Perinatal Mortality at the Ogun State University Teaching Hospital, Sagamu, Nigeria
Department of Paediatrics, Ogun State University Teaching Hospital, Sagamu, Nigeria. Journal of Tropical Pediatrics
(Impact Factor: 1.26).
05/1994; 40(2):78-81. DOI: 10.1093/tropej/40.2.78
A study of perinatal mortality at the Ogun State University Teaching Hospital during the first 30 months (March 1989 to August, 1991) of the establishment of a separate neonatal unit was made. One-hundred-and-sixty-two (87.5/1000) of the 1852 deliveries were stillborn and 60 (35.5/1000) of the 1690 live births died in the early neonatal period. The overall perinatal mortality rate was 119.9/1000 deliveries. Of stillbirths, 82 per cent occurred in unbooked mothers and were diagnosed at presentation. The major causes of stillbirths were teenage pregnancy, elderly motherhood, high maternal parity, and prolonged, obstructed labour. The major causes of early neonatal death were low birth weight, breech delivery, and severe birth asphyxia. The need for increased utilization, improvement, and regionalization of antenatal and perinatal services is emphasized.
Available from: Joshua Akinyemi
- "Unfortunately, most of the few local studies on neonatal mortality in Nigeria were conducted in tertiary health facilities and have focused mainly on causes of death in children. These studies have identified neonatal tetanus , birth asphyxia, prematurity, septicaemia and pneumonia as the commonly reported causes of death131415161718. The major drawback in these studies is their selection bias which is common to health facility-based studies. "
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Nigeria's efforts to reduce under-five mortality has been biased in favour of childhood mortality to the neglect of neonates and as such the literature is short of adequate information on the determinants of neonatal mortality. Whereas studies have shown that about half of infant deaths occur in the neonatal period. Knowledge of the determinants of neonatal mortality are essential for the design of intervention programes that will enhance neonatal survival. Therefore, this study was conducted to investigate the trends and factors associated with neonatal mortality in Nigeria.
This was a retrospective analysis of the reproductive history data collected in the Nigeria Demographic and Health Surveys (NDHS) for 1990, 2003, 2008 and 2013. Neonatal mortality rates were estimated as the probability of dying before 28 completed days using synthetic cohort life table techniques. Univariate and multiple Cox proportional hazards regression models were used to explore the effects of selected maternal and bio-demographic variables on neonatal mortality. The Hazard Ratio (HR) and its 95% Confidence Interval (CI) were estimated to prioritize obtained significant factors.
Nigeria neonatal mortality rate stagnated at 41 per 1000 live births between 1990 and 2013. There were rural-urban and regional differences with more deaths occurring in rural areas and northern regions. In 1990, antenatal care (HR = 0.76; CI = 0.61-0.95), facility delivery (HR = 0.69; CI = 0.53-0.90) and births interval less than 24 months (HR = 1.67; CI = 1.41-1.98) were significantly associated with neonatal deaths. Factors identified from the 2013 data were antenatal care (HR = 0.76; CI = 0.61-0.95), birth interval less than 24 months (HR = 1.67; CI = 1.41-1.98), delivery at health facility (HR = 0.69; CI = 0.53-0.90), and small birth size (HR = 1.72; CI = 1.39-2.14).
There was little improvement in neonatal survival in Nigeria between 1990 and 2013. Bio-demographic and health care related characteristics are significant determinants of neonatal survival. Family planning should be intensified while government should improve the quality of maternal and child health services to enhance the survival of neonates.
- "This was reflected in the fact that majority of the stillbirths 84% occurred in the unbooked patients. This is also similar to findings in Shagamu and Lagos, Nigeria, which showed that majority of the women were unbooked. Being unbooked, these women cannot fully access antenatal care, which includes the detection of at risk women and providing them with specialized care and delivery. "
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ABSTRACT: Stillbirths often are not seen as a major public health problem, for despite increasing attention and investment on maternal, neonatal, and child health, stillbirths remain invisible.
The objective of this study was to determine the stillbirth rate at the Imo State University Teaching Hospital, Orlu.
Analysis of the case records of stillbirths that occurred in the institution over a 5-year period from 1(st) July 2005 to 30(th) June 2010 was made. Data retrieved was analyzed for age of the women, parity, presumptive risk factor for the stillbirth, and booking status of the women. Also, the total births during the period of study were obtained. A P-value of <0.05 is said to be significant at confidence level of 95% (95/100).
There were a total of 1,142 deliveries within the study period, out of which 206 resulted in stillbirths. This gave an institutional stillbirth rate of 18% (180/1000 deliveries). One-hundred and fifty-five 75.2% (155/206) of the stillbirths were macerated stillbirth. The age range of the women was 15-44 years. The modal age was 31 years. The age group of 26-30 years had the highest prevalence rate of stillbirths of 79 (38.3%, 79/206), while age group of more than 40 years contributed the least with four stillbirths 4 (1.9%, 4/206).
The stillbirth rate at the institution is too high and efforts must be made to reduce it.
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ABSTRACT: A comparative study of perinatal mortality patterns over a period was conducted at a teaching hospital of South India. Among the 6,048 babies born from January 1984 to December 1985 (Group A), there were 265 (43.8/1000) still births and 127 (22.0/1000) early neonatal deaths. Three hundred and thirty seven (41/1000) babies were still born and 235 (29.8/1000) early neonatal deaths out of 8,215 deliveries during 1992-93 (Group B). The perinatal mortality rate (PMR) in Groups A and B were 57.9/1000 and 57.7/1000 respectively. Unbooked cases accounted for the majority (> 75%) of perinatal deaths during both the periods. The overall mortality rates in unbooked cases were three to four times higher than booked cases. Among the various causes of still births, antepartum haemorrhage and uterine rupture had increased. Septicaemia was the major cause of early neonatal deaths in Group A, but in Group B birth asphyxia and prematurity were the leading causes. Effective interventions like creating awareness among the target population to utilise maternal and child health services and early referral of high risk cases with improved intranatal and perinatal care can decrease the perinatal mortality.
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