Preterm birth, Caesarean section and intrapartum complications were associated with neonatal death. 2017;41(1):34–39. Table 1 Major categories of neonatal diseases and definitions. Of the estimated 130 million infants born each year worldwide,1 4 million die in the first 28 days of life. Hasan IJ, Khanum A. Using Multivariate analysis, to test the association of socio demographic variables with neonatal mortalities, four variables were found to be significantly associated with neonatal death. Neonatal mortality declined from 49 deaths per 1,000 live births in 2000 to 29 deaths per 1,000 births in 2016, a reduction of 41% over the past 16 years. During their routine home visits, LHWs provided study information to pregnant women who were screened as eligible for the study. UNICEF, WHO, World Bank Group, Nations U. Rates were as follows: stillbirth, 33.6 per 1000 births (95% CI: 23.6–43.6); early neonatal mortality, 34.8 per 1000 live births (95% CI: 24.1–45.5); 28-day neonatal mortality, 47.3 per 1000 live births (95% CI: 34.9–59.7); perinatal mortality-1 (i.e. Back to Journals » Pediatric Health, Medicine and Therapeutics » Volume 10, Causes and factors associated with neonatal mortality in Neonatal Intensive Care Unit (NICU) of Jimma University Medical Center, Jimma, South West Ethiopia, Authors Seid SS, Ibro SA, Ahmed AA, Olani Akuma A, Reta EY, Haso TK, Fata GA, Published 3 May 2019 this site will not function whilst javascript is disabled. Two-thirds of the world’s neonatal deaths occur in just 10 countries, mostly in Asia. Two-thirds of the world’s neo… 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. Professor Roosy Aulakh, Sheka Shemsi Seid, Shemsedin Amme Ibro, Abdulwahid Awol Ahmed, Adugna Olani Akuma, Ebrahim Yimam Reta, Tura Koshe Haso, Gutema Ahmed FataSchool of Nursing and Midwifery, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, EthiopiaBackground: The neonatal period is the most susceptible phase of life. Time to focus child survival programmes on the newborn: assessment of levels and causes of infant mortality in rural Pakistan. … The neonatal mortality rate is the number of children that die under 28 days of age in a given year, per 1,000 live births. Tekleab AM, Amaru GMTY. doi:10.3329/bjch.v41i1.33634. Lawn JE, Cousens SN, Wilczynska K. Estimating the causes of four million neonatal deaths in the year 2000: statistical annex. •  Terms & Conditions   This work is published and licensed by Dove Medical Press Limited. Less than one third, 864(27.9%) of the neonates were preterm whereas 2229(72.1%) were term neonates. Factors found to be significantly associated with neonatal death in the univariate analysis include gestational age  37> 2000 g> 37>. Approximately three-quarters of newborn deaths occur in the first week of life; 25-45% of these deaths take place in the first 24 hours (UNICEF, 2013). Maternal pregnancy complications. 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. The authors report no conflicts of interest in this work. Funding: The study was supported through a cooperative agreement with the Bill and Melinda Gates Foundation and the US National Institute of Child Health and Human Development (NICHD) Global Network for Women’s and Children’s Health Research (U01HD040607 and U0104063606). Of the 53 neonatal deaths, 39 (75%) occurred in the first 7 days. Mortality rates for other leading causes of infant death did not change significantly. The study populations were all neonates admitted to the Neonatal Intensive Care Unit (NICU) of JUMC from September 11, 2014 to September 10, 2017. The above percentage of manuscripts have been rejected in the last 12 months. Several features of An analysis of quality of public sector maternal health services, District Multan, Pakistan. The odds of neonatal death in preterm birth was two times higher compared to term births as shown in Table 5. Thus, 83% of those eligible, or 1369 women, were enrolled at 20–26 weeks’ gestation. Available from: http://www.who.int/healthinfo/global_burden_disease/en/ Accessed February 1, 2016. Dove Medical Press is a member of the OAI. Research Triangle Institute, 3040 Cornwallis Road, Durham, NC, 27709, United States of America.c. Bonde JP, Wilcox A. causes of infant death in 2018 accounted for 67.6% of all infant deaths in the United States. The infant mortality rate is the number of infant deaths per 1,000 live births. 15. 2018;6(9):8185–8194. Int J Contemp Pediatr. Bulletin of the World Health Organization, Volume 87, Number 2, February 2009, 81-160. J Clin Neonatol. 2014;10(10):44–54. Congenital Defects. The reason for this difference was that the late neonatal mortality rate (i.e. We were surprised by the high Caesarean section rate of 19% in this community. 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. stillbirths plus all early neonatal deaths), 70.4 per 1000 births (95% CI: 55.7–85.1); and perinatal mortality-2 (i.e. The neonatal period, from birth to the first 28 days of life, is the most hazardous period of life because of the various diseases that the neonate faces. Because most neonatal deaths occurred in hospitals, maternal reports were supplemented by a review of hospital records by the study physician. St Geme S. Nelson Textbook of Pediatrics. High risk pregnancies and factors associated with neonatal death. 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). 2018;7(February):73–75. Javascript is currently disabled in your browser. The quality of the data collected was guaranteed by pretesting using the medical records of 5% of the newborns before actual data collection. doi:10.4038/sljch.v45i2.7981. Improving infant mortality rate. The relative importance of these causes is reflected in the distribution of the final causes of neonatal death: immaturity-related in 26%, birth asphyxia or hypoxia in 26% and infection in 23%. Therefore, efforts to achieve the UN Millennium Development Goal 4 of reducing childhood mortality by two-thirds by 2015 are focused on reducing neonatal deaths in high-mortality countries. National Institute of Child Health and Human Development, Rockville, MD, USA.d. Okechukwu AA, Achonwa A. Morbidity and mortality patterns of admissions into the special care baby unit of university of abuja teaching hospital, Gwagwalada, Nigeria. Rockville (MD): ICF; 2016. Preterm birth is the most common cause of perinatal mortality, causing almost 30 percent of neonatal deaths. Of the 45 infants who died within 28 days and who received medical treatment, 87% were treated in a hospital and 13% in a clinic. We believe there are two reasons for this finding. Liu L, Mathers C, Oza S, et al. The unit has 20 neonatal beds and 14 Kangaroo mother care (KMC) beds. The current finding is slightly lower than the studies conducted in northwestern parts of Ethiopian and significantly lower than the study carried out in Addis Ababa which was 14.3%, 15.9%, and 23.2% respectively. In addition, a perinatal mortality-1 rate was defined as the sum of all stillbirths and neonatal deaths on or prior to day 7 (henceforth 7-day neonatal deaths) per 1000 births, and a perinatal mortality-2 rate as the sum of all stillbirths and deaths on or prior to day 28 (henceforth 28-day neonatal deaths) per 1000 births. 17. In addition, the final cause of a neonatal death was also assigned according to the event that caused the death, as follows: immaturity-related, birth asphyxia or hypoxia, infection, congenital abnormality, trauma, other or unknown. Korejo R, Bhutta S, Noorani KJ, Bhutta ZA. In order to provide our website visitors and registered users with a service tailored to their individual preferences we use cookies to analyse visitor traffic and personalise content. 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. Given the paucity of reliable population-based information in Pakistan, this study was undertaken to examine the prevalence, sex distribution, timing and causes of neonatal death in a population-based pregnancy cohort in urban Pakistan. 12. Table 5 presents the primary obstetric and final causes of neonatal death as determined using the Pattinson et al. Outcomes for all fetuses and neonates delivered after enrolment were clearly defined. stillbirths plus all early neonatal deaths), 70.4 per 1000 births (95% CI: 55.7–85.1); and perinatal mortality-2 (i.e. Population Estimates 1950-2017, report 2017. The types of infant mortality shown in the charts below include neonatal mortality and postneonatal mortality: Neonatal mortality: death of a live-born infant within the first 27 days of life. McGrew-Hill’s; 2007. 2016;3(3):854–857. 2. Neonatal outcomes and length of stay: a firm grasp of the obvious? Fikree FF, Mir A, Haq IU. 2010;35(2):205–208. Residency being outside Jimma city (AOR 1.89, 95% CI: 1.43, 2.51) and the length of stay <7Days (AOR 3.93, 95% CI: 2.82, 5.50), low birth weight (AOR 1.54, 95% CI: 1.06, 2.25), prematurity (AOR 2.2, 95% CI: 1.41, 3.42), RDS (AOR 4.15, 95% CI: 2.9, 5.66), perinatal asphyxia (AOR 4.95, 95% CI: 3.6, 7.34), and congenital malformations (AOR 4, 95% CI: 2.55, 2.68) were significantly associated with neonatal mortality.Conclusions: A significant proportion of neonates attending the neonatal ICU died. the unit also has 2 incubators,10 radiant warmers, 4 continuous positive airway pressure (CPAP), phototherapy and oxygen concentrator machines. In other words, there were 30 deaths per 1,000 live births at the JUMC for the period under the study. Qazi GR, Akhtar S. Obstetrical correlates of the first time cesarean section, compared with the repeated cesarean section. The mortality 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). 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. Some 45% of the deaths occurred within 48 hours and 73% within the first week. Available from: http://journal.frontiersin.org/Article/10.3389/fpubh.2015.00225/abstract. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms. Ethical clearance to conduct the study was obtained from the institutional review board of the Institute of Health, Faculty of Health Sciences, Jimma University. The obstetric factors associated with neonatal death were: preterm labour (34%), intrapartum asphyxia (21%), antepartum haemorrhage (9%), infection (4%), congenital abnormality (4%) and intrauterine growth retardation (2%). Ali SR, Hospital I, Ahmed S, Lohana H. Disease patterns and outcomes of neonatal admissions at a secondary care hospital in Pakistan. DHS Program. Various demographic and health data and routine antenatal laboratory test results were collected on pretested study forms by trained female research staff, which included two doctors, one dentist, two health visitors and one midwife. 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 CORONIS Trial. Available from: http://www.who.int/intellectualproperty/documents/thereport/ENPublicHealthReport.pdf. 2016;5(3):183. The data collection was closely supervised by the supervisors to check for its completeness and clarity before data entry. Around the world, the top causes for infant mortality are neonatal encephalopathy (problems with brain function … In the four study units, approximately 90 LHWs were trained in the research protocols, study recruitment, communication skills and confidentiality. 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). These LHWs are female community residents who have had eight or more years of education and 15 months of government training. Infant mortality is a key measure of a nation's health, reflecting socioeconomic conditions, maternal health, public health practices, and access to high-quality medical care, among other factors (1, 2).Major causes of infant mortality include birth defects, low birthweight and preterm birth, maternal pregnancy complications, and sudden infant death syndrome (3). This prospective population-based study was conducted from September 2003 to August 2005 in four of 12 administrative units in the town of Latifabad, Hyderabad, Pakistan. Data were extracted from the medical records of neonates admitted during a three year period from September 07, 2014 to August 31, 2017, using pretested checklists. Additionally, there is pulse oximetry, glucometer and neonatal resuscitation equipment. Res Rep Neonatol. J Pak Med Assoc. Furthermore, 157(5.1%), 112(3.6%), and 86(2%) of the neonates were admitted due to meningitis, sub-glial haemorrhage, and macrosomia, respectively (Table 4). J Perinatol. Congenital defects, also known as birth defects, occur while a fetus is still in the … 11. 2016;45(2):84–89. Between September 2003 and August 2005, LHWs identified 2205 pregnant women from the study area, 25% of whom were not eligible for study enrolment. We also retain data in relation to our visitors and registered users for internal purposes and for sharing information with our business partners. 2014;64(10):1123–1126. Because pregnant women from a defined population were enrolled at 20 to 26 weeks’ gestation and followed with their infants to 28 days postpartum, data on antepartum history, delivery and events before neonatal death, in addition to maternal interview data, were available, so we could determine the causes of death quite reliably. Furthermore, the unit also receives neonates referred from other health facilities and homes. Finally, the completed study forms on mothers who experienced a neonatal death were reviewed jointly by a neonatologist (. A postnatal visit for data collection was made on about day 28. Of these, the major causes of mortality are pneumonia (64 percent) and diarrhea (38 percent). Demographic and clinical characteristics of the mothers of infants who died within 28 days postpartum or who survived, in a prospective study in an urban Pakistani population, 2003–2005, Table 3. Zaidi AKM, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldman DA. Okposio MM, Ighosewe OI. The … Ansari-Moghaddam A, Sadeghi-Bojd S, Imani M, Movahedinia S, Pourrashidi A, Mohammadi M. A multivariate analysis of factors associated with infant mortality in South-East of Iran. 14. Jehan I, McClure EM, Salat S, Rizvi S, Pasha O, Harris H, et al. Levels and Trends in Child Mortality: Report 2018. If you agree to our use of cookies and the contents of our Privacy Policy please click 'accept'. 4 million neonatal deaths: When? Sime H, Workneh N, Girma E. Morbidity and Mortality of Neonates Admitted in Jimma University Specialized Hospital Paediatrics Neonatal Ward: A One Year Retrospective Analysis. 2017. The most common primary obstetric causes of neonatal death were preterm delivery in 34%, intrapartum asphyxia in 21% and antepartum haemorrhage in 9%. Ethiop J Health Dev. The highest admission of neonates was observed in 2015 which accounted for half (50%) of the total neonatal admissions studied (Table 2). The aim of this study was to assess the causes and factors associated with neonatal mortality at Jimma Medical Center.Materials and methods: A cross-sectional study was conducted for 11 days from February 12, 2018 at the Neonatal ICU of Jimma Medical Center. Kulmala T, Vaahtera M, Ndekha M, Koivisto AM, Cullinan T, Salin ML, et al., et al. Rates of caesarean section: analysis of global, regional and national estimates. 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