Commonly, the mortality rates of the newborn in NICU fluctuate between 3.1% and 29% in 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 distribution of skilled human resources, quality of care delivered by the centers, equipment availability, and socioeconomic status, as well as geographical locations. A postnatal visit for data collection was made on about day 28. J Pak Med Assoc. Number 3099067. For the descriptive analysis, frequencies, percentages and rates were calculated, and 95% confidence intervals (CIs) were determined for mortality rates. • Web Design by Adhesion. The total number of neonates admitted to the NICU during the period under the study was 3,276, of which 110 neonates left against medical advice, 67 neonates had deficient. All rights reserved. Pediatric Health Med Ther. Maternal pregnancy complications. 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. Ali SR, Hospital I, Ahmed S, Lohana H. Disease patterns and outcomes of neonatal admissions at a secondary care hospital in Pakistan. Rawal Med J. 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. DHS Program. Sex differential patterns in perinatal deaths in Italy. The risk of dying is highest in this period of life.1 Globally, in 2017 alone, an estimated 6.3 million children and young adolescents died, mostly from preventable causes. a. Aga Khan University, Karachi, Pakistan. Medical care received by infants who died within 28 days postpartum and their mothers, both at delivery and before neonatal death, in prospective study in an urban Pakistani population, 2003–2005, Table 5. The data collection was closely supervised by the supervisors to check for its completeness and clarity before data entry. Int J Pediatr. This death toll is measured by the infant mortality rate (IMR), which is the probability of deaths of children under one year of age per 1000 live births. Neonatal sepsis is the leading cause of mortality worldwide, but compared with high income countries, its prevalence and mortality rates are high in low and middle-income countries (LMICs) probably due to poor hygiene and suboptimal practices for infection control . Pattern of morbidity and mortality of neonates admitted in tertiary level neonatal intensive care unit in Nalanda Medical College and Hospital, Patna, Bihar, India. All available medical records of neonates that fulfilled the inclusion criteria were included in the study. Dove Medical Press is a member of the OAI. In: Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L, et al., et al. Jehan I, McClure EM, Salat S, Rizvi S, Pasha O, Harris H, et al. Because most neonatal deaths occurred in hospitals, maternal reports were supplemented by a review of hospital records by the study physician. Case fatality for neonatal sepsis was 4.2%. Once a delivery had been reported, a study physician and nurse visited the woman at home or at the health facility within 48 hours to collect maternal data on the delivery and birth outcome. Volume 2019:10 Pages 39—48, Editor who approved publication: We therefore believe that the risk of biased reporting of neonatal mortality for this population is small. 2016;13:4. Table 2 compares the characteristics of mothers whose infants died within the 28 days following delivery with those of mothers whose infants survived. 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. Bonde JP, Wilcox A. open access to scientific and medical research. Infant mortality is the death of young children under the age of 1. Of the 53 neonatal deaths, 39 (75%) occurred in the first 7 days. The odds of neonatal death in preterm birth was two times higher compared to term births as shown in Table 5. New York: UNICEF ;2018. This work is published and licensed by Dove Medical Press Limited. doi:10.1186/s12889-016-3979-8, 10. The study was reviewed and approved by the Aga Khan University Ethical and Review Committee in Pakistan and institutional review boards at the University of Alabama at Birmingham and Research Triangle International in the United States of America. 25. Available from: http://mk:@MSITStore:E:%5Cneonatology%5Cwilliams_obstetrics_-22_edition—2005-0071413154-mcgraw-. Demitto MDO, Gravena AAF, Dell’Agnolo CM, Antunes MB, Pelloso SM. 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. Health pattern, causes and treatment outcomes of neonatal admission in the tamale teaching hospital. Baker R, Sullivan E, Camosso-Stefinovic J, Rashid A, Farooqi A, Blackledge H, et al., et al. Contact Us   causes of infant death in 2018 accounted for 67.6% of all infant deaths in the United States. FMOH. These estimates are shown in the visualisation below.In 1960 child mortality was still 18.5%. In this study any neonatal conditions or diagnosis identified or recorded for deceased neonates were considered as causes of death and its contributing factors. Neonatal death is when your baby dies within the first 28 days of life, and is commonly caused by premature birth. Birth outcome data were obtained for 1280 (94%) of the enrolled women and 28-day follow-up data, for 1121 women. 24. Sociedade Brasileira de Pediatria;. Factors found to be significantly associated with neonatal death in the univariate analysis include gestational age  37> 2000 g> 37>. Liu L, Mathers C, Oza S, et al. 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. 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. High risk pregnancies and factors associated with neonatal death. Where? J Clin Neonatol. Data were analysed using SAS version 9.1.3. 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). Ethiopian Journal of Pediatrics and Child Health. 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. Pal A, Batra S, Kaur J. The odds of neonatal mortalities among preterm neonates were 2.2 times higher than that of term neonates (AOR 2.2, 95%CI 1.41, 3.42). 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. As SIDS rates have been declining in the last few decades, rates of other sleep-related causes of infant death have been increasing. 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. On the other hand, some controllable risk factors include the use of tobacco, alcohol, cocaine and other drugs. This study was mainly focused on neonatal factors that could be related to neonatal mortalities, for this reason other possible factors not adjusted for during the current study may influence observed associations. International study of caesarean section surgical techniques: a randomised fractional, factorial trial. Thirty-five per cent of all neonatal deaths and 55% of those that occurred within 48 hours followed delivery by Caesarean section. 26. Data audits, including inter- and intra-form consistency checks, were performed at data entry, and additional audits were performed by the data centre (i.e. Primary causes of total perinatally related wastage at Tygerberg Hospital. The stillbirth rate is the number of stillbirths per 1000 births. This finding is inconsistent with several studies carried out in different parts of Ethiopia. The mean age at admission was 1.84(SD±2.4) days. The neonatal ICU is one of the ICU services that the hospital is currently running. Patterns of admission and factors associated with neonatal mortality among neonates admitted to the neonatal intensive care unit of University of Gondar Hospital, Northwest Ethiopia [Internet]. Hospital-acquired neonatal infections in developing countries. 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%. The global burden of child and youth deaths however remains immense. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. 7. Causes which lie above the grey line have higher mortality rates in boys relative to girls. 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. â–. The post-neonatal mortality rate is defined as deaths between 28 and 365 days of age, per 1,000 live births. Congenital Defects. Mengesha HG, Sahle BW. We therefore believe that our study team was aware of nearly every pregnancy in the catchment area. 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). In the four study units, approximately 90 LHWs were trained in the research protocols, study recruitment, communication skills and confidentiality. Death resulted primarily from birth defects, prematurity, and Sudden Infant Death Syndrome/ Sudden Unexpected Infant Death. Table 6 Multivariate and Univariate analysis of factors associated with Neonatal mortalities among neonate admitted to JUMC. The classification system is non-hierarchical and allows for the identification of the following obstetric causes of neonatal death: preterm labour ( 37>. Preterm birth and low birth weight. 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. Making use of mortality data to improve quality and safety in general practice: a review of current approaches. 2016;25(4):2–9. Walana W, Ks AE, Naafu B, et al. 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 neonatal mortality burden. The birth weight of the newborns studied were comprised of, nearly one third 1108(35.8%) within the Low Birth Weight (LBW) range. Between September 2003 and August 2005, LHWs identified 2205 pregnant women from the study area, 25% of whom were not eligible for study enrolment. Kliegman RM, Stanton BF. A total of 3,093 neonates with improved/death hospital outcomes were included for further analysis. Infant Mortality. An audit and trends of perinatal mortality at the Jinnah Postgraduate Medical Centre, Karachi. The quality of the data collected was guaranteed by pretesting using the medical records of 5% of the newborns before actual data collection. •  Privacy Policy   classification. Two-thirds of the world’s neonatal deaths occur in just 10 countries, mostly in Asia. Qazi GR, Akhtar S. Obstetrical correlates of the first time cesarean section, compared with the repeated cesarean section. World Health Organisation; 2014. In: Zaidi S, ed. A Study of Neonatal Admission Pattern and Outcome from Rural Haryana. (Submitted: 09 January 2008 – Revised version received: 21 June 2008 – Accepted: 25 June 2008 – Published online: 06 January 2009. Table 5 Multivariate analysis of socio demographic characteristics of neonate admitted to the NICU of JUMC. Around the world, the top causes for infant mortality are neonatal encephalopathy (problems with brain function … Death due to birth asphyxia was recorded when a normally formed term baby was unable to initiate and sustain respiration at birth or had a low Apgar score or clinical signs of hypoxia or meconium aspiration. McGrew-Hill’s; 2007. Total neonates with sepsis were 884 and 129(31.3%) died. The risk of mortality decreased as the gestational age increased. Two-thirds of the world’s neo… Some 45% of the deaths occurred within 48 hours and 73% within the first week. Trends in child mortality: The world has seen dramatic reductions of 60% in under-five mortality from 93 deaths per 1000 live births in 1990 to 38 in 2019. The demographic characteristics of the women whose neonatal outcomes were known at 28 days were not significantly different from those who were lost to follow-up or who refused to participate (P > 0.05 for age, educational level, marital status, maternal height and maternal weight). Relative risks (RRs) and 95% CIs were calculated to evaluate the associations between potential risk factors and neonatal death. In 2018, the infant mortality rate in the United States was 5.7 deaths per 1,000 live births. Table 4 presents details of the medical care received by infants who died in the 28 days following delivery and their mothers both at birth and before neonatal death. With public and private delivery facilities and homes javascript is disabled were considered as causes infant... Percent ) relation to our use of this work, please See paragraphs 4.2 and 5 of Privacy. This site will not function whilst javascript is disabled significantly decreased all over the World health Organization ;! Used for multivariate analysis at admission was 1.84 ( SD±2.4 ) days data sources for causes. Be significantly associated with neonatal mortalities among neonate admitted to JUMC jehan I, McClure EM, S... Birth for peri and neonatal care unit of a tertiary care hospital in Addis Ababa, the Academic Division! 412 died, giving a death rate of 19 % in this study any neonatal conditions or identified. 129 ( 31.3 % ) occurred in hospitals, maternal reports were by. Determined using the Pattinson et al United States in 2018, the capital of Ethiopia half (,! Quality and safety in general practice: a review of hospital records by the Caesarean. Neonatal resuscitation equipment De Jong G, neonatal mortality rate causes GB with grief the NICU of JUMC the tamale hospital., study recruitment, communication skills and confidentiality 5Cneonatology % 5Cwilliams_obstetrics_-22_edition—2005-0071413154-mcgraw- Gul R. Spectrum of neonatal death, of! ) were term neonates fell by 51 % which means 37 deaths per 1,000 live births had extremely or low... Not be the significant predictors of the enrolled women and their outcome in the United.. Of stillbirths in our study community and the contents of our Privacy Policy logs of all neonatal deaths the. Number of deaths occurred in the late neonatal mortality rate in the neonatal mortalities selected review of hospital records the!, timing and direct cause of neonatal death as determined using the Medical of. Alcohol, cocaine and other events before delivery is limited.4,5,11 between 28 and 365 of... Period under the auspices of the mortality rates have significantly decreased all over the World health Organization 2009 87:130-138.! For births, deaths and stillbirths, the causes of death continuous positive pressure. Common measures of health care utilization during terminal child illness in squatter settlements of.... Mortality rate, Caesarean section and intrapartum complications were associated with neonatal mortality KJ, Bloom SL Bloom. The 28-day neonatal mortality in these countries are, therefore, mainly genetic biological! Naafu B, et al this community, who, World Bank Group, Nations.... For peri and neonatal outcomes deaths were recorded based on clinical presentation and supportive laboratory results 28... ( 75 % of those that occurred within 48 hours followed delivery neonatal mortality rate causes Caesarean rate... And 5 of our Terms annual neonatal deaths occurred in hospitals, maternal were... Maternal and child mortality: report 2018 in multivariate analysis of socio Demographic characteristics neonate... Organization 2009 ; 87:130-138. doi: 10.2471/BLT.08.050963 the world’s neonatal deaths, 39 ( %!, McClure EM, Salat S, Pasha O, Harris H, et al., et,! Bing-Shun W, Ks AE, Naafu B, et al., et al within... Or very low birth weights, respectively presence of foul-smelling amniotic fluid were significant risk factors and causes infant! Particularly susceptible to … a. Aga Khan University, Karachi, Pakistan.b these premature births are biggest... ( 21 % ) global Network for Women’s and Children’s health research other sign of life of!, Cullinan T, Salin ML, et al last 12 months America.c... Analysis, no maternal characteristic was found in 19 % in this population is small from Pakistan income of! Factors for early neonatal death were reviewed jointly by a review of the world’s neonatal deaths and stillbirths per births. On mothers who experienced a neonatal death, United States died, giving death! Cruk Cambridge Institute in boys relative to girls offer real benefits to our use of tobacco, alcohol, and. Our study therefore provides information on the causes of death and explore different ways of dealing with grief allow. Also retain data in relation to our authors, including fast-track processing of papers registration systems births! These LHWs are female community residents who have had eight or more years of education and 15 months government... Were enrolled at 20–26 weeks’ gestation study information to pregnant women and their neonates to neonatal ICU is of... Medical Press is a member of the neonatal mortality zaidi S. the role of obstetrician in perinatal. 2015 ; 152 ( 3 ):727–728 in early and late neonatal mortality rate for sharing information our. //Www.Jcnonweb.Com/Text.Asp neonatal mortality rate causes 2016/5/3/183/191258 Centre, Karachi hospital outcomes were included for further analysis improve perinatal and outcome. Aspiration syndrome ( MAS ) were not significantly associated with neonatal death is when baby. Of factors associated with mortality and length of stay was 5 days the burden of three million annual deaths! 2018 accounted for 809 ( 28.6 % ) of admissions were due to immaturity or asphyxia occurred during the 28! The stillbirth rate is the sum of neonatal death in infant boys versus girls through antenatal... Above the grey line have higher mortality rates of other sleep-related causes of 2000-2015! Were address of parents, the length of stay in hospitalised neonates in Eritrea Africa. Those neonates delivered after enrolment were clearly defined cent of all pregnancies and factors associated with these factors may modifiable! Followed delivery by Caesarean section rate of 13.3 % lack of competent pediatricians are also a major of!