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Perin J, Liu L, Mullany LC, Tielsch JM, Verhulst A, Guillot M, Katz J. Adapting the log quadratic model to estimate age- and cause-specific mortality among neonates. PLoS One 2024; 19:e0304841. [PMID: 38995896 PMCID: PMC11244816 DOI: 10.1371/journal.pone.0304841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 05/21/2024] [Indexed: 07/14/2024] Open
Abstract
INTRODUCTION Estimates for cause-specific mortality for neonates are generally available for all countries for neonates overall (0 to 28 days). However, cause-specific mortality is generally not being estimated at higher age resolution for neonates, despite evidence of heterogeneity in the causes of deaths during this period. We aimed to use the adapted log quadratic model in a setting where verbal autopsy was the primary means of determining cause of death. METHODS We examined the timing and causes of death among a cohort of neonates in rural Nepal followed as part of the Nepal Oil Massage Study (NOMS). We adapted methods defined by Wilmoth et al (2012) and Guillot et al. (2022) to estimate age and cause-specific mortality among neonates. We used cross validation to estimate the accuracy of this model, holding out each three month period. We took the average cross validation across hold out as our measure of model performance and compared to a standard approach which did not account for the heterogeneity in cause-specific mortality rate within this age group. RESULTS There were 957 neonates in the NOMS cohort with known age and cause of death. We estimated an average cross-validation error of 0.9 per 1000 live births for mortality due to prematurity in the first week, and 1.1 for mortality due to birth asphyxia, compared to the standard approach, having error 7.4 and 7.8 per 1000 live births, respectively. Generally mortality rates for less common causes such as congenital malformations and pneumonia were estimated with higher cross-validation error. CONCLUSIONS The stability and precision of these estimates compare favorably with similar estimates developed with higher quality cause-specific mortality surveillance from China, demonstrating that reliably estimating causes of mortality at high resolution is possible for neonates in low resources areas.
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Affiliation(s)
- Jamie Perin
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Li Liu
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Luke C Mullany
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - James M Tielsch
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America
| | - Andrea Verhulst
- Institut National d'Études Démographiques, Aubervilliers, France
| | - Michel Guillot
- Institut National d'Études Démographiques, Aubervilliers, France
- Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Joanne Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Burgess A, Deannuntis T, Wheeling J. Postpartum Remote Blood Pressure Monitoring Using a Mobile App in Women with a Hypertensive Disorder of Pregnancy. MCN Am J Matern Child Nurs 2024; 49:194-203. [PMID: 38512155 DOI: 10.1097/nmc.0000000000001019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
BACKGROUND Hypertensive disorders of pregnancy affect approximately 15% of pregnancies in the United States and are a leading cause of postpartum readmissions. Morbidity due to hypertension may be higher in the first several weeks postpartum. The ability to monitor blood pressure and intervene in the postpartum period is critical to reducing morbidity and mortality. LOCAL PROBLEM At WellSpan Health, hypertensive disorders were increasing and a leading cause of severe maternal morbidity and readmission. INTERVENTIONS A remote blood pressure monitoring app called BabyScripts™ myBloodPressure was implemented in September 2020. Prior to discharge postpartum, all patients with a diagnosis of a hypertensive disorder of pregnancy were given an automatic blood pressure cuff and instructions on how to monitor and track their blood pressure daily in the app. RESULTS A total of 1,260 patients were enrolled in the BabyScripts™ myBloodPressure module between September 2020 and July 2022 across five maternity hospitals. Of those enrolled 74% ( n = 938) entered seven or more blood pressures, and of those who entered at least one blood pressure 9% ( n = 107) entered at least one critical range blood pressure ( ≥ 150 mmHg systolic and or ≥ 100 mmHg diastolic). CONCLUSION Most women enrolled in the app were highly engaged and entered seven or more readings. Patients with critical blood pressures were identified; thus, the program has the potential to identify those at risk of severe complications. Barriers should be removed, and remote patient monitoring considered as a solution to improve postpartum assessment in patients with hypertensive disorders of pregnancy.
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Nacher M, Basurko C, Osei L, Thomas N, Louis A, Leneuve M, Dotou D, Tosi A, Lambert V, Monjardé E, Muhigirwa GB, Elenga N, Hcini N. Timing of infant mortality in French Guiana: The persistence of high post neonatal mortality. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202535. [PMID: 38851108 DOI: 10.1016/j.jeph.2024.202535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/25/2024] [Accepted: 04/05/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Infant mortality in French Guiana, a French overseas territory, is 2.7 times greater than in mainland France. Given the importance of better understanding infant mortality we aimed to describe the early & late neonatal, and postneonatal mortality in French Guiana between 2007 and 2022. METHODS We used data from the Institut National de la Statistique et des Etudes Economiques to describe trends and performed survival analysis. RESULTS Overall, there were 1 073 deaths before one year of age, of which 297 (27.7 %) occurred on the first day of life. The overall proportion of early neonatal deaths was 47.1 %, late neonatal deaths was 17.3 %, and post-neonatal deaths was 35.6 %. The overall incidences were 4.6 per 1,000 for early neonatal mortality, 1.4 per 1,000 for late neonatal mortality, and 3.1 per 1,000 for post neonatal mortality. The incidence for infant mortality for French Guiana residents was thus 9.1 per 1,000. CONCLUSIONS We show that post neonatal deaths in French Guiana are proportionally greater than in mainland France and they do not seem to decline, as they did in France. The relative proportions of post-neonatal mortality can thus help to identify important areas for action to correct excess infant mortality. Although poor pregnancy follow-up remains a problem we show that follow-up of infants is also a pressing problem that warrants increased efforts.
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Affiliation(s)
- Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Universite de Guyane, 97300 Cayenne, French Guiana, France; Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana, France.
| | - Celia Basurko
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Lindsay Osei
- Pediatrics department, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Protection Maternelle et Infantile, 97300 Cayenne, French Guiana, France
| | - Nadia Thomas
- Departement des centres délocalisés de prévention et de soins, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Alphonse Louis
- Service de Gynécologie Obstétrique, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Malika Leneuve
- Service de Gynécologie Obstétrique, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Dominique Dotou
- Service de Gynécologie Obstétrique, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Alice Tosi
- Registre des Handicaps de l'Enfant et observatoire de la périnatalité, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Veronique Lambert
- Western French Guiana Hospital, Saint Laurent du Maroni, 97320, French Guiana, France
| | | | | | - Narcisse Elenga
- Pediatrics department, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Najeh Hcini
- Western French Guiana Hospital, Saint Laurent du Maroni, 97320, French Guiana, France
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Apanga DA, Kumbeni MT, Salifu AM, Mireku-Gyimah N, Apanga PA. Predictors of neonatal mortality in the Eastern Regional Hospital in Ghana: A retrospective cohort study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003295. [PMID: 38843308 PMCID: PMC11156434 DOI: 10.1371/journal.pgph.0003295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 05/08/2024] [Indexed: 06/10/2024]
Abstract
Neonatal mortality accounts for nearly half of under-5 mortality in Ghana. The aim of this study was to identify the predictors of neonatal mortality in the Eastern Regional Hospital, Ghana. This was a retrospective cohort study conducted using secondary data from electronic medical records from the Eastern Regional Hospital between 1st January 2022 and 31st December 2022. The Kaplan-Meier estimator and adjusted Cox regression model were used to estimate survival probability and to assess the predictors of neonatal mortality. Data on 1684 neonates were analyzed and we found that 11.82% deaths occurred with a neonatal mortality rate (NMR) of 13.98 (95% CI: 12.05, 15.91) per 1000 person-days. Most neonatal deaths occurred within the first 24hrs of life (9.9%). The predictors of neonatal mortality were found to be low birthweight [Adjusted hazard rate (aHR): 1.63, 95% CI: 1.04, 2.54], hypothermia (aHR: 1.82, 95% CI: 1.16, 2.85), hyperthermia (aHR: 1.85, 95% CI: 1.01, 3.39), birth asphyxia (aHR: 3.69, 95% CI: 1.68, 8.11), and multiparty (aHR: 1.66, 95% CI: 1.02, 2.70). However, neonates aged 8-28 days (aHR: 0.41, 95% CI: 0.21, 0.81), born in the Eastern Regional Hospital (aHR: 0.39, 95% CI: 0.28, 0.55), walk-in neonates (aHR: 0.54, 95% CI: 0.32, 0.90), and neonates whose mothers had 8 or more antenatal contacts (aHR: 0.54, 95% CI: 0.32, 0.92) had lower neonatal mortality. There was high NMR in the Eastern Regional Hospital in Ghana. Averting complications such as low birthweight, hypothermia, hyperthermia, birth asphyxia, including the provision of obstetric and early neonatal care within the first 24 hours of life is critical to reducing neonatal mortality. Adherence to the World Health Organization's recommendation of 8 or more antenatal contacts among pregnant women is also essential in reducing neonatal mortality.
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Affiliation(s)
| | - Maxwell Tii Kumbeni
- School of Public Health and Nutrition, College of Health, Oregon State University, Corvallis, Oregon, United States of America
| | | | | | - Paschal Awingura Apanga
- Nuffield Department of Medicine, Jenner Institute, University of Oxford, Oxford, United Kingdom
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Pepper M, Campbell OMR, Woodd SL. Current Approaches to Following Up Women and Newborns After Discharge From Childbirth Facilities: A Scoping Review. GLOBAL HEALTH, SCIENCE AND PRACTICE 2024; 12:e2300377. [PMID: 38599685 PMCID: PMC11057794 DOI: 10.9745/ghsp-d-23-00377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/12/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION The postpartum period is critical for the health and well-being of women and newborns, but there is limited research on the most effective methods of post-childbirth follow-up. This scoping review synthesizes evidence from high-, middle-, and low-income countries on approaches to following up individuals after discharge from childbirth facilities. METHODS Using a systematic search in Ovid MEDLINE, we identified quantitative studies describing post-discharge follow-up methods deployed up to 12 months postpartum. We searched for English-language, peer-reviewed articles published between January 1, 2007 and November 2, 2022, with search terms covering 2 broad areas: "postpartum/postnatal period" and "surveillance." We single-screened titles and abstracts and double-extracted all included articles, recording study design and location, population, health outcome, method, timing and frequency of data collection, and percentage of study participants reached. RESULTS We identified 1,654 records, of which 31 studies were included. Eight studies used in-person visits to follow up participants, 10 used telephone calls, 7 used self-administered questionnaires, and 6 used multiple methods. Across studies, the minimum length of follow-up was 1 week after delivery, and up to 4 contacts were made within the first year after delivery. Follow-up (response) rates ranged from 23% to100%. Postpartum infection was the most common outcome investigated. Other outcomes included maternal (ill-)health, neonatal (ill-)health and growth, maternal mental health and well-being, care-giving/-seeking behaviors, and knowledge and intentions. CONCLUSION Our scoping review identified multiple follow-up methods after discharge, ranging from home visits to self-administered electronic questionnaires, which could be implemented with high response rates. The studies demonstrated that post-discharge follow-up of women and newborns was feasible, well received, and important for identifying postpartum illness or complications that would otherwise be missed. Therefore, the identified methods have the potential to become an important component of fostering a continuum of care and measuring and addressing postpartum morbidity.
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Affiliation(s)
- Maxine Pepper
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | - Oona M R Campbell
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Susannah L Woodd
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Madadi-Sanjani O, Ure BM. Benchmarks for Pediatric Surgical Registries: Recommendations for the Assessment and Grading of Complications. Eur J Pediatr Surg 2024; 34:182-188. [PMID: 37871645 DOI: 10.1055/a-2196-1755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Procedure-related registries in general surgical practice offer a platform for prospective trials, the pooling of data, and detailed outcome analysis. Recommendations by the Idea, Development, Exploration, Assessment, and Long-term follow-up (IDEAL) collaboration and Outcome4Medicine have further improved the uniform reporting of complications and adverse events.In the pediatric surgical network, disease-specific registries for rare and inherited congenital anomalies are gaining importance, fostering international collaborations on studies of low-incidence diseases. However, to date, reporting of complications in the pediatric surgical registries has been inconsistent. Therefore, the European Reference Network for Rare Inherited and Congenital Anomalies (ERNICA) recently endorsed the validation of the first severity grading system for children. The planned reform of the European Paediatric Surgical Audit (EPSA) registry, which includes the implementation of the Clavien-Madadi classification, represents a further effort to establish uniform outcome reporting.This article provides an overview of experiences with surgical registries and complication reporting, along with the potential application of this knowledge to future pediatric surgical practice.
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Affiliation(s)
| | - Benno M Ure
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
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Beacom MJ, Frasch MG, Lear CA, Gunn AJ. Monitoring chaos at the cot-side. Pediatr Res 2024:10.1038/s41390-024-03151-1. [PMID: 38509228 DOI: 10.1038/s41390-024-03151-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/02/2024] [Indexed: 03/22/2024]
Affiliation(s)
- Michael J Beacom
- Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Martin G Frasch
- Department of Obstetrics and Gynecology and Institute on Human Development and Disability, University of Washington School of Medicine, Seattle, WA, USA
| | - Christopher A Lear
- Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Alistair J Gunn
- Department of Physiology, The University of Auckland, Auckland, New Zealand.
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Cantin C, Snelgrove-Clarke E, Gaudet L, Ross-White A. Characteristics of breastfeeding newborns in the first month of life with in utero selective serotonin reuptake inhibitor medication exposure: a scoping review protocol. JBI Evid Synth 2024; 22:144-152. [PMID: 37799099 DOI: 10.11124/jbies-23-00048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
OBJECTIVE The objective of this scoping review is to understand the extent and type of evidence in relation to the characteristics of breastfeeding newborns in the first month of life who have been exposed in utero to selective serotonin reuptake inhibitor (SSRI) medications. INTRODUCTION SSRIs are the most commonly prescribed antidepressant medication in pregnancy. Up to 30% of newborns who are prenatally exposed to SSRIs demonstrate withdrawal signs. Poor neonatal adaptation syndrome represents a constellation of signs observed in these newborns. Little information has been studied regarding breastfeeding, as it relates to the impact of in utero SSRI exposure on the newborn. Parents have many questions regarding the safety of taking medications during pregnancy and breastfeeding. It is important for health care providers to collate evidence-based information and facilitate shared decision-making. We aim to identify the approaches researchers have used to investigate in utero SSRI exposure among breastfed newborns to determine knowledge gaps. INCLUSION CRITERIA Primary peer-reviewed studies will be considered for inclusion according to the following criteria: newborns, 31 days of age or less, with in utero SSRI exposure in any trimester of pregnancy, who were breastfed or received breast-milk feedings. METHODS MEDLINE, CINAHL, Embase, LactMed, the Maternity and Infant Care Database, and ClinicalTrials.gov databases will be searched. JBI methodology will be used. Abstracts will be assessed for eligibility and full texts will be retrieved if they meet the inclusion criteria. Two reviewers will independently extract the data from identified studies using a data extraction form and the results will be summarized descriptively and in tabular format. REVIEW REGISTRATION Open Science Framework osf.io/2bt39.
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Affiliation(s)
- Christina Cantin
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Erna Snelgrove-Clarke
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
| | - Laura Gaudet
- School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Department of Obstetrics and Gynaecology, Maternal-Fetal Medicine, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Amanda Ross-White
- Queen's University Library, Queen's University, Kingston, ON, Canada
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Lambert M, Dankel M. Reflecting on 2023: achievements and milestones in JBI Evidence Synthesis. JBI Evid Synth 2024; 22:1-3. [PMID: 38200707 DOI: 10.11124/jbies-23-00550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Affiliation(s)
- Mara Lambert
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Ashemo MY, Shiferaw D, Biru B, Feyisa BR. Prevalence and determinants of adequate postnatal care in Ethiopia: evidence from 2019 Ethiopia mini demographic and health survey. BMC Pregnancy Childbirth 2023; 23:834. [PMID: 38049724 PMCID: PMC10694903 DOI: 10.1186/s12884-023-06147-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 11/20/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND The postpartum period is critical for both the mother's and newborn child's health and survival. Rising morbidity and mortality are usually the consequence of absence of adequate, suitable, or timely care during that time period. There is lack of information on the adequacy of postnatal care in Ethiopia and this study was aimed to investigate adequacy of postnatal care and its determinants in the study area. METHODS In this study, we used a cross-sectional dataset from the 2019 Ethiopia Mini Demographic and Health Survey. A multistage stratified clustered design applied and survey weights were used to take into account the complicated sample design. A multilevel mixed effects logistic regression was fitted on 3772 women who were nested within 305 clusters. The fixed effect models were fitted and expressed as adjusted odds ratios with 95% confidence intervals, while intra-class correlation coefficients, median odds ratio, and proportional change in variance explained measures of variation. As model fitness criteria, the deviance information criterion and the Akaike information criterion were used. RESULTS This study found that only 563(16.14%, 95% CI: 16.05-16.24) women had adequate post natal care. Age of between 25-35 years old (AOR = 1.55, 95%CI = 1.04-2.31), secondary level of education (AOR = 2.23, 95%CI = 1.43-3.45), Having parity of between two and four had (AOR = 0.62, 95%CI = 0.42 0.93), having ANC follow up four and above (AOR = 1.74, 95%CI = 1.31-2.33), being residents of Oromia region (AOR = 0.10, 95CI = 0.02- 0.43) were strong predictors of adequate postnatal care. CONCLUSION The study found that prevalence of adequate PNC in Ethiopia was significantly low. To increase postnatal care adequacy, it was recommended to reinforce existing policies and strategies such as increasing number of antenatal care follow up, and scheduling mothers based on the national postnatal care follow-up protocol.
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Affiliation(s)
- Mubarek Yesse Ashemo
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
- Department of Public Health, College of Medical and Health Science, Werabe University, Werabe, Ethiopia.
| | - Desalegn Shiferaw
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
- Department of Public Health, College of Medical and Health Science, Dambi Dollo University, Dambi Dollo, Ethiopia
| | - Bayise Biru
- Department of Human Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia
- Department of Public Health, Institute of Health, Wallaga University, Nekemte, Ethiopia
| | - Bikila Regassa Feyisa
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
- Department of Public Health, Institute of Health, Wallaga University, Nekemte, Ethiopia
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de Almeida MFB, Sanudo A, Areco KN, Balda RDCX, Costa-Nobre DT, Kawakami MD, Konstantyner T, Marinonio ASS, Miyoshi MH, Bandiera-Paiva P, Freitas RMV, Morais LCC, Teixeira MLP, Waldvogel B, Kiffer CRV, Guinsburg R. Temporal Trend, Causes, and Timing of Neonatal Mortality of Moderate and Late Preterm Infants in São Paulo State, Brazil: A Population-Based Study. CHILDREN 2023; 10:children10030536. [PMID: 36980094 PMCID: PMC10047302 DOI: 10.3390/children10030536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
Moderate and late preterm newborns comprise around 85% of live births < 37 weeks gestation. Data on their neonatal mortality in middle-income countries is limited. This study aims to analyze the temporal trend, causes and timing of neonatal mortality of infants with 320/7–366/7 weeks gestation without congenital anomalies from 2004–2015 in the population of São Paulo State, Brazil. A database was built by deterministic linkage of birth and death certificates. Causes of death were classified by ICD-10 codes. Among 7,317,611 live births in the period, there were 545,606 infants with 320/7–366/7 weeks gestation without congenital anomalies, and 5782 of them died between 0 and 27 days. The neonatal mortality rate decreased from 16.4 in 2004 to 7.6 per thousand live births in 2015 (7.47% annual decrease by Prais–Winsten model). Perinatal asphyxia, respiratory disorders and infections were responsible, respectively, for 14%, 27% and 44% of the 5782 deaths. Median time to death was 24, 53 and 168 h, respectively, for perinatal asphyxia, respiratory disorders, and infections. Bottlenecks in perinatal health care are probably associated with the results that indicate the need for policies to reduce preventable neonatal deaths of moderate and late preterm infants in the most developed state of Brazil.
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Affiliation(s)
| | - Adriana Sanudo
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Kelsy N. Areco
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Rita de Cássia X. Balda
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Daniela T. Costa-Nobre
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Mandira D. Kawakami
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Tulio Konstantyner
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Ana Sílvia S. Marinonio
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Milton H. Miyoshi
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Paulo Bandiera-Paiva
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Rosa M. V. Freitas
- Fundação Sistema Estadual de Análise de Dados, São Paulo 05508-000, SP, Brazil
| | - Liliam C. C. Morais
- Fundação Sistema Estadual de Análise de Dados, São Paulo 05508-000, SP, Brazil
| | | | | | | | - Ruth Guinsburg
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
- Correspondence:
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Affiliation(s)
- Edoardo Aromataris
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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