Neonatal mortality and coverage of essential newborn interventions 2010 - 2013: A prospective, population-based study from low-middle income countries

Sangappa M. Dhaded, Manjunath S. Somannavar, Sunil S. Vernekar, Shivaprasad S. Goudar, Musaku Mwenche, Richard Derman, Janet L. Moore, Archana Patel, Omrana Pasha, Fabian Esamai, Ana Garces, Fernando Althabe, Elwyn Chomba, Edward A. Liechty, K. Michael Hambidge, Nancy F. Krebs, Mabel Berrueta, Alvaro Ciganda, Patricia L. Hibberd, Robert L. GoldenbergElizabeth M. McClure, Marion Koso-Thomas, Albert Manasyan, Waldemar A. Carlo

Research output: Contribution to journalReview article

21 Citations (Scopus)

Abstract

Background: Approximately 3 million neonatal deaths occur each year worldwide. Simple interventions have been tested and found to be effective in reducing the neonatal mortality. In order to effectively implement public health interventions, it is important to know the rates of neonatal mortality and understand the contributing risk factors. Hence, this prospective, population-based, observational study was carried out to inform these needs. Methods: The Global Network's Maternal Newborn Health Registry was initiated in the seven sites in 2008. Registry administrators (RAs) attempt to identify and enroll all eligible women by 20 weeks gestation and collect basic health data, and outcomes after delivery and at 6 weeks post-partum. All study data were collected, reviewed, and edited by staff at each study site. The study was reviewed and approved by each sites' ethics review committee. Results: Overall, the 7-day neonatal mortality rate (NMR) was 20.6 per 1000 live births and the 28-day NMR was 25.7 per 1000 live births. Higher neonatal mortality was associated with maternal age > 35 and <20 years relative to women 20-35 years of age. Preterm births were at increased risk of both early and 28-day neonatal mortality (RR 8.1, 95% CI 7.5-8.8 and 7.5, 95% CI 6.9-8.1) compared to term as were those with low birth weight (<2500g). Neonatal resuscitation rates were 4.8% for hospital deliveries compared to 0.9% for home births. In the hospital, 26.5% of deliveries were by cesarean section with an overall cesarean section rate of 12.5%. Neonatal mortality rates were highest in the Pakistan site and lowest in Argentina. Conclusions: Using prospectively collected data with high follow up rates (99%), we documented characteristics associated with neonatal mortality. Low birth weight and prematurity are among the strongest predictors of neonatal mortality. Other risk factors for neonatal deaths included male gender, multiple gestation and major congenital anomalies. Breech presentation/transverse lie, and no antenatal care were also significant risk factors for neonatal death. Coverage of interventions varied by setting of delivery, with the overall population rate of most evidence-based interventions low. This study informs about risk factors for neonatal mortality which can serve to design strategies/interventions to reduce risk of neonatal mortality.

Original languageEnglish (US)
Article numberS6
JournalReproductive Health
Volume12
Issue number2
DOIs
StatePublished - Jun 8 2015

Fingerprint

Infant Mortality
Newborn Infant
Population
Live Birth
Low Birth Weight Infant
Cesarean Section
Registries
Mortality
Breech Presentation
Pregnancy
Ethics Committees
Prenatal Care
Pakistan
Argentina
Premature Birth
Maternal Age
Advisory Committees
Administrative Personnel
Resuscitation
Observational Studies

Keywords

  • neonatal mortality
  • newborn care
  • risk factors

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Neonatal mortality and coverage of essential newborn interventions 2010 - 2013 : A prospective, population-based study from low-middle income countries. / Dhaded, Sangappa M.; Somannavar, Manjunath S.; Vernekar, Sunil S.; Goudar, Shivaprasad S.; Mwenche, Musaku; Derman, Richard; Moore, Janet L.; Patel, Archana; Pasha, Omrana; Esamai, Fabian; Garces, Ana; Althabe, Fernando; Chomba, Elwyn; Liechty, Edward A.; Hambidge, K. Michael; Krebs, Nancy F.; Berrueta, Mabel; Ciganda, Alvaro; Hibberd, Patricia L.; Goldenberg, Robert L.; McClure, Elizabeth M.; Koso-Thomas, Marion; Manasyan, Albert; Carlo, Waldemar A.

In: Reproductive Health, Vol. 12, No. 2, S6, 08.06.2015.

Research output: Contribution to journalReview article

Dhaded, SM, Somannavar, MS, Vernekar, SS, Goudar, SS, Mwenche, M, Derman, R, Moore, JL, Patel, A, Pasha, O, Esamai, F, Garces, A, Althabe, F, Chomba, E, Liechty, EA, Hambidge, KM, Krebs, NF, Berrueta, M, Ciganda, A, Hibberd, PL, Goldenberg, RL, McClure, EM, Koso-Thomas, M, Manasyan, A & Carlo, WA 2015, 'Neonatal mortality and coverage of essential newborn interventions 2010 - 2013: A prospective, population-based study from low-middle income countries', Reproductive Health, vol. 12, no. 2, S6. https://doi.org/10.1186/1742-4755-12-S2-S6
Dhaded, Sangappa M. ; Somannavar, Manjunath S. ; Vernekar, Sunil S. ; Goudar, Shivaprasad S. ; Mwenche, Musaku ; Derman, Richard ; Moore, Janet L. ; Patel, Archana ; Pasha, Omrana ; Esamai, Fabian ; Garces, Ana ; Althabe, Fernando ; Chomba, Elwyn ; Liechty, Edward A. ; Hambidge, K. Michael ; Krebs, Nancy F. ; Berrueta, Mabel ; Ciganda, Alvaro ; Hibberd, Patricia L. ; Goldenberg, Robert L. ; McClure, Elizabeth M. ; Koso-Thomas, Marion ; Manasyan, Albert ; Carlo, Waldemar A. / Neonatal mortality and coverage of essential newborn interventions 2010 - 2013 : A prospective, population-based study from low-middle income countries. In: Reproductive Health. 2015 ; Vol. 12, No. 2.
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abstract = "Background: Approximately 3 million neonatal deaths occur each year worldwide. Simple interventions have been tested and found to be effective in reducing the neonatal mortality. In order to effectively implement public health interventions, it is important to know the rates of neonatal mortality and understand the contributing risk factors. Hence, this prospective, population-based, observational study was carried out to inform these needs. Methods: The Global Network's Maternal Newborn Health Registry was initiated in the seven sites in 2008. Registry administrators (RAs) attempt to identify and enroll all eligible women by 20 weeks gestation and collect basic health data, and outcomes after delivery and at 6 weeks post-partum. All study data were collected, reviewed, and edited by staff at each study site. The study was reviewed and approved by each sites' ethics review committee. Results: Overall, the 7-day neonatal mortality rate (NMR) was 20.6 per 1000 live births and the 28-day NMR was 25.7 per 1000 live births. Higher neonatal mortality was associated with maternal age > 35 and <20 years relative to women 20-35 years of age. Preterm births were at increased risk of both early and 28-day neonatal mortality (RR 8.1, 95{\%} CI 7.5-8.8 and 7.5, 95{\%} CI 6.9-8.1) compared to term as were those with low birth weight (<2500g). Neonatal resuscitation rates were 4.8{\%} for hospital deliveries compared to 0.9{\%} for home births. In the hospital, 26.5{\%} of deliveries were by cesarean section with an overall cesarean section rate of 12.5{\%}. Neonatal mortality rates were highest in the Pakistan site and lowest in Argentina. Conclusions: Using prospectively collected data with high follow up rates (99{\%}), we documented characteristics associated with neonatal mortality. Low birth weight and prematurity are among the strongest predictors of neonatal mortality. Other risk factors for neonatal deaths included male gender, multiple gestation and major congenital anomalies. Breech presentation/transverse lie, and no antenatal care were also significant risk factors for neonatal death. Coverage of interventions varied by setting of delivery, with the overall population rate of most evidence-based interventions low. This study informs about risk factors for neonatal mortality which can serve to design strategies/interventions to reduce risk of neonatal mortality.",
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TY - JOUR

T1 - Neonatal mortality and coverage of essential newborn interventions 2010 - 2013

T2 - A prospective, population-based study from low-middle income countries

AU - Dhaded, Sangappa M.

AU - Somannavar, Manjunath S.

AU - Vernekar, Sunil S.

AU - Goudar, Shivaprasad S.

AU - Mwenche, Musaku

AU - Derman, Richard

AU - Moore, Janet L.

AU - Patel, Archana

AU - Pasha, Omrana

AU - Esamai, Fabian

AU - Garces, Ana

AU - Althabe, Fernando

AU - Chomba, Elwyn

AU - Liechty, Edward A.

AU - Hambidge, K. Michael

AU - Krebs, Nancy F.

AU - Berrueta, Mabel

AU - Ciganda, Alvaro

AU - Hibberd, Patricia L.

AU - Goldenberg, Robert L.

AU - McClure, Elizabeth M.

AU - Koso-Thomas, Marion

AU - Manasyan, Albert

AU - Carlo, Waldemar A.

PY - 2015/6/8

Y1 - 2015/6/8

N2 - Background: Approximately 3 million neonatal deaths occur each year worldwide. Simple interventions have been tested and found to be effective in reducing the neonatal mortality. In order to effectively implement public health interventions, it is important to know the rates of neonatal mortality and understand the contributing risk factors. Hence, this prospective, population-based, observational study was carried out to inform these needs. Methods: The Global Network's Maternal Newborn Health Registry was initiated in the seven sites in 2008. Registry administrators (RAs) attempt to identify and enroll all eligible women by 20 weeks gestation and collect basic health data, and outcomes after delivery and at 6 weeks post-partum. All study data were collected, reviewed, and edited by staff at each study site. The study was reviewed and approved by each sites' ethics review committee. Results: Overall, the 7-day neonatal mortality rate (NMR) was 20.6 per 1000 live births and the 28-day NMR was 25.7 per 1000 live births. Higher neonatal mortality was associated with maternal age > 35 and <20 years relative to women 20-35 years of age. Preterm births were at increased risk of both early and 28-day neonatal mortality (RR 8.1, 95% CI 7.5-8.8 and 7.5, 95% CI 6.9-8.1) compared to term as were those with low birth weight (<2500g). Neonatal resuscitation rates were 4.8% for hospital deliveries compared to 0.9% for home births. In the hospital, 26.5% of deliveries were by cesarean section with an overall cesarean section rate of 12.5%. Neonatal mortality rates were highest in the Pakistan site and lowest in Argentina. Conclusions: Using prospectively collected data with high follow up rates (99%), we documented characteristics associated with neonatal mortality. Low birth weight and prematurity are among the strongest predictors of neonatal mortality. Other risk factors for neonatal deaths included male gender, multiple gestation and major congenital anomalies. Breech presentation/transverse lie, and no antenatal care were also significant risk factors for neonatal death. Coverage of interventions varied by setting of delivery, with the overall population rate of most evidence-based interventions low. This study informs about risk factors for neonatal mortality which can serve to design strategies/interventions to reduce risk of neonatal mortality.

AB - Background: Approximately 3 million neonatal deaths occur each year worldwide. Simple interventions have been tested and found to be effective in reducing the neonatal mortality. In order to effectively implement public health interventions, it is important to know the rates of neonatal mortality and understand the contributing risk factors. Hence, this prospective, population-based, observational study was carried out to inform these needs. Methods: The Global Network's Maternal Newborn Health Registry was initiated in the seven sites in 2008. Registry administrators (RAs) attempt to identify and enroll all eligible women by 20 weeks gestation and collect basic health data, and outcomes after delivery and at 6 weeks post-partum. All study data were collected, reviewed, and edited by staff at each study site. The study was reviewed and approved by each sites' ethics review committee. Results: Overall, the 7-day neonatal mortality rate (NMR) was 20.6 per 1000 live births and the 28-day NMR was 25.7 per 1000 live births. Higher neonatal mortality was associated with maternal age > 35 and <20 years relative to women 20-35 years of age. Preterm births were at increased risk of both early and 28-day neonatal mortality (RR 8.1, 95% CI 7.5-8.8 and 7.5, 95% CI 6.9-8.1) compared to term as were those with low birth weight (<2500g). Neonatal resuscitation rates were 4.8% for hospital deliveries compared to 0.9% for home births. In the hospital, 26.5% of deliveries were by cesarean section with an overall cesarean section rate of 12.5%. Neonatal mortality rates were highest in the Pakistan site and lowest in Argentina. Conclusions: Using prospectively collected data with high follow up rates (99%), we documented characteristics associated with neonatal mortality. Low birth weight and prematurity are among the strongest predictors of neonatal mortality. Other risk factors for neonatal deaths included male gender, multiple gestation and major congenital anomalies. Breech presentation/transverse lie, and no antenatal care were also significant risk factors for neonatal death. Coverage of interventions varied by setting of delivery, with the overall population rate of most evidence-based interventions low. This study informs about risk factors for neonatal mortality which can serve to design strategies/interventions to reduce risk of neonatal mortality.

KW - neonatal mortality

KW - newborn care

KW - risk factors

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