Cause-specific neonatal mortality in a neonatal care unit in Northern Tanzania: a registry based cohort study.
Cause-specific neonatal mortality in a neonatal care unit in Northern Tanzania: a registry based cohort study.
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坦桑尼亚北部新生儿护理病房的特定原因新生儿死亡率：一项基于登记的队列研究。
DOI：
10.1186/1471-2431-12-116
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发表时间：
2012-08-07
期刊：
影响因子：
2.4
通讯作者：
Daltveit AK
中科院分区：
文献类型：
--
作者：
Mmbaga BT;Lie RT;Olomi R;Mahande MJ;Kvåle G;Daltveit AK
目前五岁以下儿童死亡率的下降表明，新生儿死亡比例有所上升。为了解决新生儿死亡率，并可能确定预防和干预领域，我们研究了坦桑尼亚基利曼哈罗基督教医疗中心（KCMC）新生儿监护病房的入院原因和新生儿死亡原因。研究对象为2000年至2010年在KCMC医学出生登记处和新生儿登记处登记的5033例新生儿监护室（NCU）新生儿。记录临床诊断、胎龄、出生体重、Apgar评分及入院和出院日期。新生儿死因按改良Wigglesworth分类法进行分类。统计分析采用SPSS18.0。入院的主要原因是出生窒息（26.8%）、早产（18.4%）、感染风险（16.9%）、新生儿感染（15.4%）和出生体重超过4000 g（10.7%）。总体死亡率为10.7%（536例死亡）。主要单一死因为出生窒息（n = 245，45.7%）、早产（n = 188，35.1%）、先天性畸形（n = 49，9.1%）和感染（n = 46，8.6%）。出生体重低于2500克的婴儿占所有入院人数的29%，占所有死亡人数的52.1%。除先天畸形外，病死率随出生体重增加而下降。出生窒息是正常出生体重婴儿（n = 179/246，73.1%）和低出生体重婴儿（n = 178/188，94.7%）中最常见的死亡原因。大多数死亡（n = 304，56.7%）发生在24小时内，490例（91.4%）发生在第一周内。正常出生体重婴儿的出生窒息和低出生体重婴儿的早产各占这一人口所有死亡的三分之一。出生体重正常的婴儿因出生窒息而死亡的人数很高，这表明需要进一步研究以确定因果机制。旨在及时提供产科和新生儿护理的战略，包括适当的产前、孕产妇和新生儿护理支助，以及关于复苏技能的定期培训，将改善儿童的存活率。
The current decline in under-five mortality shows an increase in share of neonatal deaths. In order to address neonatal mortality and possibly identify areas of prevention and intervention, we studied causes of admission and cause-specific neonatal mortality in a neonatal care unit at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania. A total of 5033 inborn neonates admitted to a neonatal care unit (NCU) from 2000 to 2010 registered at the KCMC Medical Birth Registry and neonatal registry were studied. Clinical diagnosis, gestational age, birth weight, Apgar score and date at admission and discharge were registered. Cause-specific of neonatal deaths were classified by modified Wigglesworth classification. Statistical analysis was performed in SPSS 18.0. Leading causes of admission were birth asphyxia (26.8%), prematurity (18.4%), risk of infection (16.9%), neonatal infection (15.4%), and birth weight above 4000 g (10.7%). Overall mortality was 10.7% (536 deaths). Leading single causes of death were birth asphyxia (n = 245, 45.7%), prematurity (n = 188, 35.1%), congenital malformations (n = 49, 9.1%), and infections (n = 46, 8.6%). Babies with birth weight below 2500 g constituted 29% of all admissions and 52.1% of all deaths. Except for congenital malformations, case fatality declined with increasing birth weight. Birth asphyxia was the most frequent cause of death in normal birth weight babies (n = 179/246, 73.1%) and prematurity in low birth weight babies (n = 178/188, 94.7%). The majority of deaths (n = 304, 56.7%) occurred within 24 hours, and 490 (91.4%) within the first week. Birth asphyxia in normal birth weight babies and prematurity in low birth weight babies each accounted for one third of all deaths in this population. The high number of deaths attributable to birth asphyxia in normal birth weight babies suggests further studies to identify causal mechanisms. Strategies directed towards making obstetric and newborn care timely available with proper antenatal, maternal and newborn care support with regular training on resuscitation skills would improve child survival.
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影响因子：
168.9
作者：
Black, RE;Morris, SS;Bryce, J
通讯作者：
Bryce, J
影响因子：
3
作者：
Paul, VK
通讯作者：
Paul, VK
影响因子：
168.9
作者：
Masanja, Honorati;de Savigny, Don;Mshinda, Hassan
通讯作者：
Mshinda, Hassan
影响因子：
7.7
作者：
Lawn JE;Mwansa-Kambafwile J;Horta BL;Barros FC;Cousens S
通讯作者：
Cousens S
影响因子：
3.1
作者：
Mmbaga BT;Lie RT;Kibiki GS;Olomi R;Kvåle G;Daltveit AK
通讯作者：
Daltveit AK