Trends in Neonatal Mortality at Chaiyaphum Hospital , 2012-2019
Keywords:
neonatal mortality rate; time of death; causes of death; factors contributing to the neonatal mortalityAbstract
Background and Objectives: Neonatal mortality is considered a basic measure of public maternal and child health. This study aimed to determine trends in neonatal mortality at Chaiyaphum Hospital during the period from 2012 to 2019 and to determine potential factors contributing to neonatal mortality.
Methods: A retrospective descriptive study of 30,375 live births , who were admitted in Chaiyaphum Hospital between 1 October 2011 and 30 September 2019. 232 neonatal deaths (0 - 28 days) at Chaiyaphum Hospital were analyzed. Data were analyzed for statistical significant (p < 0.05) by
chi – square test. Neonatal mortality rates , time of death , causes of death were calculated. Factors contributing to the neonatal mortality stratified by gestational age and birth weight were compared in univariate analyses by calculating odd ratio (OR) and 95% confidence interval.
Results: The overall neonatal mortality rate at Chaiyaphum Hospital during the period from 2012 to 2019 was 7.64 per 1000 live births. Overall neonatal mortality remained unchanged from 2012 to 2019
(p = 0.34). Factors significantly associated with neonatal mortality include preterm and low birth weight , especially extremely preterm < 28 weeks gestation (OR 357.553 , 95 % CI 236.748 – 540.002 , p < 0.001) and extremely low birth weight 500 - 999 gram (OR 384.270 , 95 % CI 256.998 - 574.573 , p < 0.001). Time of death , 72.84 % were early neonatal deaths. Cause of neonatal death , the largest neonatal mortality was neonatal sepsis (40.52 %). The trends in neonatal mortality rates of respiratory distress syndrome , late onset neonatal sepsis showed statistically significant decreases , but early onset neonatal sepsis significantly increased.
Conclusion: The overall neonatal mortality at Chaiyaphum Hospital remained unchanged from 2012 to 2019. Factors significantly associated with neonatal mortality include preterm and low birth weight. Cause of neonatal death , the largest neonatal mortality was neonatal sepsis.
References
2.Alexander M, Alkema L. Global estimation of neonatal mortality Using a bayesian hierarchical splines regression model, 2016. [cited March 1, 2020 ]. Available from :https://arxiv.org/abs/1612.03561.
3. You D, Hug L, Ejdemyr S, Idele P, Hogan D, Mathers C, et al. Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency group for child mortality estimation. Lancet 2015; 386: 2275–2286.
4. Neonatal mortality- UNICEF DATA: Monitoring the situation of children and women. [cited March 1, 2020]. Available from : https://data.unicef.org/topic/child-survival/neonatal-mortality/, access September 2019.
5. Neonatal mortality - WHO . [cited March 1, 2020]. Available from : https://www.who.int/gho /child_health/mortality/neonatal_text/en/.
6. Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? where? why?. Lancet 2005; 365:891-900.
7. Lucia Hug, Monica Alexander, Danzhen You, Leontine Alkema. National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030: a systematic analysis. Lancet Glob Health 2019;7: e710–720 .
8. United Nations, 2015. Transforming our World: the 2030 Agenda for Sustainable Development. [cited March 2, 2020]. Available from : https://sustainabledevelopment.un.org/content/documents /21252030%20Agenda%20for%20Sustainable%20Development%20web.pdf.
9. Thailand - Neonatal mortality rate. [cited March 1, 2020]. Available from:https ://knoema.com/ atlas/Thailand/Neonatal-mortality-rate.
10. Neonatal mortality rate -UNICEF Data: Monitoring the situation of children and women. [cited March 1, 2020]. Available from: https://data.unicef.org/resources/data_explorer/unicef_f/?ag UNICEF&df=GLOBAL_DATAFLOW&ver=1.0&dq=.CME_MRM0..&startPeriod=2016&endPeriod=2019.
11. HDC-Dashboard กระทรวงสาธารณสุข. (เข้าถึงเมื่อ 1 มีนาคม 2563) เข้าถึงได้จาก: HDC - Report (moph.go.th).
12. Conley D, Springer KW. Welfare state and infant mortality. AJS 2001 ;107(3):768-807.
13. ณัฐพงศ์ จันทร์เจริญ. สาเหตุและอัตราการเสียชีวิตของทารกแรกเกิดอายุ 0 –28 วันโรงพยาบาลพระปกเกล้าจันทบุรี. (เข้าถึงเมื่อ 7 ธันวาคม 2563) เข้าถึงได้จาก : Nattapong_Chancharoen.pdf (thaipediatrics.org).
14. Ely DM, Driscoll AK. Infant Mortality in the United States, 2017: Data From the Period Linked Birth/Infant Death File. Natl Vital Stat Rep 2019; 68: 1-20.
15.Qi-Jun Wu, Li-Li Li, Jing Li, Chen Zhou, Yan-Hong Huang.Time trends of neonatal mortality by causes of death in Shenyang 1997–2014. Oncotarget 2016 ; 7(13): 16610–16618.
16. Neonatal mortality. UNICEF Data: Monitoring the situation of children and women. [cited November 1, 2020]. Available from : https://data.unicef.org/topic/child-survival/neonatal-mortality/, access September 2020.
17. Ananth CV, Goldenberg RL, Friedman AM, Vintzileos AM. Association of temporal changes in gestational age with perinatal mortality in the United States, 2007-2015. JAMA Pediatr 2018; 172(7): 627-634.
18. Shawn K Ahlfeld. Respiratory distress syndrome (Hyaline membrane disease).In Robert M Kliegman, Joseph W ST Geme III, Nathan J Blum, Samir S Shah, Robert C Tasker, Karen M Wilson, Richard E Berhrman, editors. Nelson Textbook of Pediatrics 21thed. Philadelphia: Elsevier; 2020: 932-936.
19. Barbara J Stoll, Nellie I Hansen, Edward F Bell, Michele C Walsh, Waldemar A Carlo, Seetha Shankaran ,et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates,1993–2012. JAMA 2015 ; 314(10): 1039–1051.
20. Lui K, Lee SK, Kusuda S, Adams M, Vento M, Reichman B, et al. Trends in outcomes for neonates born very preterm and very low birth weight in 11 high-income countries. J Pediatr 2019; 215: 32-40.
21. Richter LL, Ting J, Muraca GM, Synnes A, Lim KI, Lisonkova S.Temporal trends in neonatal mortality and morbidity following spontaneous and clinician-initiated preterm birth in Washington State, USA: a population-based study. BMJ Open 2019; 9(1): e023004.
22. อรพรรณ ทิพย์ธารา. การศึกษาผลการรักษาทารกแรกเกิดที่มีน้ำหนักน้อยกว่า 1,000 กรัมและค่าใช้จ่ายในการดูแลรักษา. วารสารกุมารเวชศาสตร์ 2555; 51: 222-232.
23. Won-Ho Hahn, Ji-Young Chang, Yun Sil Chang, Kye Shik Shim, Chong-Woo Bae. Recent trends in neonatal mortality in very low birth weight Korean infants: in comparison with Japan and the USA. J Korean Med Sci 2011; 26(4): 467–473.
24. Horiuchi T, Ohno T, Itani Y, Kabe K, Nakamura T, Nakamura H. Studies on the states of care for high risk neonates and neonatal mortality in our country (year 2000). J Jpn Pediatr Soc 2002; 106: 603–613.
25. Lee JH, Noh OK, Chang YS. Neonatal outcomes of very low birth weight infants in Korean neonatal network from 2013 to 2016.J Korean Med Sci 2019; 34(5): e40.
26. Veloso FCS, Kassar LML, Oliveira MJC, Lima THB, Bueno NB, Gurgel RQ, et al. Analysis of neonatal mortality risk factors in Brazil: a systematic review and meta-analysis of observational studies. J Pediatr (Rio J) 2019; 95(5): 519-530.
27. Manuck TA, Rice MM, Bailit JL, Grobman WA, Reddy UM, Wapner RJ, et al. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obstet Gynecol 2016 ; 215: 103.e1-103.e14.
28. Platt MJ. Outcomes in preterm infants. Public Health 2014; 128(5): 399-403.
29. Elmi Farah A, Abbas AH, Tahir Ahmed A. Trends of admission and predictors of neonatal mortality: A hospital based retrospective cohort study in Somali region of Ethiopia. PLoS One 2018 ;13(9): e0203314.
30.นภาพร เกียรติดำรง. การรอดชีวิตและผลการรักษาของทารกน้ำหนักน้อยมากที่คลอดในโรงพยาบาลอำนาจเจริญ.วารสารกุมารเวชศาสตร์ 2555;51:177- 182.
31. Rudan I, Chan KY, Zhang JS, Theodoratou E, Feng XL, Salomon JA, et al .Causes of deaths in children younger than 5 years in China in 2008. Lancet 2010; 375(9720): 1083-1089.
32. American College of Obstetricians and Gynecologists. Committee opinion—antenatal corticosteroid therapy for fetal maturation. Obstet Gynecol 2016; 128: e187- 194.
33. Wang XL, Wang J, Yuan L, Shi WJ, Cao Y, Chen C. Trend and causes of neonatal mortality in a level III children's hospital in Shanghai: a 15-year retrospective study. World J Pediatr 2018; 14(1): 44-51.
34. International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)-WHO Version for ;2016. [cited March 1, 2020]. Available from: https://icd.who.int/ browse10/2016/en#/P21.0
35. ศศิวิมล สุ่นสวัสดิ์. Sepsis. ใน: อนันต์ โฆษิตเศรษฐ, เปรมฤดี ภูมิถาวร, อัญชลี ลิ้มรังสิกุล, พฤหัส พงษ์มี, ณัฐชัย อนันตสิทธิ์, บรรณาธิการ. Ramathibodi Handbook of P/NICU. พิมพ์ครั้งที่ 1. กรุงเทพฯ: ภาควิชากุมารเวชศาสตร์ คณะแพทยศาสตร์โรงพยาบาลรามาธิบดี มหาวิทยาลัยมหิดล, 2561; 52: 177- 179.
