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Satrinawati Berkat. "THE INFLUENCE OF MATERNAL AND CHILD HEALTH SERVICES ON NEONATAL DEATH OF LOW BIRTH WEIGHT NEONATES IN ACEH PROVINCE." Malaysian Journal of Public Health Medicine 19, no. 1 (January 1, 2019): 15–24. http://dx.doi.org/10.37268/mjphm/vol.19/no.1/art.82.
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Low birth weight (LBW) is one of the most crucial problem related to neonatal mortality and infant mortality. The LBW is defined as babies born with a birth weight less than 2500 grams. LBW does not only contribute to neonatal morbidity, but may lead to neonatal mortality. This study aim to determine the influence of maternal and child health services (MCH) services to neonatal death among LBW babies in Aceh province, Indonesia.This study is observational study with mix method, using quantitative (Unmatched case control study) and qualitative (case study). The study was conducted between 2011-2015 in 8 district/municipality in Aceh Province, Indonesia. Total sample for quantitative study was 500 neonates (1:1), 250 neonates who died in neonatal period (case) and 250 LBW neonates who survived in the neonatal period (control group). Meanwhile, the total sample for qualitative study was 22, there were 12 (mother) and 10 (midwife).The result of A simple logistic regression analysis for MCH factors found that 4 of 7 variable were significant association with neonatal death among LBW (P value < 0.05), these variables include: Antenatal care (ANC), place of delivery, level of health facilities and neonatal visit. Multiple logistic regression found the ANC has a strongest influence on neonatal death among LBW babies in Aceh Province (OR=3.6; 95% CI: 2.3-5.7). The LBW neonates who were born to mothers who received number of ANC equal to or less than 3 times had a 3.6 times higher risk of death, than neonates who were born to mothers who received ANC ≥ 4 times. The appropriate of health services in health facilities are needed to reduce the NMR and improve the health of neonate.
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Wakjira Basha, Garoma, Ashenafi Abate Woya, and Abay Kassa Tekile. "Determinants of neonatal mortality in Ethiopia: an analysis of the 2016 Ethiopia Demographic and Health Survey." African Health Sciences 20, no. 2 (July 22, 2020): 715–23. http://dx.doi.org/10.4314/ahs.v20i2.23.
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Background: The first 28 days of life, the neonatal period, are the most vulnerable time for a child’s survival. Neonatal mortality accounts for about 38% of under-five deaths in low and middle income countries. This study aimed to identify the determinants of neonatal mortality in Ethiopia.
Methods: The study used data from the nationally representative 2016 Ethiopia Demographic and Health Survey (EDHS). Once the data were extracted; editing, coding and cleaning were done by using SAS 9.4.Sampling weights was applied to en- sure the representativeness of the sample in this study. Both bivariate and multivariable logistic regression statistical analysis was used to identify determinants of neonatal mortality in Ethiopia.
Results: A total of 11,023 weighted live-born neonates born within five years preceding the 2016 EDHS were included this in this study. Multiple logistic regression analysis showed that multiple birth neonates (Adjusted Odds Ratio (AOR)=6.38;95%- Confidence Interval (CI):4.42-9.21), large birth size (AOR=1.35; 95% CI: 0.28-1.62), neonates born to mothers who did not utilize ANC (AOR=1.41; 95% CI: 1.11-1.81), neonates from rural area (AOR=1.88; 95% CI: 1.15-3.05) and neonates born in Harari region (AOR=1.45; 95% CI: 0.61-3.45)had higher odds of neonatal mortality. On the other hand, female neonates (AOR=0.60; 95% CI: 0.47-0.75), neonates born within the interval of more than 36 months of the preceding birth (AOR=0.56; 95% CI: 0.43-0.75), neonates born to fathers with secondary and higher education level (AOR=0.51; 95%CI: 0.22-0.88) had lower odds of neonatal mortality in Ethiopia.
Conclusion: To reduce neonatal mortality in Ethiopia, there is a need to implement sex specific public health intervention mainly focusing on male neonate during pregnancy, child birth and postnatal period. A relatively simple and cost-effective public health intervention should be implemented to make sure that all pregnant women are screened for multiple pregnancy and if positive, extra care should be given during pregnancy, child birth and postnatal.
Keywords: Neonatal mortality; logistic regression; odds ratio; Ethiopia.
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Mazumdar, J., and S. Sen. "Neonatal Empyema Thoracis." Journal of Nepal Paediatric Society 34, no. 1 (March 24, 2014): 65–67. http://dx.doi.org/10.3126/jnps.v34i1.8233.
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Empyema thoracis, is a rare cause of respiratory distress in neonates. Only a few cases of neonatal empyema thoracis are described in medical literature. Empyema thoracis is not a well known entity in the neonates. It is fulminant with rapid progression with a high mortality. Compounding the problem is its uncertain etiopathogenesis and lack of definite treatment guidelines. We shall describe one case of neonatal empyema in a newborn aged five days caused by Pseudomonas aeruginosa. The neonate died subsequently. DOI: http://dx.doi.org/10.3126/jnps.v34i1.8233 J Nepal Paediatr Soc 2014;34(1):65-67
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Ewere, F., and D. O. Eke. "Neonatal Mortality and Maternal/Child Health Care in Nigeria: An Impact Analysis." Journal of Applied Sciences and Environmental Management 24, no. 7 (August 9, 2020): 1299–306. http://dx.doi.org/10.4314/jasem.v24i7.26.
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Reducing the rate of mortality in neonates to as low as 12 per 1,000 live births is one of the clearly spelt out aims of the third tenet of the Sustainable Development Goals (SDG) because of its importance to the dynamics of population. While there have been various studies focused majorly on the causes, rates and determinants of neonatal mortality in Nigeria, studies on the impact of maternal/child care characteristics on neonatal mortalityand the potential implication of failing to attain the SDG target for neonatal mortality have seemingly been neglected. In this study, we undertake an analysis of the impact of maternal / child care characteristics on neonatal mortality using the logistic regression model. Results from the study showed that antenatal care (P-value = 0.000, odds ratio = 0.546 for women who visited the hospital during pregnancy on more than 5 occasions), post natal care (P-value = 0.004, odds ratio = 0.402 for women who received early neonatal care from skilled medical personnel), place ofdelivery (P-value = 0.000, odds ratio = 0.592 for babies that were delivered in a government hospital) and skill of birth attendant (P-value = 0.000, odds ratio = 0.706 for babies who were delivered by trained doctors/nurses/midwives) had significant impact on neonatal mortality at the 95% confidence level implying that improved maternal health care: before, during and immediately after delivery as well as the quality of care to motherand child are both important and necessary to the reduction of neonatal mortality in Nigeria. To achieve the sustainable development target for neonatal mortality, it is therefore recommended that stake holders in the public health sector improve the quality of existing health care facilities and access to quality services.
Keywords: Neonatal mortality, logistic regression, maternal care, child health care, Nigeria
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Borum, Peggy R. "Carnitine in Neonatal Nutrition." Journal of Child Neurology 10, no. 2_suppl (November 1995): 2S25–2S31. http://dx.doi.org/10.1177/0883073895010002s04.
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Experimental evidence from several investigators suggests that carnitine is a conditionally essential nutrient for neonates. If camitine is a conditionally essential nutrient for the neonate, most neonates on total parenteral nutrition in the United States are not receiving adequate nutritional support. The metabolic functions of carnitine are varied and important in sev eral aspects of neonatal physiology. All neonates receiving breast milk receive dietary carnitine and most neonates receiv ing enteral infant formulas receive dietary carnitine at a level similar to that of the breast-fed neonate. However, most neonates on total parenteral nutrition receive no dietary carnitine. Investigators have been testing the working hypothesis that carnitine is a conditionally essential nutrient for the neonate for many years. This review discusses (1) data support ing the hypothesis, (2) reasons why it has not been either proved or disproved by now, and (3) the author's view of a prudent approach to dietary camitine supplementation of neonates. (J Child Neurol 1995;10(Suppl):2525-2531).
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Das, Amit Kumar, Deepak Mishra, Nitu Kumari Jha, Rakesh Mishra, and Soniya Jha. "Role of Lumbar Puncture in Late Onset Neonatal Sepsis." Journal of Nepal Paediatric Society 39, no. 3 (December 31, 2019): 155–61. http://dx.doi.org/10.3126/jnps.v39i3.28459.
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Introduction: Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. It is responsible for about 30-50% of the total neonatal deaths in developing countries. Neonatal sepsis can be divided into two sub-types depending upon whether the onset of symptoms within the first 72 hours of life (Early Onset Neonatal Sepsis) or after 72 hours of life (Late Onset Neonatal Sepsis ). Meningitis is an important complication of late onset neonatal sepsis.
Method: This was hospital based prospective observational study conducted among the neonates admitted with diagnosis of late onset neonatal sepsis in Neonatal Intermediate Care Unit (NIMCU) and Neonatal Intensive Care Unit (NICU) of Kanti Children’s Hospital from July 2016 to June 2017. The objective of this study was to evaluate the importance of performing LP in neonates with LONS.
Results: 16.8% neonates with late onset neonatal sepsis were found to have meningitis. Among the neonates with meningitis CRP was positive 57.2% and negative in 42.8 %. Among the cases with abnormal CSF findings, blood culture was sterile in 85% cases and organism was isolated 15% cases. In 88.8% cases with positive blood culture, no meningitis was detected. Lumbar puncture was traumatic in 1 neonate (0.8%) in first attempt. Apart from this no other complication of performing lumbar puncture was noted.
Conclusion: Lumbar puncture and CSF examination is mandatory in all cases with late-onset sepsis.
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Chandrasekar, Indira, Mary Anne Tablizo, Manisha Witmans, Jose Maria Cruz, Marcus Cummins, and Wendy Estrellado-Cruz. "Obstructive Sleep Apnea in Neonates." Children 9, no. 3 (March 15, 2022): 419. http://dx.doi.org/10.3390/children9030419.
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Neonates have distinctive anatomic and physiologic features that predispose them to obstructive sleep apnea (OSA). The overall prevalence of neonatal OSA is unknown, although an increase in prevalence has been reported in neonates with craniofacial malformations, neurological disorders, and airway malformations. If remained unrecognized and untreated, neonatal OSA can lead to impaired growth and development, cardiovascular morbidity, and can even be life threatening. Polysomnography and direct visualization of the airway are essential diagnostic modalities in neonatal OSA. Treatment of neonatal OSA is based on the severity of OSA and associated co-morbidities. This may include medical and surgical interventions individualized for the affected neonate. Based on this, it is expected that infants with OSA have more significant healthcare utilization.
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Christian, Parul, Luke C. Mullany, Kristen M. Hurley, Joanne Katz, and Robert E. Black. "Nutrition and maternal, neonatal, and child health." Seminars in Perinatology 39, no. 5 (August 2015): 361–72. http://dx.doi.org/10.1053/j.semperi.2015.06.009.
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Chang, Mei-Hwei. "Towards Better Neonatal and Child Health Care." Pediatrics & Neonatology 49, no. 2 (April 2008): 1. http://dx.doi.org/10.1016/s1875-9572(08)60001-7.
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Ibrahim, Riyadh M. "Morbidity and Mortality Pattern of Neonates Admitted to Neonatal Care Unit.Central Teaching Pediatric Hospital Baghdad." AL-Kindy College Medical Journal 16, no. 1 (September 5, 2020): 38–48. http://dx.doi.org/10.47723/kcmj.v16i1.188.
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Background; Neonatal period is a very vulnerable period of life due to many problems, In spite of advances in perinatal and neonatal care still, the mortality rate of neonate high especially in developing country The World Health Organization estimates that globally four million neonatal deaths per year, Developing countries account for around 99% of the neonatal mortality in the world, In Iraq. Neonatal mortality rate about 19 per 1000 live births which represent 56% of child death below 5 years age in 2012. .Objectives The aims of the study were to determine the institutional new-born case fatality rate and the cause of admission and death in the neonatal care unit.Method; Across-section study was carried out of the Neonatal Care Unit of Central Teaching Hospital of Pediatric in Baghdad Al-krakh Health DirectorateResult; During 2015, 1977 neonates were admitted, Mortality rate was 9%, Four main causes of death were identified; Respiratory related condition, Bacterial sepsis, premature neonate (Disorder related to short gestational and low birth weight not relayed to elsewhere classification) and congenital malformation 37.5%, 33.3%, 7.1% and 7.1% respectively , The main causes of morbidity were Neonatal jaundice, Respiratory related condition, Bacterial sepsis 37.5%, 35.2%. 14.1% respectively Conclusions: The majority of neonatal morbidity and mortality can be prevented by appropriate interventions
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Banik, Souradip, Kumar Ankur, Sanjeev Chetry, and Aparna Prasad. "Neonatal Chikungunya Presented as Apnea." Journal of Neonatology 35, no. 4 (October 6, 2021): 189–91. http://dx.doi.org/10.1177/09732179211048409.
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Neonatal Chikungunya virus (CHIKV) infection is sporadic, and the prevalence of the entity has been described only recently. Neurological complications in adults have been reported, but there is a lack of data in this regard in neonates. In this retrospective case series done during the outbreak of Chikungunya, we observed 7 neonates who presented with fever, irritability, excessive cry, and rash, which was confirmed by polymerase chain reaction. Out of 7, 5 neonates presented with encephalopathy with apnea and seizures (80%), which were the most common presenting symptoms. Identifying this entity based on clinical and epidemiological background helps in management and aids in prognostication of the affected neonate.
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Hill, Harry R. "Granulocyte Transfusions in Neonates." Pediatrics In Review 12, no. 10 (April 1, 1991): 298–302. http://dx.doi.org/10.1542/pir.12.10.298.
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Human neonates, especially those born prematurely, are prone to developing overwhelming infections in response to bacterial pathogens. It is estimated that 1 to 8 per 1000 live births are complicated by such infections. Moreover, almost 30% of neonatal mortality and morbidity can be attributed to neonatal infection. Thus, in spite of all of the support measures offered in neonatal intensive care units and the use of new, potent antimicrobial agents, we continue to lose far too many infants to overwhelming infections. It is likely that we have come as far as we can with these accepted regimens for treating bacterial infection in the neonate. This has led many investigators to explore the possibility of using various forms of immunotherapy in neonates who have infections, because the neonatal host defense system is compromised significantly. Most neonates who develop infection lack opsonic antibody to the infecting strain of bacteria. In addition, the infant complement system is compromised significantly with the concentration of most components being only approximately 50% of that of adults. Deficiency of antibody and complement lead to defective opsonization of most bacteria by neonatal serum. Additional consistent abnormalities in the neonatal host defense system are present in the cells that act as the first line of defense against bacterial invasion, polymorphonuclear leukocytes (PMNs), PMNs must arrive at the site of bacterial invasion within a very critical 2- to 4-hour period if infection is to be contained so that systemic spread does not occur.
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Ogbolu, Yolanda. "Neonatal Mortality: A Critical Global Health Issue." Neonatal Network 26, no. 6 (November 2007): 357–60. http://dx.doi.org/10.1891/0730-0832.26.6.357.
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Almost all of the millions of babies who die worldwide in the first four weeks of life are in low- and middle-income countries. The socioeconomic status of developing countries adversely affects maternal-child health because it limits access to adequate nutrition, quality health care, medications, safe water, adequate sanitation, and other basic social services. The factors associated with high infant mortality rates transcend national boundaries, making infant mortality a critical global health problem. Poverty is one of the most important factors affecting the infant mortality rate in Nigeria. This examination of infant mortality in Nigeria exemplifies the multifactorial national and international issues underlying infant mortality in developing countries. Infant mortality in these countries will not improve without global attention and intervention. By finding creative ways to share expert knowledge about caring for neonates, neonatal nurses can contribute to global improvements in maternal-child health care.
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Jaraiseh Abcarius, Margaret, Berly Alejandra Zambrano Bravo, Manuel Eugenio Morocho-Cayamcela, and Ana Belén Tulcanaza-Prieto. "FACTORES DE RIESGO ASOCIADOS A LA MORTALIDAD Y PESO AL NACER DE PACIENTES NEONATOS, CASO DE ESTUDIO: HOSPITAL PEDIÁTRICO BACA ORTIZ." Enfermería Investiga 7, no. 1 (January 3, 2022): 17. http://dx.doi.org/10.31243/ei.uta.v7i1.1473.2022.
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Introducción: El peso al nacer es uno de los principales indicadores pronóstico de mortalidad neonatal, en el que influyen factores asociados con la madre, el neonato, y también con las características socioeconómicas del núcleo familiar. Los factores de riesgo implican comorbilidades al momento del nacimiento, por lo que, la intervención adecuada y el oportuno acceso a los servicios de salud constituyen elementos primordiales para la reducción de la mortalidad neonatal. Objetivo: establecer los factores de riesgo asociados a la mortalidad y peso al nacer de pacientes neonatos, de la Unidad de Cuidados Intensivos Neonatales del Hospital Pediátrico Baca Ortiz. Métodos: Se realizó una investigación de diseño observacional, transversal de tipo descriptivo que con una muestra de 204 recién nacidos ingresados en la Unidad de Cuidados Intensivos Neonatales del Hospital Pediátrico Baca Ortiz en la ciudad de Quito, Ecuador, durante el año 2019. Resultados: El peso al nacimiento tiene una asociación lineal negativa significativa con la mortalidad neonatal, siendo los neonatos de género masculino los más susceptibles a fallecer. También, existe mayor frecuencia de mortalidad neonatal en las madres que residen en el área urbana de la sierra ecuatoriana. Conclusiones: El peso al nacer es una variable de gran influencia en la salud y supervivencia infantil, debido a que los datos epidemiológicos muestran que un niño que nace con un peso por debajo de los límites normales tiene un mayor riesgo de fallecer, en comparación con los niños nacidos con un peso dentro del rango considerado normal. Palabras clave: Mortalidad infantil, factores de riesgo, recién nacido de bajo peso, enfermería neonatal, mortalidad neonatal. Abstract Introduction: Birth weight is one of the main prognostic indicators of neonatal mortality, which is influenced by factors associated with the mother, the neonate, and the socioeconomic characteristics of the family. Moreover, the risk factors imply comorbidities at birth. Therefore, adequate intervention and timely access to health services constitute essential elements to reduce neonatal mortality. Objective: establish the risk factors associated with mortality and birth weight of neonatal patients, from the Neonatal Intensive Care Unit of the Baca Ortiz Pediatric Hospital. Methods: An observational, cross-sectional, descriptive research was carried out with a sample of 204 newborns admitted to the Neonatal Intensive Care Unit of the Baca Ortiz Pediatric Hospital in the city of Quito, Ecuador, during the year 2019. Results: The birth weight shows a significant negative linear association with neonatal mortality, where the male infants are the most susceptible to death. Furthermore, there is a higher frequency of neonatal mortality in mothers who live in the urban area of the Ecuadorian highlands. Conclusions: The birth weight is a highly influential variable for child health and survival since epidemiological data show that a newborn with a weight below the range considered normal, has a higher risk of death as compared to children with a normal weight. Keywords: Infant mortality, risk factors, low birth weight, neonatal nursing, neonatal mortality.
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Mullan, Zoë. "Moving the needle on neonatal and child health." Lancet Global Health 2, no. 8 (August 2014): e431. http://dx.doi.org/10.1016/s2214-109x(14)70284-0.
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Shahidullah, Mohammod, M. Zahidul Hasan, Ismat Jahan, Firoz Ahmed, Arjun Chandra Dey, Sanjoy Kumer Dey, and MA Mannan. "Perinatal Characteristics and Outcome of Neonates at NICU of a Tertiary Level Hospital in Bangladesh." Bangladesh Journal of Child Health 41, no. 1 (August 20, 2017): 34–39. http://dx.doi.org/10.3329/bjch.v41i1.33634.
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Background: One of the Millennium Development Goals (MDG-4) is to reduce child mortality up to two-thirds by 2015. In most developing countries, a higher proportion of neonatal deaths are observed. It has been recognized that without a substantial reduction in neonatal deaths, MDG-4 will not be met.Objective: To assess the perinatal characteristics, pattern of admissions and outcome of neonates in a tertiary care centre in Bangladesh.Methods: A retrospective review of consecutive neonatal admissions to Bangabandhu Sheikh Mujib Medical University, between January and December 2013, was conducted. Data were collected from the neonatal admission, discharge and death registers. Standard definitions of the conditions were used to diagnose the clinical conditions.Results: Total 683 neonates were admitted to the NICU. Among them 56.1% were inborn and males were 56.8%. Total 61.3% neonates were low birth weight and 60.3 % were preterm. The overall cesarean section rate was 61.9%. Total 35.3% neonates had sepsis and perinatal asphyxia was present in 16.8% neonates. Congenital anomaly was present in 17.6% neonates. The mean duration of hospital stay was 11.1 days and overall mortality rate was 14.9%.Conclusion: Prematurity, neonatal infections, birth asphyxia and congenital anomalies were the main causes of neonatal hospital admission and neonatal deaths in this study.Bangladesh J Child Health 2017; VOL 41 (1) :34-39
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Yengkhom, Rameshwor, Pradeep Suryawanshi, Rahul Murugkar, Bhavya Gupta, Sujata Deshpande, and Yogen Singh. "Point of Care Neonatal Ultrasound in Late-Onset Neonatal Sepsis." Journal of Neonatology 35, no. 2 (April 15, 2021): 59–63. http://dx.doi.org/10.1177/09732179211007599.
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Background and Objectives: Point of care neonatal ultrasound is a useful tool in evaluation of heart, brain, lungs, and abdomen in neonatal sepsis. The objective of our study was to perform bedside ultrasound screening of heart, brain, lungs, and abdomen in neonates with late onset culture positive sepsis and study the patterns of abnormalities and also their role in change of patient management. Methods: This prospective observational study was conducted at a tertiary level neonatal care unit from March 2017 to May 2018. All neonates with suspected late onset sepsis on the basis of clinical and laboratory findings underwent point of care neonatal ultrasound of heart, brain, lungs, and abdomen. Results: Of 153 suspected and eligible late-onset neonatal sepsis (LONS) cases, 67 (44%) had positive blood culture and were analyzed. Of this 67 neonates, 30 (45%) had abnormal neurosonography, 38 (57%) had abnormal cardiac output, 14 (20%) had abnormal cardiac contractility, 17 (25%) had abnormal pulmonary pressure, 18 (27%) had pulmonary arterial hypertension, 19 (28%) had pneumonia, and 7 (10%) had free fluid in abdomen. Clinical management was changed in 26 (39%) neonates. Conclusion: Bedside point of care neonatal ultrasound is a useful tool in assessment of heart, brain, lungs, and abdomen in a LONS. It could help in making appropriate decisions in the management, and therefore potentially reduce morbidity and mortality.
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McCormick, Marie C., and Jeanne Brooks-Gunn. "Concurrent Child Health Status and Maternal Recall of Events in Infancy." Pediatrics 104, Supplement_6 (November 1, 1999): 1176–81. http://dx.doi.org/10.1542/peds.104.s6.1176.
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Background. Obtaining information on children's health and health events is heavily dependent on maternal report. Experience as to what factors influence accuracy of reporting varies, and few studies have examined the influence of current child health status on recall. Methods. A prospective cohort study involving 1833 children who were assessed in infancy and at 8 to 10 years of age was conducted to assess maternal reports of birth weight, gestational age, neonatal transport, length of neonatal hospitalization, and rehospitalizations in the first year compared with data collected in infancy overall, and as a function of concurrent child functional health status, socioemotional health, and ratings of child health. Results. Maternal recall of neonatal events was accurate but not that of rehospitalizations in the first year. Concurrent child health problems affected accuracy but not sufficiently to make information unusable. Conclusion. Maternal recall of neonatal events 8 to 10 years later is accurate; however, the influence of current child health status on recall may be important in research on the cognitive processes underlying health questionnaire responses.
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Bingham, William T., Anthony Chan, Robert Rennie, Kurt E. Williams, and Koravangattu Sankaran. "Neonatal Campylobacter Fetus Meningitis: A Report of an Unusual Case." Clinical Pediatrics 31, no. 4 (April 1992): 255–56. http://dx.doi.org/10.1177/000992289203100416.
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Campylobacter fetus is a rare cause of meningitis in the pediatric age group and, in particular, among neonates. The clinical presentation of campylobacter meningitis in high-risk neonates is not well-described. A review of campylobacter meningitis by Lee et al1 in 1985 reported nine cases occurring in neonates, of which only one case was caused by C. fetus. In the ensuing six years only three more confirmed cases of neonatal meningitis caused by C. fetus have been reported.2,3 We here report another confirmed case of C. fetus meningitis in a neonate.
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Ibrahim, Riyadh Mraweh, and Bushra Jabbar Hashem. "The outcome of newborn admitted in neonatal care unit, center teaching hospital of pediatric , Baghdad Al-krakh, 2015." AL-Kindy College Medical Journal 15, no. 1 (September 12, 2019): 43–51. http://dx.doi.org/10.47723/kcmj.v15i1.77.
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Background: Neonatal period is a very vulnerable period of life due to many problems, In spite of advances in perinatal and neonatal care still, the mortality rate of neonate high especially in developing country The World Health Organization estimates that globally four million neonatal deaths per year, Developing countries account for around 99% of the neonatal mortality in the world, In Iraq. Neonatal mortality rate about 19 per 1000 live births which represent 56% of child death below 5 years age in 2012. The hospital in the study represents the larger pediatric hospital in Iraq. It contains 400 children's beds and 24 neonatal incubators.
Aims of the study: are to determine the institutional new-born case fatality rate and the cause of death in the neonatal care unit.
Method; The study is cross-section study of the population sample of neonatal care unit of central teaching hospital of pediatric in Baghdad Al-krakh health directorate
Result: Study appear total neonate admission during 2015 was 1977 neonates mortality rate 9% Four main causes of death were Respiratory related condition, Bacterial sepsis, Disorder related to short gestational and low birth weight not relayed to elsewhere classification and congenital malformation 37.5%, 33.3%, 7.1% and 7.1% respectively while the main primary cause of morbidity were Neonatal jaundice, Respiratory related condition, Bacterial sepsis and 37.5%, 35.2%. 14.1% respectively Conclusions: The majority of morbidity and mortality can prevent by appropriate intervention
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Sankaran, Deepika, Emily C. A. Lane, Rebecca Valdez, Amy L. Lesneski, and Satyan Lakshminrusimha. "Role of Volume Replacement during Neonatal Resuscitation in the Delivery Room." Children 9, no. 10 (September 28, 2022): 1484. http://dx.doi.org/10.3390/children9101484.
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Volume expanders are indicated in the delivery room when an asphyxiated neonate is not responding to the steps of neonatal resuscitation and has signs of shock or a history of acute blood loss. Fetal blood loss (e.g., feto-maternal hemorrhage) may contribute to perinatal asphyxia. Cord compression or a tight nuchal cord can selectively occlude a thin-walled umbilical vein, resulting in feto-placental transfusion and neonatal hypovolemia. For severe bradycardia or cardiac arrest secondary to fetal blood loss, Neonatal Resuscitation Program (NRP) recommends intravenous volume expanders (crystalloids such as normal saline or packed red blood cells) infused over 5 to 10 min. Failure to recognize hypovolemia and subsequent delay in volume replacement may result in unsuccessful resuscitation due to lack of adequate cardiac preload. However, excess volume load in the presence of myocardial dysfunction from hypoxic–ischemic injury may precipitate pulmonary edema and intraventricular hemorrhage (especially in preterm infants). Emergent circumstances and ethical concerns preclude the performance of prospective clinical studies evaluating volume replacement during neonatal resuscitation. Translational studies, observational data from registries and clinical trials are needed to investigate and understand the role of volume replacement in the delivery room in term and preterm neonates. This article is a narrative review of the causes and consequences of acute fetal blood loss and available evidence on volume replacement during neonatal resuscitation of asphyxiated neonates.
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Darcha, Rosina, and Margaret Wekem Kukeba. "Neonatal outcomes of obstetric complications." African Journal of Midwifery and Women's Health 15, no. 3 (October 2, 2021): 1–10. http://dx.doi.org/10.12968/ajmw.2020.0030.
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Background/Aims Neonatal mortality remains a global challenge. In Ghana, neonatal mortality accounts for up to 50% of child mortality. A better understanding of the neonatal outcomes of obstetrics complications could contribute to context-specific evidence-based care to prevent neonatal deaths. This study aimed to describe the relationship between poor neonatal outcomes and obstetric complications in a tertiary health facility in the north of Ghana. Methods This was a cross-sectional quantitative study conducted at a tertiary health facility in northern Ghana. Purposive convenience sampling was used to select 384 mothers who experienced obstetric complications. A structured questionnaire was used to collect data on the participants' neonatal health outcomes. The chi-square test was performed to determine the relationship between neonatal health outcomes and obstetric complications, with significance set at P<0.05. Results A total of 20 obstetric complications were recorded. Overall, 327 participants had a single complication. The three most common obstetric complications resulting in adverse neonatal outcomes were obstructed labour (56.0%), pregnancy-induced hypertension (14.6%) and postpartum haemorrhage (11.6%). The majority (66.7%) of the neonates were healthy at birth, with 21.9% and 11.5% being sick or stillborn respectively. Obstetric complications were significantly associated with both neonatal morbidities and mortalities at P<0.000. Conclusions Preventable maternal obstetric complications continue to cause adverse neonatal outcomes in health facilities in Ghana. Appraisal of maternal and newborn care practices may be necessary to understand context-specific factors.
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Abera, Tesfaye, Lami Bayisa, Teshome Bekele, Mulugeta Dessalegn, Diriba Mulisa, and Lalisa Chewaka Gamtessa. "Neonatal Mortality and Its Associated Factors among Neonates Admitted to Wollega University Referral Hospital Neonatal Intensive Care Unit, East Wollega, Ethiopia." Global Pediatric Health 8 (January 2021): 2333794X2110301. http://dx.doi.org/10.1177/2333794x211030157.
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Ethiopia has a high neonatal mortality rate in spite of dearth of study. Therefore we aimed to assess magnitude and associated factors of neonatal mortality among neonates admitted to neonatal intensive care units of Wollega University Referral Hospital. Accordingly, a facility based cross-sectional study was conducted on 289 by reviewing medical records of neonates admitted to neonatal intensive care unit. The collected data were entered in to Epi data version 3.1 and Stata version 14 used for analysis. Variables with P-value < 0.25 at with 95% confidence interval in binary logistic regression analysis were taken to the multiple logistic regression analysis. Finally, variables with Likewise, variable with P-value < 0.05 at 95% confidence interval in multiple logistic regression analysis were considered as statistically significant. Among 289 neonates admitted to neonatal intensive care unit, 53 (18.34 %) were died. Majority 42(79.25%) of those deaths occurred at ≤ 7 days of birth. Preterm [AOR 4.15, 95% CI (1.67-10.33)], neonates faced birth asphyxia [AOR 3.26, 95% CI (1.33-7.98)], neonates who developed sepsis [AOR 2.29 95% CI (1.01-5.20)] and neonates encountered with jaundice [(AOR 11.08, 95% CI (1.03-119.59)] were more at risk to die. In general, the magnitude of neonatal mortality among neonates admitted to neonatal intensive care unit was high. Gestational age (maturity of new born), birth asphyxia, neonatal sepsis and neonatal jaundice were predictors of neonatal mortality. Neonates admitted to neonatal intensive care unit with sepsis, jaundice, and birth asphyxia demand special attention to reduce neonatal mortality.
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Borra, Cristina, Libertad González, and Almudena Sevilla. "Birth Timing and Neonatal Health." American Economic Review 106, no. 5 (May 1, 2016): 329–32. http://dx.doi.org/10.1257/aer.p20161123.
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We take advantage of a new natural experiment to evaluate the health effects of scheduling birth early for non-medical reasons on infant health. In 2010, the cancellation of a generous child benefit in Spain led may families to schedule birth early in order to remain eligible for the subsidy. We document that the affected cohort of children did not suffer any increase in birth complications or medical conditions right at birth, but were significantly more likely to be admitted to hospital during their second and third weeks of life, suggesting potentially persistent negative health effects.
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DAVIS, DEBORAH J. "How Aggressive Should Delivery Room Cardiopulmonary Resuscitation Be for Extremely Low Birth Weight Neonates?" Pediatrics 92, no. 3 (September 1, 1993): 447–50. http://dx.doi.org/10.1542/peds.92.3.447.
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The neonatology staff attending high-risk deliveries are often faced with difficult ethical decisions. One of these is whether or not to perform cardiopulmonary resuscitation on extremely low birth weight neonates in the delivery room. Unfortunately, there is a paucity of information in the medical literature addressing this dilemma. To determine whether guidelines for resuscitation of the extremely low birth weight neonate could be set, I undertook a chart review of all neonates born with a birth weight of 1000 g or less in our institution. METHODS All babies born at the Ottawa General Hospital who weighed 1000 g or less at birth were identified through the neonatal intensive care unit logbook, which records all births at which a neonatal physician is in attendance.
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Zahid, Ghulam Mustafa. "Mother’s Health-seeking Behaviour and Childhood Mortality in Pakistan." Pakistan Development Review 35, no. 4II (December 1, 1996): 719–31. http://dx.doi.org/10.30541/v35i4iipp.719-731.
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The paper examines the Mother’s Health-seeking Behaviour and Childhood Mortality in Pakistan. This is based on the 1990-91 Pakistan Demographic and Health Survey (PDHS), a nationally representative survey covering all four provinces of the country. It was found that neonatal, infant, and child mortality rate is the highest among children of mothers aged less than 20 years. Infant and Child mortality rate is likewise higher among first and higher order births than among births of second or third order. It has further found that mortality declines as the length of the birth interval increases. The results reveal that the education of mother has significant effect on the neonatal, infant and child survival, as mother’s education increases the chances of survival of neonatal, infant and child also increases. Health care factors such as antenatal care, place of delivery, assistance at delivery and immunisation also influenced neonatal, infant and child mortality. The paper suggests that for the improvement of the health conditions of children in Pakistan, first, it is necessary that the educational status of the population in general, and of mothers in particular, should be improved, and second, the health services should be accessible and available for the promotion of health care practices.
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Bell, Y., M. Barton, M. Thame, A. Nicholson, and H. Trotman. "Neonatal sepsis in Jamaican neonates." Annals of Tropical Paediatrics 25, no. 4 (December 2005): 293–96. http://dx.doi.org/10.1179/146532805x72449.
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Madewell, Zachary J., Cynthia G. Whitney, Sithembiso Velaphi, Portia Mutevedzi, Sana Mahtab, Shabir A. Madhi, Ashleigh Fritz, et al. "Prioritizing Health Care Strategies to Reduce Childhood Mortality." JAMA Network Open 5, no. 10 (October 21, 2022): e2237689. http://dx.doi.org/10.1001/jamanetworkopen.2022.37689.
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ImportanceAlthough child mortality trends have decreased worldwide, deaths among children younger than 5 years of age remain high and disproportionately circumscribed to sub-Saharan Africa and Southern Asia. Tailored and innovative approaches are needed to increase access, coverage, and quality of child health care services to reduce mortality, but an understanding of health system deficiencies that may have the greatest impact on mortality among children younger than 5 years is lacking.ObjectiveTo investigate which health care and public health improvements could have prevented the most stillbirths and deaths in children younger than 5 years using data from the Child Health and Mortality Prevention Surveillance (CHAMPS) network.Design, Setting, and ParticipantsThis cross-sectional study used longitudinal, population-based, and mortality surveillance data collected by CHAMPS to understand preventable causes of death. Overall, 3390 eligible deaths across all 7 CHAMPS sites (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) between December 9, 2016, and December 31, 2021 (1190 stillbirths, 1340 neonatal deaths, 860 infant and child deaths), were included. Deaths were investigated using minimally invasive tissue sampling (MITS), a postmortem approach using biopsy needles for sampling key organs and fluids.Main Outcomes and MeasuresFor each death, an expert multidisciplinary panel reviewed case data to determine the plausible pathway and causes of death. If the death was deemed preventable, the panel identified which of 10 predetermined health system gaps could have prevented the death. The health system improvements that could have prevented the most deaths were evaluated for each age group: stillbirths, neonatal deaths (aged &lt;28 days), and infant and child deaths (aged 1 month to &lt;5 years).ResultsOf 3390 deaths, 1505 (44.4%) were female and 1880 (55.5%) were male; sex was not recorded for 5 deaths. Of all deaths, 3045 (89.8%) occurred in a healthcare facility and 344 (11.9%) in the community. Overall, 2607 (76.9%) were deemed potentially preventable: 883 of 1190 stillbirths (74.2%), 1010 of 1340 neonatal deaths (75.4%), and 714 of 860 infant and child deaths (83.0%). Recommended measures to prevent deaths were improvements in antenatal and obstetric care (recommended for 588 of 1190 stillbirths [49.4%], 496 of 1340 neonatal deaths [37.0%]), clinical management and quality of care (stillbirths, 280 [23.5%]; neonates, 498 [37.2%]; infants and children, 393 of 860 [45.7%]), health-seeking behavior (infants and children, 237 [27.6%]), and health education (infants and children, 262 [30.5%]).Conclusions and RelevanceIn this cross-sectional study, interventions prioritizing antenatal, intrapartum, and postnatal care could have prevented the most deaths among children younger than 5 years because 75% of deaths among children younger than 5 were stillbirths and neonatal deaths. Measures to reduce mortality in this population should prioritize improving existing systems, such as better access to antenatal care, implementation of standardized clinical protocols, and public education campaigns.
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Fissha Adem, Yonas, Yosef Haile, and Moges Milashu. "Time to death and its predictors among early neonatal patients in neonatal intensive care unit of Dessie referral hospital, South Wollo Zone, Northeast Ethiopia." Journal of Pediatrics & Neonatal Care 12, no. 3 (September 9, 2022): 143–49. http://dx.doi.org/10.15406/jpnc.2022.12.00471.
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Background: Early neonatal death is a serious concern, both in the developing and developed worlds. Early neonatal death remains a health problem and is the biggest component of the neonatal mortality rate. Therefore, substantial reduction in early neonatal mortality is a crucial pre-requisite for achieving further gains in child survival in the country. However, the distribution of deaths in the community within the first week is poorly understood. Therefore, this study was conducted to assess time to death and its predictors among early neonates in the neonatal intensive care unit of Dessie Referral Hospital. Method: A retrospective cohort study was conducted in the early neonatal patient in Dessie referral hospital on the total sample size of 416 selected patients by using a simple random sampling technique. Data were collected by document review. Life table used to estimate the probability of survival, log-rank test to compare survival in two or more groups and the Cox proportional hazard model was used to determine factors associated with time to death of early neonate. The hazard ratio with 95% confidence level was used to declare statistical significant association. Result: A total of 416 early neonates were included in the study. There were 224(53.8%) male neonates. The overall early neonatal mortalities were 47(11.3%), of which 23.41% of them died on the first day of age. early neonatal mortality was associated with neonatal sepsis (AHR=3.349,95% CI,1.842-6.089), low birth weight of neonates (AHR=3.563%,95% CI,1.925-6.595), unable to breastfeeding during delivery (AHR=4.094,95% CI,1.603-10.452), neonatal respiratory distress (AHR=4.018,95% CI,1.733-9.371), perinatal asphyxia (AHR =2.540,95% CI,1.186-5.847). Conclusion: The causes of early neonatal death described in this study were preventable. Managing low birth weight, initiating exclusive breastfeeding, refining quality of service, and confirming the continuity of care are recommended to increase the survival of neonates.
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Joshi, Poonam, Bindu Sarojini, Meena Joshi, and Anu Thukral. "Nurse-Led Neonatal Follow-Up Clinic: A New Emerging Concept in a Developing Country." Journal of Neonatology 34, no. 1-2 (June 2020): 19–23. http://dx.doi.org/10.1177/0973217920936434.
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Objective: To investigate the feasibility and acceptance of nurse-led neonatal follow-up clinic (NLNFC) in a tertiary care facility. Materials and Methods: In a prospective observational study, total 105 stable mother-neonate dyads were independently followed up in both nurse led and neonatologist run follow-up clinics. The outcome was measured in terms of agreement between the nurse and neonatologist in the domains of neonatal assessment, counselling mothers on essential newborn care (ENC) and giving advice ( P < 0.05) and mothers’ acceptability for NLNFC. Results: Agreement between the trained neonatal nurse and neonatologist varied between 87 and 100%. The most unanimity was observed in neonatal assessment and counselling on ENC (93.3%-100%) followed by prescribing treatment (87%). The mean acceptability scores of the mothers for NLNFC was 33.13 ± 2.6 (25-35, maximum possible score 35). Conclusion: Establishing NLNFCs in developing countries is feasible. Nurses can be entrusted with the responsibility of following up stable neonates here and mothers will surely be satisfied with this type of clinic.
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Mannan, MA, Nazmun Nahar, Firoz Ahmed, Ismat Jahan, Taskina Mosleh, Kamrul Ahsan Khan, Sanjoy Kumer Dey, and Mohammod Shahidullah. "Neonatal Pneumonia in NICU of a Tertiary Care Center." Bangladesh Journal of Child Health 42, no. 3 (December 15, 2018): 112–17. http://dx.doi.org/10.3329/bjch.v42i3.39250.
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Background: Pneumonia is one of the causes of neonatal infection and responsible for significant morbidity and mortality, especially in developing countries. The study was aimed to reveal frequency and outcome of pneumonia among hospitalized sick newborn of neonatal intensive care unit.
Methodology: This observational study was carried out in the NICU of Bangabandhu Sheikh Mujib Medical University (BSMMU) on 94 neonates with the diagnosis of pneumonia admitted from July 2012 to June 2014. All studied neonates were subjected to history taking, clinical examination, routine investigations, chest radiography and blood culture and sensitivity.
Results: Incidence of neonatal pneumonia was 43% among admitted neonates with respiratory distress. Mean birth weight and gestational age were 2392±854 and 33±3.9 weeks respectively. Of enrolled infants with pneumonia, 38 (40.4%) were early onset, 24 (25%) were hospital acquired pneumonia and community acquired pneumonia was documented in 14 (14.8 %) and the rest 18 (19%) were ventilator associated pneumonia. Blood culture was positive in 18 (19%) of cases with neonatal pneumonia; most common pathogen isolated was acinetobacter. Mean duration of hospital stay was 19±8 days. Most of the neonatal pneumonia were cured 72 (76%) with therapy, whereas 17 (18%) died during their hospital course.
Conclusion: Overall incidence among admitted sick neonates was 8.4% which constituted 34% of distressed neonate.
Bangladesh J Child Health 2018; VOL 42 (3) :112-117
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Moallem, Mohannad, and Joyce M. Koenig. "Preeclampsia and Neonatal Neutropenia." NeoReviews 10, no. 9 (September 1, 2009): e454-e459. http://dx.doi.org/10.1542/neo.10-9-e454.
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Neutropenia is a common hematologic disorder in the newborn intensive care unit, particularly in preterm neonates. Although its cause varies, a significant proportion of the episodes are associated with pregnancy complicated by preeclampsia. In this review, we provide a brief overview of preeclampsia and neonatal neutropenia, with a focus on the neonatal neutropenia associated with maternal preeclampsia. We discuss potential contributory mechanisms to and the natural history of this type of neutropenia, as well as reasonable management strategies in affected neonates.
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Kyokan, Michiko, Veena Jirapaet, Flavia Rosa-Mangeret, Giorgia Brambilla Pisoni, and Riccardo E. Pfister. "Clinical detection of ‘cold stress’ is overlooked: an online survey of healthcare workers to explore the gap in neonatal thermal care in low-resource settings." BMJ Paediatrics Open 6, no. 1 (September 2022): e001606. http://dx.doi.org/10.1136/bmjpo-2022-001606.
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BackgroundNeonatal hypothermia has been widely regarded as a major contributory factor to neonatal mortality and morbidity in low-resource settings. The high prevalence of potentially preventable hypothermia today urges an investigation into why neonates still become hypothermic despite awareness of the problem and established thermal care guidelines. This study aimed to explore the gaps in knowledge and practices of neonatal thermal care among healthcare workers in low-resource settings.MethodsA cross-sectional, questionnaire-based survey was performed online among healthcare workers in low-resource settings. We applied a purposive and snowballing sampling method to recruit participants through a two-round international online survey. Questionnaires were developed using themes of neonatal thermal care extracted from existing neonatal care guidelines.Results55 neonatal care professionals participated in the first-round survey and 33 in the second. Almost all participants (n=44–54/55) acknowledged the importance of the WHO’s warm chain to keep a neonate warm. However, fewer participants (n=34–46/55) responded to practice them. When asked about cold stress, defined as a condition in which neonates are below optimum environmental temperature and using more oxygen and energy while maintaining normal body temperature, 15 out of 55 participants answered that checking extremity temperatures by hand touch was useless. Some participants reported concern about the extremity temperature’s inaccuracy compared with core temperature. Opinions and preferences for rewarming methods differed among participants, and so did the availability of warming equipment at their institutions.ConclusionAn inadequate understanding of cold stress underestimates the potential benefits of extremity temperatures and leads to missed opportunities for the timely prevention of hypothermia. The current thermal care guidelines fail to highlight the importance of monitoring cold stress and intervening before hypothermia occurs. Therefore, we urge introducing the concept of cold stress in any neonatal thermal care guidelines.
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Harrington, Madeline. "Letter to the Editor." Pediatrics 93, no. 6 (June 1, 1994): 1021. http://dx.doi.org/10.1542/peds.93.6.1021a.
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Wiswell et al, in their article "Circumcision in Children Beyond the Neonatal Period," (December 1993, Pediatrics), found a substantial (7%) complication rate. For this reason, they recommend that physicians "be more proactive in recommending neonatal circumcision." By this, they presumably mean that more neonates should be circumcized despite a complicated neonatal course (the reason that 32% of patients in their study were not circumcized as neonates) or that parents should be more strongly encouraged to choose neonatal circumcision (55% were not circumcized of parental choice).
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Aranha, V. P., A. Chahal, and A. K. Bhardwaj. "Neonatal aquatic physiotherapy in neonatal intensive care units: A scoping review." Journal of Neonatal-Perinatal Medicine 15, no. 2 (April 12, 2022): 229–35. http://dx.doi.org/10.3233/npm-210858.
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BACKGROUND: Therapeutic benefits of neonates undergoing neonatal aquatic physiotherapy (NAPT) are evident from the available literature. However complied report on NAPT is not yet available. Hence, we have mapped the available interventions to treat neonates admitted in neonatal intensive care units (NICUs) using NAPT in a scoping review. METHOD: Six databases which includes, MEDLINE/PubMed, SCOPUS, PEDro, CINHAL, EBSCO and Cochrane were searched with predefined keywords specific to or related to NAPT interventions from 1983 to August, 2020 for the full-text English language articles. RESULTS: A total of 6163 relevant articles were identified from the search process. After duplicates were removed, 6146 articles were screened for inclusion, leaving 809 articles assessed for eligibility criteria. Six (n = 6) articles met all criteria and were included in the final qualitative synthesis. CONCLUSION: NAPT may be an effective intervention to normalize the muscle tone, to promote active movements, postural organization, improves sleep pattern and quality, promotes the thermal and cardiorespiratory adaptations, and moreover reduces neonatal pain among the neonates admitted in NICUs.
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Khan, Azeem, Anjali Anders, and Maggie Cardonell. "Neonatal Conjunctivitis." NeoReviews 23, no. 9 (September 1, 2022): e603-e612. http://dx.doi.org/10.1542/neo.23-9-e603.
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Neonatal conjunctivitis is an important cause of ocular morbidity with infectious and noninfectious origins. Common practice in the United States is to administer prophylactic antibiotic ointment at birth; however, prophylaxis is ineffective for some causes. Moreover, recognition of the etiologies that threaten systemic complications to the neonate is critical in providing timely and appropriate treatment. This review summarizes the clinical features, etiology, and treatment recommendations of various forms of neonatal conjunctivitis.
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Workineh, Yeneneh Ayalew, and Hailemariam Mekonnen Workie. "Adverse Neonatal Outcomes and Associated Risk Factors: A Case-Control Study." Global Pediatric Health 9 (January 2022): 2333794X2210840. http://dx.doi.org/10.1177/2333794x221084070.
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Background Adverse neonatal outcomes have a significant effect on perinatal and neonatal survival and the risk of developmental disabilities and illnesses throughout future lives. Hence, the objective of this study was to identify adverse neonatal outcomes and associated risk factors. Method Institutional based unmatched case-control study was conducted among 206 neonates. Neonates who had adverse outcomes were cases with their index mothers and those neonates who hadn’t had adverse outcomes were controls with their index mothers. Sociodemographic, potential neonatal risk factors, and clinical data were taken from the mothers and medical records. Data were entered into Epi Info v7 and analyzed using SPSS v23. Bivariate and multivariable logistic regression analyses were used to adjust for confounding factors of adverse neonatal outcomes. Frequencies, means, standard deviations, percentages, and cross-tabulations were used to summarize the descriptive statistics of the data. Results In this study, low birth weight (61.5%), preterm birth (57.7%), and low Apgar score at fifth minutes (53.9%) were the major identified adverse neonatal outcomes. Based on the multivariable logistic regression analysis, rural place of residence (AOR = 5.992 to 95% CI [1.011-35.809]), low monthly income (AOR = 4.364), middle monthly income (AOR = 4.364), and emergency cesarean section (AOR = 9.969) were the potential risk factors for adverse neonatal outcomes. Conclusions The adverse neonatal outcomes & the risk factors identified in this research have the potential to harm the health of the neonates. Thus, it needs emphasis to tackle the problems and save the life of the newborn through better and strengthened ANC follow-up, accesses to health care.
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Alves-Leon, Soniza Vieira, Ieda Lucia P. Bravo, Ana Maria Pontes, Gustavo Medeiros de A. Figueira, Isabella D'Andrea Meira, and Luiz Claudio S. Thuler. "Crises epilépticas no período neonatal: análise descritiva de uma população hospitalar." Revista Paulista de Pediatria 27, no. 2 (June 2009): 173–78. http://dx.doi.org/10.1590/s0103-05822009000200009.
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OBJETIVO: Investigar a incidência e a letalidade de crises epilépticas neonatais e as condições associadas à sua presença. MÉTODOS: Estudo retrospectivo observacional de base hospitalar com crianças nascidas de janeiro de 1995 a dezembro de 2004 acompanhadas por quatro semanas após o parto. Analisaram-se os dados referentes aos períodos pré-natal, intraparto e neonatal. RESULTADOS: Foram identificados 6.600 nascidos vivos de 6.483 partos, encontrando-se 61 casos incidentes de crises epilépticas neonatais (0,9%). A primeira crise ocorreu até 12 horas após o parto em 45,3% dos neonatos. Das mães analisadas, 32,8% apresentaram síndromes hipertensivas. Entre os 61 pacientes, 91,8% eram conceptos únicos e 4,9% eram primeiro e segundo gemelares. O peso foi menor que 2500g em 50,8% e a restrição do crescimento intrauterino ocorreu em 25,9% das gestações analisadas. Obervaram-se: hipoglicemia neonatal (56,5%), icterícia neonatal (52,1%) e asfixia perinatal (70,7%). Desenvolveram sepse bacteriana 32 crianças e 17 apresentaram síndrome de aspiração meconial ao nascer. O desequilíbrio ácido-básico ocorreu em 68,1% ao longo de 28 dias pós-parto. A letalidade foi de 47,4%, sendo mais frequente no sexo masculino (65,6%) e em filhos de mães afro-descendentes (67,2%). CONCLUSÕES: A incidência de crises epilépticas no período neonatal identificada neste estudo foi três a quatro vezes superior à incidência relatada em hospitais de países desenvolvidos, embora as características dos casos fossem semelhantes. A letalidade foi de 47,4% e a asfixia grave foi a condição patológica intraparto mais frequente.
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Ahmed, Mohammed Ahmed A., Hyder M. Mahgoub, Abdullah Al-Nafeesah, Osama Al-Wutayd, and Ishag Adam. "Neonatal Mortality and Associated Factors in the Neonatal Intensive Care Unit of Gadarif Hospital, Eastern Sudan." Children 9, no. 11 (November 10, 2022): 1725. http://dx.doi.org/10.3390/children9111725.
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Background: Neonatal mortality is a serious public-health issue, especially in Sub-Saharan African countries. There are limited studies on neonatal mortality in Sudan; particularly, there are none on eastern Sudan. Therefore, this study aimed to determine the incidence, causes and associated factors for mortality among neonates admitted to the neonatal intensive care unit (NICU) of Gadarif Hospital, eastern Sudan. Methods: This retrospective study included 543 neonates admitted to the NICU of Gadarif Hospital, eastern Sudan, between January and August 2019. Data were obtained from the hospital record using a questionnaire composed of sociodemographic data, neonatal and maternal information and neonatal outcomes. Logistic regression analyses were performed and the adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated. Results: Of the 543 neonates, 50.8% were female, 46.4% were low birth weight (LBW), 43.5% were preterm babies and 27% were newborns admitted after caesarean delivery. The neonatal mortality before discharge was 21.9% (119/543) of live-born babies at the hospital. Preterm birth and its complications (48.7%), respiratory distress syndrome (33.6%), birth asphyxia (21.0%) and infection (9.0%) were the most common causes of neonatal mortality. In multivariable logistic regression analysis, preterm birth (AOR 2.10, 95% CI 1.17–3.74), LBW (AOR 2.47, 95% CI 1.38–4.41), low 5 min APGAR score (AOR 2.59, 95% CI 1.35–4.99) and length of hospital stay <3 days (AOR 5.49, 95% CI 3.44–8.77) were associated with neonatal mortality. Conclusion: There is an increased burden of neonatal mortality in the NICU of Gadarif Hospital, eastern Sudan, predominantly among preterm and LBW babies.
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Rana, Kirtan, Atul Gupta, Aditya Sood, and Madhu Gupta. "Factors leading to neonatal mortality due to neonatal purpura fulminans through the lens of a child death review." BMJ Case Reports 14, no. 6 (June 2021): e237281. http://dx.doi.org/10.1136/bcr-2020-237281.
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A case of neonatal death due to neonatal purpura fulminans (NPF) was brought to community physicians’ notice by the auxiliary nurse midwife in her catchment area as part of the routine demographic health surveillance. The community physician then conducted the child death review in the community. The neonate was born out of consanguineous marriage (mother married to her first-degree maternal cousin) with spontaneous conception. This neonate was fourth in the birth order. The second-order and third-order births had also suffered from NPF and died. The baby was delivered in a tertiary care setting, and the paediatric surgeon planned debridement of the affected part on the third day of the birth, as per the mother. However, due to inadequate counselling regarding the procedure, mother left the hospital without seeking care against medical advice, and the child died at home.
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López u., Oscar J., and Héctor M. Buriticá H. "Letalidad por sepsis neonatal, factores de riesgo y características microbiológicas." Andes Pediatrica 92, no. 5 (November 2, 2021): 690. http://dx.doi.org/10.32641/andespediatr.v92i5.2610.
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La sepsis neonatal es una de las principales causas de muerte en esta población y está relacionada con factores gestacionales y perinatales además de características inherentes al recién nacido.Objetivo: Relacionar factores perinatales, neonatales y microbiológicos con letalidad por sepsis.Pacientes y Método: Estudio retrospectivo de casos y controles de recién nacidos hospitalizados con sepsis neonatal confirmada por hemocultivos, desde el 2013 al 2019; los casos fueron definidos como aquellos pacientes con sepsis confirmada que presentaron desenlace mortal y los controles fueron aquellos neonatos con sepsis confirmada sin desenlace fatal. Se compararon los casos y los controles respecto a factores maternos, perinatales, neonatales y microbiológicos para variables cuantitativas, y así identificar la tendencia y la concentración de las variables estudiadas.Resultados: Se identificaron 11 casos y se asignaron aleatoriamente 3 controles por cada caso, estratificados por grupos de edad gestacional. Las medianas de peso al nacer y edad gestaciónal fueron 1.004 g y 28 semanas respectivamente. Se aisló Escherichia coli en un 21%, Candida parapsilosis en 16% y Staphylococcus aureus en 14%. Se encontró asociación estadísticamente significativa entre vía de parto vaginal (P = 0,023), infección antes de 7 días de vida (P = 0,025) y fungemia por Candida parapsilosis (P = 0,049) con letalidad por sepsis. El análisis multivariado determinó asociación estadísticamente significativa entre letalidad por sepsis neonatal con vía del parto vaginal y aislamiento microbiológico de Candida parapsilosis.Conclusión: La letalidad por sepsis neonatal se presentó más en el grupo de prematuros extremos y se identificaron, el antecedente de parto vaginal, aislamiento microbiológico temprano y la infección por Candida parapsilosis como las principales variables asociadas con desenlace mortal.
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Dheresa, Merga, and Gamachis Daraje. "A 12 Years Neonatal Mortality Rate and Its Predictors in Eastern Ethiopia." Global Pediatric Health 8 (January 2021): 2333794X2110254. http://dx.doi.org/10.1177/2333794x211025407.
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Introduction. Surviving and thriving of newborn is essential to ending extreme poverty. However, the surviving and thriving of new born is depends on where neonates are born. The true feature of neonatal mortality rate and trends is not well known in the study area. Thus, we aimed to estimate a neonatal mortality incidence in each year, and determine factors associated though pregnancy observation cohort study in Eastern Ethiopia. Methods. The study was conducted in Kersa Health Demographic Surveillance System (KHDSS) among 36 kebeles. We extracted all events (38 541 live birth and 776 neonatal death) occurred between January 1, 2008 and December 30, 2019. Neonatal mortality rate was presented by neonatal death per 1000 live birth with 95% confidence interval in each years, and trends of neonatal morality was described with line regression. Cox proportional regression model was used to assess predictors and presented with an adjusted hazard ratio (AHR) and 95% CI. Results. The estimated cumulative average of neonatal mortality rate in this study was 20.3 (95% CI: 18.9-21.8) per 1000 live births. The rate was decline with regression coefficient β = −1.60. Risk of neonatal death was found to be significantly associated with neonate born to mother living in rural Kersa (AHR = 5.31; 95% CI: 3.07-9.18), born to mother not receiving antenatal care (AHR = 1.43; 95% CI: 1.15-1.78), low birthweight (AHR = 2.59; 95% CI: 2.05-3.27), and preterm newborn (AHR = 12.10; 95% CI: 9.23-15.86). Conclusion. Neonatal mortality in the study site is far from reaching the national and global target goals.
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SMITH, DAVID W., DOROTHY INGUILLO, DARREL MARTIN, HENDRIK J. VREMAN, RONALD S. COHEN, and DAVID K. STEVENSON. "Use of Noninvasive Tests to Predict Significant Jaundice in Full-Term Infants: Preliminary Studies." Pediatrics 75, no. 2 (February 1, 1985): 278–80. http://dx.doi.org/10.1542/peds.75.2.278.
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Hyperbilirubinemia continues to be a common problem of the neonate. A major factor contributing to the occurrence of significant neonatal jaundice is increased bilirubin production, and in hemolytic diseases the production may exceed the normal neonatal mean by up to tenfold.1-3 However, impaired elimination of bilirubin from the body, eg, decreased conjugation or increased intestinal reabsorption, is also an important contributing factor.4 In full-term infants, the concentration of bilirubin in serum is greatest at approximately 72 hours of age,4 and significant hyperbilirubinemia occurs in approximately 5% of these neonates.5 Motivated by hospital costs and by parental requests, many pediatricians are discharging infants from the hospital before 48 hours of age.
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Yasin, Jehad, and Azmat Gani. "Private Health Care Expenditure and Child Health Outcomes in the World’s Poorest Countries." Perspectives on Global Development and Technology 17, no. 5-6 (December 11, 2018): 557–74. http://dx.doi.org/10.1163/15691497-12341495.
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AbstractEmpirical studies investigating the direct effects of private health expenditure on child health outcomes for the world’s poorest countries are rare. This study attempts to fill this gap. The methodology includes empirical estimations of cross-country annual data for the period 1995-2010 for several low-income countries. The results obtained through fixed-effects estimation provide strong evidence that private health care spending has the expected negative and statistically significant effect on neonatal, infant and under-five mortality rates. The findings also reveal that other than private health care spending, income, nutrition, urbanization, family size, immunization against measles, and access to an improved water supply and sanitation as other strong determinants of neonatal, infant and under-five mortality rates. Some policy implications are drawn.
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Indrayady, Indrayady, Afifa Ramadanti, Yulia Iriani, and Herka Pratama Putra. "Ceftazidime as an empiric therapy for neonatal sepsis." Paediatrica Indonesiana 61, no. 4 (August 16, 2021): 198–204. http://dx.doi.org/10.14238/pi61.4.2021.198-204.
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Background Sepsis is still the leading cause of death in neonates in developing countries. Proper administration of antibiotics is important for managing neonatal sepsis. The microorganisms that cause neonatal sepsis, as well as their sensitivity patterns, change over time and differ from one place to another. Since 2001, ceftazidime has been used as an empirical antibiotic for managing neonatal sepsis at Dr. Mohammad Hoesin Hospital, Palembang, South Sumatera, but its effectiveness is questionable.
Objective To evaluate the effectiveness of ceftazidime as an empiric therapy for neonatal sepsis.
Methods This study was pre-experimental, for one group, pre- and post-test, was conducted in 49 neonates with neonatal sepsis in the Neonatal Ward at Dr. Mohammad Hoesin Hospital, Palembang, South Sumatera, from April to September 2019. The effectiveness of ceftazidime was determined based on clinical and laboratory improvements 72 hours after ceftazidime administration.
Results Of 49 neonates, 28 experienced clinical and laboratory improvement, while 21 experienced improvement in only one parameter, either clinical or laboratory. Gram positive bacteria were found in 22/49 subjects.
Conclusion There is a significant difference on white blood cell count and CRP level between before and after ceftazidime administration but overall ceftazidime is no longer effective as empiric antibiotic therapy in neonatal sepsis.
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Shaha, Chandan Kumar, Sanjoy Kumer Dey, Kamrul Hassan Shabuj, Jubair Chisti, MA Mannan, Md Jashimuddin, Md Tariqul Islam, and Mohammod Shahidullah. "Neonatal Sepsis A Review." Bangladesh Journal of Child Health 36, no. 2 (December 22, 2012): 82–89. http://dx.doi.org/10.3329/bjch.v36i2.13084.
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Eshete, Akine, and Sileshi Abiy. "When Do Newborns Die? Timing and Cause-Specific Neonatal Death in Neonatal Intensive Care Unit at Referral Hospital in Gedeo Zone: A Prospective Cohort Study." International Journal of Pediatrics 2020 (February 15, 2020): 1–8. http://dx.doi.org/10.1155/2020/8707652.
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Background. Maternal, newborn, and child health have a high stake in the global health agenda, however, neonates’ risk of dying is unacceptable in the world. Ethiopia is one of the countries with high burden of neonatal morbidity and mortality. Yet, timing and cause-specific neonatal death are under-investigated. The present study aimed to determine the timing and cause-specific neonatal death. Methods. We conducted a prospective cohort study at Dilla University Referral Hospital Neonatal Care Unit from November 2016 to January 2018. All admitted neonates to the neonatal care unit were followed from cohort entry up to the occurrence of an event (death) or end of follow-up. We generated descriptive statistics to determine the timing of neonatal death and the cause of deaths. Results. Overall, 11.6% of neonates died during the follow-up. We found that 34.0% and 64.3% of deaths occurred during the first and second weeks of neonatal life, respectively. Neonatal sepsis and low birth weight were the main causes of death and hospital admission. Jaundices and low birth weight were the most common causes of death during the early neonatal period, whereas birth asphyxia, low birth weight, and sepsis were during late neonatal life. However, for other causes of death, the slight difference was seen between the death patterns in early and late neonatal periods. Conclusions. The timing and cause-specific neonatal deaths were varying among different time of the neonatal periods that needs to design context-based policy and interventions.
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Rezai, Tania, Kedar Baral, Samir Koirala, Sudarshan Paudel, and Saraswati Kache. "Assessing neonatal care practices in rural Nepal." Journal of Patan Academy of Health Sciences 2, no. 2 (December 1, 2015): 23–27. http://dx.doi.org/10.3126/jpahs.v2i2.20326.
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Introductions: Child health indicators of under-five and infant mortality has improved in Nepal, but neonatal mortality remains high. The aim of this study is to assess neonatal care practices among mothers in rural Nepal.Methods: A household survey was conducted in the village of Daman in Makwanpur district, Nepal. All households that had an infant less than one year of age, and had been residing in Daman for greater than six months were included in the study.Results: There were 117 mothers with neonate assessed. The average age of mothers was 24 years and 39 (33.3%) were illiterate, 53 (45.3%) were home births and 36 (30.8%) births were registered. Ninety seven (82.9%) neonates cried immediately after birth, 95 (81.1%) used a new or boiled blade for umbilical cord, 20 (16.7%) applied oil to the cord stump and 71 (61%) breastfed within first hour of birth. There was a significant relationship between non-exclusive breastfeeding and sickness.Conclusions: In Daman village community awareness for umbilical cord care and breastfeeding after birth was high. For thermal regulation of the infant, more health education is required.Journal of Patan Academy of Health Sciences, Vol. 2, No. 2, 2015. page: 23-27
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Ghimire, Pramesh, Kingsley Agho, Osita Ezeh, Andre Renzaho, Michael Dibley, and Camille Raynes-Greenow. "Under-Five Mortality and Associated Factors: Evidence from the Nepal Demographic and Health Survey (2001–2016)." International Journal of Environmental Research and Public Health 16, no. 7 (April 8, 2019): 1241. http://dx.doi.org/10.3390/ijerph16071241.
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Child mortality in Nepal has reduced, but the rate is still above the Sustainable Development Goal target of 20 deaths per 1000 live births. This study aimed to identify common factors associated with under-five mortality in Nepal. Survival information of 16,802 most recent singleton live births from the Nepal Demographic and Health Survey for the period (2001–2016) were utilized. Survey-based Cox proportional hazard models were used to examine factors associated with under-five mortality. Multivariable analyses revealed the most common factors associated with mortality across all age subgroups included: mothers who reported previous death of a child [adjusted hazard ratio (aHR) 17.33, 95% confidence interval (CI) 11.44, 26.26 for neonatal; aHR 13.05, 95% CI 7.19, 23.67 for post-neonatal; aHR 15.90, 95% CI 11.38, 22.22 for infant; aHR 16.98, 95% CI 6.19, 46.58 for child; and aHR 15.97, 95% CI 11.64, 21.92 for under-five mortality]; nonuse of tetanus toxoids (TT) vaccinations during pregnancy (aHR 2.28, 95% CI 1.68, 3.09 for neonatal; aHR 1.86, 95% CI 1.24, 2.79 for post-neonatal; aHR 2.44, 95% CI 1.89, 3.15 for infant; aHR 2.93, 95% CI 1.51, 5.69 for child; and aHR 2.39, 95% CI 1.89, 3.01 for under-five mortality); and nonuse of contraceptives among mothers (aHR 1.69, 95% CI 1.21, 2.37 for neonatal; aHR 2.69, 95% CI 1.67, 4.32 for post-neonatal; aHR 2.01, 95% CI 1.53, 2.64 for infant; aHR 2.47, 95% CI 1.30, 4.71 for child; and aHR 2.03, 95% CI 1.57, 2.62 for under-five mortality). Family planning intervention as well as promotion of universal coverage of at least two doses of TT vaccine are essential to help achieve child survival Sustainable Development Goal (SDG) targets of <20 under-five deaths and <12 neonatal deaths per 1000 births by the year 2030.
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Dreher, Melanie C., Kevin Nugent, and Rebekah Hudgins. "Prenatal Marijuana Exposure and Neonatal Outcomes in Jamaica: An Ethnographic Study." Pediatrics 93, no. 2 (February 1, 1994): 254–60. http://dx.doi.org/10.1542/peds.93.2.254.
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Objective. To identify neurobehavioral effects of prenatal marijuana exposure on neonates in rural Jamaica. Design. Ethnographic field studies and standardized neurobehavior assessments during the neonatal period. Setting. Rural Jamaica in heavy-marijuana-using population. Participants. Twenty-four Jamaican neonates exposed to marijuana prenatally and 20 nonexposed neonates. Measurements and main results. Exposed and nonexposed neonates were compared at 3 days and 1 month old, using the Brazelton Neonatal Assessment Scale, including supplementary items to capture possible subtle effects. There were no significant differences between exposed and nonexposed neonates on day 3. At 1 month, the exposed neonates showed better physiological stability and required less examiner facilitation to reach organized states. The neonates of heavy-marijuana-using mothers had better scores on autonomic stability, quality of alertness, irritability, and self-regulation and were judged to be more rewarding for caregivers. Conclusions. The absence of any differences between the exposed on nonexposed groups in the early neonatal period suggest that the better scores of exposed neonates at 1 month are traceable to the cultural positioning and social and economic characteristics of mothers using marijuana that select for the use of marijuana but also promote neonatal development.