight were observed in the target areas. Substantial gaps in the delivery of prenatal care remained due to the continuing poverty of the population and the resultant lack of financial coverage for health services. We conclude that improved perinatal medical care can reduce infant mortality in poor rural areas to average levels experienced in the United States, and that the high rates still observed in some rural counties are unnecessary.

Black or African American↗