Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Neonatal Mortality”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

[Differences between neonatal mortality and stillbirth rates in Brazil: a study based on the Unified Health System (SIH/SUS) Hospital Information System].

The main objective of this article is to estimate stillbirth and neonatal mortality rates in Brazilian States based upon the country's Hospital Information System. Analysis of 1995 data reveals contrasting rates between the various regions of the country. In order to elucidate the States' different rates, we focused on the association between indicators of coverage, utilization, and access to the Unified Health System (SUS). The results for the neonatal period mostly showed higher early neonatal mortality rates when compared to late neonatal mortality rates, higher neonatal mortality rates in the States comprising the South and Southeast regions, less variable rates between those States, and extremely low rates in some States of the North, Central-West, and Northeast regions. The limited supply of SUS services and low access to same are relevant constraints on health care for the population in the North and Northeast. Aspects related to quality of childbirth and neonatal care are also reflected in the rates studied. The findings suggest that spatial and temporal monitoring of these rates could provide analytical support for organizing the Maternal and Child Health Program.

Brazil↗
PubMed1981

Differences among hospitals as a source of excess neonatal mortality: the District of Columbia, 1970-1978.

Between 1970 and 1978 the neonatal mortality rate for black infants in the District of Columbia remained essentially constant while the national rate declined steadily. This report examines adjusted hospital-specific neonatal mortality rates in order to determine the extent to which the District's lack of improvement can be explained by excess mortality in a few hospitals. The indirect method of adjustment utilizing standardized morality ratios (SMRs) is used to control for the effect of the birth weight distribution on hospital-specific neonatal mortality rates. A generalized least squares approach is used to model the changes in the SMRs over time. No change was found in the SMRs for any hospital between 1970-72 and 1973-75, and four hospitals experienced no change in the 1973-75 to 1976-78 period (although one of these hospitals had very low SMRs initially). The remaining four hospitals experienced a 37% decline in their SMR's during the second interval (1973-75 to 1976-78). If the three hospitals that had high initial rates and showed no change in mortality rates from 1973-75 to 1976-78 had experienced the 37% decline, the District's SMR in 1976-78 would have been reduced by 20%.

Black or African American↗
PubMedDate not supplied

Improvement in rural neonatal mortality: a case study of medical community intervention.

Previous studies have demonstrated that maternity care by family physicians can produce statistically similar outcomes to obstetric management in some communities. Obstetrical and perinatal literature suggest that those specialties may be able to decrease rural neonatal mortality. However, family practice literature has not shown any examples of direct intervention decreasing neonatal mortality in rural areas. This paper presents an isolated rural Utah community which had a neonatal mortality rate twice that of the rest of the state from 1971-1980. Through local family practice initiatives, the neonatal mortality rate decreased in a significant fashion to a level equal to the rest of the state from 1981-1985. Other social, economic, and political factors which may influence the neonatal mortality rate were examined and did not contribute to decreased mortality.

Community Health Services↗
PubMed1998

Assessing the relationship between maternal opiate use and neonatal mortality.

UNLABELLED: We undertook a number of meta-analyses to estimate more precisely the relationship between neonatal mortality and use of opiates in three groups of women. First, women who continued to use illicit heroin throughout pregnancy; secondly, women stabilized on methadone at the time of conception or shortly after and thirdly, women who use heroin well into pregnancy with late entry into methadone treatment, or who continued to use illicit heroin during pregnancy while receiving methadone. FINDINGS: The pooled estimates of the relative risks of neonatal mortality for separate heroin and methadone use were both near unity: 1.47 (95% CI 0.88-2.33) and 1.75 (95% CI 0.60-4.59), respectively. The result for heroin may be due to the inclusion in the meta-analysis of a particularly large study, which, unlike the two other smaller studies included found a relative risk near unity. When this study was excluded from the meta-analysis the pooled estimate of the relative risk of neonatal mortality for heroin use was 3.27 (95% CI 0.95-9.60). In contrast to the results for use of methadone only, the pooled relative risk associated with heroin and methadone use was 6.37 (95% CI 2.57-14.68). CONCLUSIONS: The increased relative risk for neonatal mortality associated with women using heroin and methadone during pregnancy, compared to those stabilized on methadone, is probably due to the chaotic and high-risk life-style associated with illicit heroin use and not solely to the use of heroin and methadone per se. It is recommended tht women who use heroin well into pregnancy with late entry into methadone treatment, or who continue to use illicit heroin during pregnancy while receiving methadone, receive special attention over and above that provided to women stabilized on methadone.

Female↗
PubMed1991

A 2-year study of neonatal mortality in a large Malaysian hospital.

A 2-year study was carried out in the Maternity Hospital, Kuala Lumpur to determine the neonatal mortality rates. This Hospital functions both as the local service centre as well as the national referral centre in Malaysia. Its neonatal services, however, were equipped and manned at those below Level III perinatal centre. During the study period 52, 877 livebirths took place in the Hospital. In 1987 and 1988 respectively, the low birthweight (less than 2500 gm) rates were: 112.8 and 101.9 per 1000 livebirths, very low birthweight (less than 1500 gm) rates: 11.1 and 8.8 per 1000 livebirths, neonatal mortality rates: 12.5 and 10.7 per 1000 livebirths and neonatal mortality risk ratio: 1.15 and 1.27. There was significant difference in mortality rates among the Malay, Chinese and Indian babies born in this hospital: the Indians had the highest and the Chinese the lowest rates. Babies delivered by breech or lower segment Caesarean section (LSCS) also had significantly higher mortality than those delivered by other modes of delivery. Low birthweight neonates constituted less than 45% of the total special care nursery admission but contributed to more than 70% of the total neonatal deaths. The common causes of neonatal deaths were problems of prematurity, infection, asphyxia and congenital malformations. Preterm and low birthweight neonates died primarily from problems of prematurity or infection. Term and larger neonates died mainly from asphyxia. More than 75% of the neonatal deaths occurred before 7 days of life. Improvement of antenatal care in the community and upgrading of perinatal services in this Hospital could help to lower the morbidity and mortality due to preventable causes.

Birth Weight↗
PubMed2001

Can improvements in breast-feeding practices reduce neonatal mortality in developing countries?

OBJECTIVE: to review the literature on the relationship between breast-feeding practices in the first month of life and neonatal mortality. METHODS: Medline and Cochrane databases were searched using the keywords breastfeeding, and neonatal mortality, supplemented with additional searches using the keywords developing countries, colostrum, infant feeding and infant mortality, hypoglaecemia, hypothermia, breastfeeding practices, and suckling. FINDINGS: breast feeding helps prevent hypothermia and hypoglycaemia in newborn babies, which are contributory causes of early neonatal deaths especially among low birth weight and premature babies. During the late neonatal period, most deaths in developing countries are due to infections such as sepsis, acute respiratory tract infection, meningitis, omphalitis and diarrhoea. Feeding colostrum and breast feeding, especially exclusive breast feeding, protects against such deaths. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: in most developing countries, nearly all women breast feed in the first month of life, but often breast feeding is delayed beyond the first hour after birth, and exclusive breast feeding is not usually practised. Policies and training of staff of maternity centres and hospitals can encourage early initiation of breast feeding and exclusive breast feeding. Midwives can support community-based efforts to support exclusive breast feeding. Breast feeding plays an important role in reducing neonatal mortality and should be strongly emphasised by programmes attempting to reduce neonatal mortality.

Age Factors↗
PubMed2004

Reexamining the effects of gestational age, fetal growth, and maternal smoking on neonatal mortality.

BACKGROUND: Low birth weight (<2,500 g) is a strong predictor of infant mortality. Yet low birth weight, in isolation, is uninformative since it is comprised of two intertwined components: preterm delivery and reduced fetal growth. Through nonparametric logistic regression models, we examine the effects of gestational age, fetal growth, and maternal smoking on neonatal mortality. METHODS: We derived data on over 10 million singleton live births delivered at >/= 24 weeks from the 1998-2000 U.S. natality data files. Nonparametric multivariable logistic regression based on generalized additive models was used to examine neonatal mortality (deaths within the first 28 days) in relation to fetal growth (gestational age-specific standardized birth weight), gestational age, and number of cigarettes smoked per day. All analyses were further adjusted for the confounding effects due to maternal age and gravidity. RESULTS: The relationship between standardized birth weight and neonatal mortality is nonlinear; mortality is high at low z-score birth weights, drops precipitously with increasing z-score birth weight, and begins to flatten for heavier infants. Gestational age is also strongly associated with mortality, with patterns similar to those of z-score birth weight. Although the direct effect of smoking on neonatal mortality is weak, its effects (on mortality) appear to be largely mediated through reduced fetal growth and, to a lesser extent, through shortened gestation. In fact, the association between smoking and reduced fetal growth gets stronger as pregnancies approach term. CONCLUSIONS: Our study provides important insights regarding the combined effects of fetal growth, gestational age, and smoking on neonatal mortality. The findings suggest that the effect of maternal smoking on neonatal mortality is largely mediated through reduced fetal growth.

Journal Article↗
PubMed1992

Birth weight-specific fetal deaths and neonatal mortality and the rising cesarean section rate.

To address the question of what effect the rising cesarean section rate has on fetal and neonatal mortality, 33,843 births and 4,132 sections were studied at a community hospital (1968-1987). Crude fetal and neonatal mortality rates declined as the annual section rate rose from 4.7% to 25.7%. However, weight-specific mortality rates bore little relationship to weight-specific section rates. Neonatal mortality rates for infants weighing over 2499 g and without congenital anomalies remained essentially the same (.91, 1.0, 1.02 per 1000 live births) for each of the five-year periods included in the study, despite marked increases in section rates. Among fetal deaths in this weight group, only antepartum deaths declined in each period. This analysis of birth weight-specific mortality indicates that a five-fold rise in the annual cesarean section rate has contributed little, if anything, to reductions in fetal and neonatal mortality during this time.

Birth Weight↗
PubMed1999

The changing pattern of neonatal mortality in a regionalized system of perinatal care: A current update.

OBJECTIVE: Our earlier studies about the changing pattern of neonatal mortality were based on data from 1978-1979 and 1982-1983. In this report, we provide a modern update of the causes of neonatal deaths to help focus prevention measures. STUDY DESIGN: We reviewed neonatal deaths for the years 1995 and 1996 and assigned a clinical cause of death. Deaths were reviewed and analyzed by place of birth and death, according to level of care. We provided an estimate of the change in causes of death between 1982-1983 and 1995-1996 and calculated an idealized neonatal mortality rate for each level of care and for the entire state. RESULTS: The major changes in causes of death occurred in the respiratory distress syndrome (RDS) and extremely low birth weight (ELBW) categories. RDS showed a substantial decline, but ELBW deaths increased by nearly the same amount that RDS declined. The idealized neonatal mortality rate calculations suggest that fewer potentially medically preventable deaths occur now than in 1982-1983. Currently, more neonatal deaths of level I births occur in level III facilities than in 1982-1983. However, at that time, Iowa had only one tertiary facility, and the level II regional hospitals were the site of more deaths. CONCLUSION: We believe that assigning deaths to a clinical category rather than to a catastrophic final event helps focus on sources of preventable death in the medical care system. To reduce neonatal mortality, the incidence of lethal congenital malformations and ELBW infants must be impacted.

Cause of Death↗
PubMed1993

Siblings' neonatal mortality risks and birth spacing in Bangladesh.

This paper studies the familial association of neonatal mortality in Matlab, Bangladesh and its relationship to birth-spacing effects on mortality. Findings show that familial association is strongest for siblings of adjacent birth orders. Moreover, birth-spacing effects on neonatal mortality are stronger when the preceding child has survived the neonatal period than when it has died. Transitional (Markov), random-effects, and marginal models for correlated data are introduced, and are contrasted in interpretation and technique. Familial association of neonatal mortality can be approximately well by a first-order Markov model using generalized estimating equations (GEE) to allow for higher-order correlation.

Adult↗
PubMed1998

Fetal and neonatal mortality in the postterm pregnancy: the impact of gestational age and fetal growth restriction.

OBJECTIVE: Our purpose was to examine the impact of gestational age and fetal growth restriction on fetal and neonatal mortality rates in the postterm pregnancy. STUDY DESIGN: All deliveries occurring in Sweden between Jan. 1, 1987, and Dec. 31, 1992, were evaluated for participation in this study. Data were derived from the National Swedish Medical Birth Registry. Pregnancies were selected for inclusion in the study on the basis of the following criteria: (1) singleton pregnancy, (2) reliable dates, (3) gestational age > or = 40 weeks, and (4) maternal age 15 to 44 years. Fetal growth restriction was defined as birth weight <2 SD below the mean for gestational age. A total of 181,524 pregnancies met the inclusion criteria and formed the study population. Fetal and neonatal mortalities at 40 weeks' gestation were used as reference levels. Logistic regression analysis was used to estimate the independent effects of gestational age and fetal growth restriction on fetal and neonatal mortality rates. RESULTS: A significant rise in the odds ratio for fetal death was detected from 41 weeks' gestation and on (odds ratios 1.5, 1.8, and 2.9 at 41, 42, and 43 weeks, respectively). Odds ratios for neonatal mortality did not demonstrate a significant gestational age dependency. Fetal growth restriction was associated with significantly higher odds ratios for both fetal and neonatal mortality rates at every gestational age examined (with odds ratios ranging from 7.1 to 10.0 for fetal death and from 3.4 to 9.4 for neonatal death). CONCLUSIONS: Postterm pregnancies have long been considered to be at high risk for adverse perinatal outcome. This study documents a small but significant increase in fetal mortality in accurately dated pregnancies that extend beyond 41 weeks of gestation. This study also demonstrates that fetal growth restriction is independently associated with increased perinatal mortality in these pregnancies.

Adolescent↗
PubMed1998

Saving more neonates in hospital: an intervention towards a sustainable reduction in neonatal mortality in a Nicaraguan hospital.

A process of change was initiated in a Nicaraguan regional hospital in order to achieve a sustainable reduction of early neonatal mortality. A series of organizational, educational and hygienic measures was introduced, involving all staff in antenatal care, delivery care and neonatal care. Neonatal mortality decreased from 56/1000 live births in 1985 to 11/1000 in 1993. A commission of maternal and child health, a weekly perinatal audit, the active involvement of all staff and dedicated work of key individuals, as well as national policy decisions, are considered important determinants of the process. Keeping neonatal mortality in focus through continuous analysis of care routines, and through external exchange of ideas is important in order to sustain improvements and to decrease further the mortality.

Adult↗
PubMed1990

Recent trends in neonatal mortality in South Carolina.

This study examines some of the primary factors responsible for the decline in South Carolina's neonatal mortality rate during the 1980s. Essentially all of the observed decline between 1980-82 and 1984-86 could be attributed to improved birthweight-specific survival rather than improvements in the infant birthweight distribution. Improved survival of 500-1,499 g infants accounted for 64% of the decline in white neonatal mortality and 70% of the decline among blacks. Also, during this period, the percentage of 500-1,499 g infants delivered at Level III hospitals increased significantly for both race groups. Comparisons with other southeastern states suggest that further reductions in South Carolina's neonatal mortality rate are possible through continued efforts aimed at improving birthweight-specific survival. Existing state-supported programs such as regional perinatal referral networks and the High Risk Channeling Project will continue to play an important role in maintaining the decline in the state's neonatal mortality rate.

Black or African American↗
PubMed1990

Socio-economic and ethnic factors in stillbirth and neonatal mortality in the NE Thames Regional Health Authority (NETRHA) 1983.

All stillbirths and neonatal deaths occurring in the North East Thames region were studied in 1983. This report describes the socio-economic and ethnic differences in that cohort. The stillbirth and neonatal mortality rates of babies born to fathers of social class V (16.8 per 1000 total births) was almost double that of social class I fathers (8.6 per 1000 total births). The most marked social class gradient was seen in the macerated stillbirth groups. Of particular concern was the extremely high stillbirth and neonatal mortality rate for women born in the Indian subcontinent. This was most evident in Pakistani women who had a stillbirth plus neonatal mortality rate of 17.3 per 1000 total births, almost twice that of the women born in the UK (9.0 per 1000 total births). Again, as with social class, macerated stillbirths appeared to contribute disproportionately to the excess mortality. Mortality rates were aggregated into four birthweight specific groups. Asian women had higher mortality rates in the higher birthweight groups, whereas in the lower birthweight group their babies did slightly better. This study indicated that the special needs for working class and ethnic minority mothers within NE Thames were not being met, and the Regional Health Authority was strongly recommended to review services to these groups.

Adult↗
PubMed1982

Newborn intensive care and neonatal mortality in low-birth-weight infants: a population study.

We examined the neonatal mortality rates of low-birth-weight infants (501 to 2250 g) born between 1976 and 1978 in three kinds of hospitals in New York City: those with newborn-intensive-care units (Level 3), those with capabilities for the care of most premature infants (Level 2), and those without any special facilities for premature newborns (Level 1). Among 13,560 singleton low-birth-weight infants, the adjusted neonatal mortality rate for Level 3 hospitals was 128.5 per thousand live births - significantly lower (P less than 0.001) than the rates for both level 2 (168.1) and Level 1 units (163.0). The association of level of care with mortality could not be accounted for by differences between groups in social or demographic status, in prenatal care, or in medical complication of pregnancy. We infer that birth at a Level 3 center lowers neonatal mortality in low-birth-weight infants. However, only 34 per cent of the patients in this study were born in such units.

Critical Care↗
PubMed2005

[Dynamics and structure of the neonatal mortality in Kutaisi and Imereti region].

Dynamics of neonatal mortality and analysis of its structure in Kutaisi and in the region of Imereti during 1999-2000 are presented. Insufficiency in the organization of the prophylactic and treatment measures during the pregnancy and delivery and mistakes in the treatment, were determined according to the analyses of expert cards. Data of the State Department of Statistics and statistical counting of the labor houses and labor-helping setting of Kutaisi also were used. Analysis of the collected data shows high rates of perinatal and neonatal mortality in Kutaisi and birth reduction. However some trends in the reduction of these findings were occurred in the year 1996, which could be explained by the aids in the delivery blocks in the labor houses of Kutaisi.

Georgia (Republic)↗
PubMed1986

Advances in perinatal care and declining regional neonatal mortality in Finland, 1968-82.

Neonatal mortality (NNM) was investigated in the region of the University Central Hospital of Turku (UCHT), Finland, during a 15-year period from 1968 till 1982. During the study period 81 620 liveborn infants were born. The NNM rate declined from 13.5 in 1968 to 3.0 in 1982 during the study period. Significant declines occurred in NNM due to respiratory distress syndrome (RDS) and asphyxia. The decline in NNM was more obvious during the early neonatal period (0-6 days after birth) and in the low birth weight (LBW) group (BW less than 2500 g). We believe that centralization of obstetric and neonatal services in risk cases and the new neonatal intensive care accounted for the decline in NNM.

Asphyxia Neonatorum↗
PubMed2003

Can a mortality excess in remote areas of Australia be explained by indigenous status? A case study using neonatal mortality in Queensland.

OBJECTIVE: To assess the extent to which indigenous status confounds the association between remoteness and neonatal mortality in Queensland. METHODS: We used routine data from the Queensland Perinatal Data Collection. Poisson regression modelling was used to assess confounding. RESULTS: Babies born to Indigenous mothers have mortality rates 2.42 times those of the rest of the population, regardless of whether they live in urban, rural or remote areas (95% CI 2.09-2.80). The babies of non-Indigenous women who live in remote areas have a low risk of neonatal death, similar to their rural and urban counterparts. CONCLUSION: In Queensland, the key demographic variable that determines neonatal mortality is indigenous status, not remoteness. IMPLICATIONS: Policymakers should not assume that an excess of a particular health problem in remote areas necessarily reflects equal disadvantage for all the Australians who live there.

Fetal Death↗