Neonatal deaths in rural Karnataka, India 2014-2018: a prospective population-based observational study in a low-resource setting.
Neonatal deaths in rural Karnataka, India 2014-2018: a prospective population-based observational study in a low-resource setting.
复制标题
DOI：
10.1186/s12978-020-01014-6
复制
发表时间：
2020-11-30
影响因子：
3.4
通讯作者：
Goudar SS
中科院分区：
文献类型：
--
作者：
Dhaded SM;Somannavar MS;Moore JL;McClure EM;Vernekar SS;Yogeshkumar S;Kavi A;Ramadurg UY;Nolen TL;Goldenberg RL;Derman RJ;Goudar SS
在低收入和中等收入国家 (LMIC)，新生儿死亡率占 5 岁以下儿童死亡率的很大一部分。我们对居住在印度卡纳塔克邦特定地理区域的孕妇进行了一项基于人群的前瞻性研究，这是全球妇女和儿童健康研究网络的研究地点。研究人员收集了符合条件的女性的人口和医疗保健特征，以及分娩时和第 28 天获得的新生儿结局。第 28 天的新生儿死亡率的原因是使用前瞻性定义的变量通过算法分配的。 2014年至2018年，新生儿死亡率为每1000名活产儿24.5人。 28天新生儿死亡的原因包括早产（27.9%）、出生窒息（25.1%）、感染（23.7%）和先天性异常（18.4%）。与较少的 ANC 就诊相比，四次或以上的产前护理 (ANC) 就诊与较低的新生儿死亡风险相关。在调整后的模型中，与活产婴儿 ≥ 2500 g相比，出生体重< 1000 g的婴儿死亡率RR为25.6（95% CI 18.3, 36.0），对于1000-1499 g婴儿，RR为19.8（95% CI 14.2, 27.5）。 1500–2499 g 婴儿的 RR 为 3.1 (95% CI 2.7, 3.6)。然而，超过三分之一（36.8%）的死亡发生在出生体重≥2500克的婴儿中。与 ≥ 37周的婴儿相比，早产儿（< 37周）的28天死亡率风险也更高（RR 7.9，95% CI 6.9，9.0）。分娩时孕周缩短 1 周与较高的死亡风险相关，RR 为 1.3（95% CI 1.3，1.3）。超过 70% 的分娩是在医院进行的。在死亡婴儿中，50.3%的婴儿接受了球袋/面罩通气，47.3%的婴儿接受了抗生素治疗，55.6%的婴儿接受了氧气治疗。与之前的研究一致，该研究发现，在印度，早产儿和低出生体重的婴儿 28 天新生儿死亡的风险仍然最高。尽管现在大多数分娩都在卫生机构内进行，但仍有相当一部分人没有接受基本的救生干预措施。需要进一步努力了解护理对婴儿结局的影响。研究注册 该试验在 ClinicalTrials.gov 上注册。 ClinicalTrial.gov 试验注册：NCT01073475
Neonatal mortality causes a substantial proportion of the under-5 mortality in low and middle-income countries (LMIC). We undertook a prospective, population-based research study of pregnant women residing in defined geographic areas in the Karnataka State of India, a research site of the Global Network for Women’s and Children’s Health Research. Study staff collected demographic and health care characteristics on eligible women enrolled with neonatal outcomes obtained at delivery and day 28. Cause of neonatal mortality at day 28 was assigned by algorithm using prospectively defined variables. From 2014 to 2018, the neonatal mortality rate was 24.5 per 1,000 live births. The cause of the 28-day neonatal deaths was attributed to prematurity (27.9%), birth asphyxia (25.1%), infection (23.7%) and congenital anomalies (18.4%). Four or more antenatal care (ANC) visits was associated with a lower risk of neonatal death compared to fewer ANC visits. In the adjusted model, compared to liveborn infants ≥ 2500 g, infants born weighing < 1000 g RR for mortality was 25.6 (95%CI 18.3, 36.0), for 1000-1499 g infants the RR was 19.8 (95% CI 14.2, 27.5) and for 1500–2499 g infants the RR was 3.1 (95% CI 2.7, 3.6). However, more than one-third (36.8%) of the deaths occurred among infants with a birthweight ≥ 2500 g. Infants born preterm (< 37 weeks) were also at higher risk for 28-day mortality (RR 7.9, 95% CI 6.9, 9.0) compared to infants ≥ 37 weeks. A one-week decrease in gestational age at delivery was associated with a higher risk of mortality with a RR of 1.3 (95% CI 1.3, 1.3). More than 70% of all the deliveries occurred at a hospital. Among infants who died, 50.3% of the infants had received bag/mask ventilation, 47.3% received antibiotics, and 55.6% received oxygen. Consistent with prior research, the study found that infants who were preterm and low-birth weight remained at highest risk for 28-day neonatal mortality in India. Although most of births now occur within health facilities, a substantial proportion are not receiving basic life-saving interventions. Further efforts to understand the impact of care on infant outcomes are needed. Study registration The trial is registered at clinicaltrials.gov. ClinicalTrial.gov Trial Registration: NCT01073475
登录
查看更多内容
影响因子：
3.8
作者：
Goudar, Shivaprasad S.;Carlo, Waldemar A.;McClure, Elizabeth M.;Pasha, Omrana;Patel, Archana;Esamai, Fabian;Chomba, Elwyn;Garces, Ana;Althabe, Fernando;Kodkany, Bhalachandra;Sami, Neelofar;Derman, Richard J.;Hibberd, Patricia L.;Liechty, Edward A.;Krebs, Nancy F.;Hambidge, K. Michael;Buekens, Pierre;Moore, Janet;Wallace, Dennis;Jobe, Alan H.;Koso-Thomas, Marion;Wright, Linda L.;Goldenberg, Robert L.
通讯作者：
Goldenberg, Robert L.
DOI：
10.1080/14767058.2017.1419177
发表时间：
2019-01-01
影响因子：
1.8
作者：
Goldenberg, Robert L.;Muhe, Lulu;McClure, Elizabeth M.
通讯作者：
McClure, Elizabeth M.
影响因子：
168.9
作者：
Lawn, Joy E.;Blencowe, Hannah;Cousens, Simon N.
通讯作者：
Cousens, Simon N.
影响因子：
3
作者：
Koso-Thomas, Marion;McClure, Elizabeth M.
通讯作者：
McClure, Elizabeth M.
DOI：
10.1111/apa.13805
发表时间：
2017-06
期刊：
Acta paediatrica (Oslo, Norway : 1992)
影响因子：
--
作者：
Garces AL;McClure EM;Pérez W;Hambidge KM;Krebs NF;Figueroa L;Bose CL;Carlo WA;Tenge C;Esamai F;Goudar SS;Saleem S;Patel AB;Chiwila M;Chomba E;Tshefu A;Derman RJ;Hibberd PL;Bucher S;Liechty EA;Bauserman M;Moore JL;Koso-Thomas M;Miodovnik M;Goldenberg RL
通讯作者：
Goldenberg RL