BACKGROUND:
Neonatal mortality is mainly caused by infections, birth asphyxia and pneumonia (developing nations). Determinants included socioeconomic-demographic factors, healthcare system and culture. Risk factors: low birth weight, prematurity, insufficient antenatal care, repeated caesarian deliveries. Limited neonatal deaths research in Iraq justified this study.
AIM OF THE STUDY:
Describe and plot the neonatal mortality trend during the period of 2008-2017, and finding relation with key determinants and risk factors.
METHODS:
Retrospective software and hardcopy neonatal medical records review & analysis (February-June 2019) in MOH, Central Statistical Organization, Baghdad's Health directorates, International Health Organizations, & 2-3 conveniently selected hospitals in health directorate. Records studied: Annual Statistical Reports, "Neonatal deaths Statistics Form", "Born", admission files, intensive care units' logbooks, death certificates, international organizations’ estimates & Multiple Indicator Cluster Surveys.
RESULTS:
Highest mortality rate was in West region 2015 (18.38/1000), lowest in east 2014 (3.78/1000) excluding Kurdistan; the decline during 2014-2015. Highest admission deaths: males (57.8%), cesarean deliveries (52%), extreme low birth weight (8.5%), preterm (71.2%), >31 years (20.2%). Top death cause: Respiratory distress syndrome (51.9%), & late death: sepsis (33.36%).
CONCLUSION:
Mortality rate declined to lowest in 2014, followed by a rise attributed to increased registration; highest in west 2015, lowest in east 2014. Respiratory distress & sepsis were the most common causes. Most deaths in: preterm neonates, males, extremely low birth weight, operative deliveries & >31 years maternal age. |
- Jawad HA, Al-kaseer EA, Al-Diwan JK. Neonatal Mortality in Two Tertiary Pediatric Hospitals in Baghdad (2012-2016). Journal of the Faculty of Medicine Baghdad. 2017;59:330-32.
- Hyder AA, Wali SA, McGuckin J. The burden of disease from neonatal mortality: a review of South Asia and Sub Saharan Africa. BJOG: An International Journal of Obstetrics & Gynaecology. 2003 ;110:894-901.
- Mekonnen Y, Tensou B, Telake DS, Degefie T, Bekele A. Neonatal mortality in Ethiopia: trends and determinants. BMC public health. 2013;13:483.83.
- Shah GS, Yadav S, Thapa A, Shah L. Clinical profile and outcome of neonates admitted to neonatal intensive care unit (NICU) at a tertiary care centre in Eastern Nepal. Journal of Nepal Paediatric Society. 2013;33:177-81.
- Karim LA, Al-Mafraji S. The Effect of Weight and Gestational age on Neonatal Mortality. Iraqi Journalof Community Medicine. 2006;19:286-90.
- Abd AW, Mohammed MJ. Descriptive Study for Neonatal Death in Neonatal care Unit in of Maternity and Children Teaching Hospital in Al-Diwaniya. Medical Journal of Babylon. 2016;13:117-24.
- Hameed LA. Survival of preterm babies beyond the neonatal period. The Medical Journal of Basrah University. 2016;34:101-6.
- Ali Aa. Neonatal Death: Explotary Study In The Neonatal Care Unit Of Alkarkh Maternity Hospital/Alkarkh/Baghdad Over Year 2015. DOI:10.20959/wjpr201817-13347.
- Sherwani VR, Shakir IM. Neonatal outcomes in elective repeated caesarean section at term pregnancy. Diyala Journal of Medicine. 2017;12:9-14.
- Indongo N. Risk factors and causes of neonatal deaths in Namibia. European Scientific Journal, ESJ. 2014;10.
- Ramaiya A, Kiss L, Baraitser P, Mbaruku G, Hildon Z. A systematic review of risk factors for neonatal mortality in Adolescent Mother's in Sub Saharan Africa. BMC research notes. 2014 ;7:750.
- Guevvera Y. World Health Organisation: Neonatal and perinatal mortality: country, regional and global estimates. WHO. cebu: sun. 2006.
- Coll-Seck A, Clark H, Bahl R, Peterson S, Costello A, Lucas T. Framing an agenda for children thriving in the SDG era: a WHO-UNICEF-Lancet commission on child health and wellbeing. The Lancet. 2019;393:109-12.
- Rojahn R. Community?Based Intervention Packages for Reducing Maternal and Neonatal Morbidity and Mortality and Improving Neonatal Outcomes: A Review Synopsis. Public Health Nursing. 2011;28:246-48.
- Bash SS, AL-Kaseer EA. Neonatal mortality post ISIS conflict in Iraq. Journal of the Faculty of Medicine Baghdad. 2018; 60:172-73.
- Darweesh A, Al-Kaseer E. Low Birth Weight in Post-Conflict Baghdad. Iraq. IJSR. 2015;4:2789.; 90.
- Lafta R, Aflouk NA, Dhiaa S, Lyles E, Burnham G. Needs of internally displaced women and children in Baghdad, Karbala, and Kirkuk, Iraq. PLoS currents. 2016;8.
- Debelew GT, Afework MF, Yalew AW. Determinants and causes of neonatal mortality in Jimma zone, southwest Ethiopia: a multilevel analysis of prospective follow up study. PLoS One. 2014 ;9:e107184.
- Azize PM, Muhammad LA, Kareem NA. The causes of early neonatal death in Sulaimani Intensive Care Unite at Maternity Teaching Hospital between Jan 2016-Feb 2017. Kurd. J Applied Research. 2017;2:121-27.
- Oza S, Lawn JE, Hogan DR, Mathers C, Cousens SN. Neonatal cause-of-death estimates for the early and late neonatal periods for 194 countries: 2000-2013. Bulletin of the WHO. 2014;93:19-28.
- Al-Azzawi SN. The deterioration of environmental and life quality parameters in Iraq since the 2003 American occupation of Iraq. International Journal of Contemporary Iraqi Studies. 2016;10:53-72.
- Haroon A, Ali SR, Ahmed S, Maheen H. Short-term neonatal outcome in late preterm vs. term infants. JCPSP: Journal of the College of Physicians and Surgeons Pakistan. 2014;24:34.
- Weng YH, Yang CY, Chiu YW. Neonatal outcomes in relation to sex differences: a national cohort survey in Taiwan. Biology of sex differences. 2015; 6:30.
- O'Driscoll DN, McGovern M, Greene CM, Molloy EJ. Gender disparities in preterm neonatal outcomes. Acta Paediatrica. 2018 ; 107:1494-99.
- Tsai LY, Chen YL, Tsou KI, Mu SC, Taiwan Premature Infant Developmental Collaborative Study Group. The impact of small-for-gestational-age on neonatal outcome among very-low-birth-weight infants. Pediatrics & Neonatology. 2015;56:101-7.
- Said AS, Manji KP. Risk factors and outcomes of fetal macrosomia in a tertiary centre in Tanzania: a case-control study. BMC pregnancy and childbirth. 2016;16:243.
- Prado DS, Mendes RB, Gurgel RQ, Barreto ID, Cipolotti R, Gurgel RQ. The influence of mode of delivery on neonatal and maternal short and long-term outcomes. Revista de saude publica. 2018 ;52:95.
- Blue NR, Van Winden KR, Pathak B, et al. Neonatal outcomes by mode of delivery in preterm birth. Am. J. Perinatology. 2015;32:1292-97.
- Donoso E, Carvajal JA, Vera C, Poblete JA. The age of women as a risk factor for maternal, fetal, neonatal and infant mortality. Medical magazine of Chile. 2014;142:168-74.
- Schimmel MS, Bromiker R, Hammerman C et al. The effects of maternal age and parity on maternal and neonatal outcome. Archives of gynecology and obstetrics. 2015;291:793-98.
|