Study of the Causes and Predisposing Factors in Neonatal Mortality in Ghaem Hospital (March 2009 to May 2010)

Document Type : Original Article

Authors

1 Assistant Professor of Neonatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 B.Sc. of Nursing, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 M.Sc. student of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Neonatal mortality rate is a standard indicator for development of health care, educational and social systems which influences the mortality indicators of infant and children younger than 5 years of age, directly. Since the first step to reduce mortality and improve this indicator is to identify the causes of mortality so this study was conducted with the goal of evaluation of the causes and predisposing factors of neonatal mortality in Ghaem hospital in Mashhad.
 
Methods: This cross-sectional, descriptive – analytical study was conducted from June of 2009 to June of 2010. Following neonatal death, epidemiological data, neonatal physical examination, diagnostic-therapeutic procedures and course of the disease before death, including the neonate’s and mother’s features were recorded and then predisposing factors and death causes were evaluated by an expert team (neonatal subspecialty, neonatal fellowship, resident of pediatrics and nurse who present at the time of death). The data was analyzed using SPSS software (version 11.5) and descriptive Chi square statistic test.
 
Results: Of 1630 hospitalized neonates in this center, 162 (9.94%) died and 63% of which weighted less than 1500 grams. The major causes of neonatal mortality in this study were severe prematurity (less than 32 weeks) 57.4%, asphyxia (5 minute Apgar less than 6- 30.86%), congenital anomalies (27.16%), infections (25.3%), respiratory complications (24.7%), hematologic disorders (6.8%) and cerebral disorders (6.2%).
 
Conclusion: According to death patterns and most frequent causes of neonatal mortality in the present study, preventing preterm labour and low birth weight neonates, preventing delivery injuries and asphyxia, plans to prevent congenital anomalies and infection preventing plans, especially in neonates department could be effective in reducing neonatal mortality in our hospital.

Keywords


1. Stoll BJ, Kliegman RM. Overview of mortality and morbidity. In: Behrman RE, Kliegman RM, Jenson HB. Nelson
textbook of pediatrics. 18th ed, Philadelphia:Saunders;2007:671-4.
2. Mirza Rahimi M, Abedi A, Shahnazi F, Saadati H, Enteshari Moghadam A. [The causes and rate of mortality among
newborns in NICU and newborns unit at Imam Khomeini and Alavi Hospitals in Ardabil from September 2006 to
September 2007]. Ardebil Univ Med J 2008;8(4):424-30. [Article in Persian].
3. Amani F, Berak M, Amini Sani N, Dehghan MH. [Associated factors with neonatal mortality in affiliated hospitals to
Ardebil University Medical 1381-82]. Ardebil Univ Med J 2005;5(4):305-10. [Article in Persian].
4. Nayeri F, Amini E, Oloomi Yazdi Z, Dehghan Naieri A. [Evaluation of the cause and predisposing factors in neonatal
mortality by using international coding diseases version 10 in Valiasr Hospital. Iran]. J Pediatr 2007;17(1):21-26 [
Article in Persian].
5. Jehan I, Harris H, Salat S, Zeb A, Mobeen N, Pasha O, et al. Neonatal mortality, risk factors and causes: a
prospective population-based cohort study in urban Pakistan. Bull World Health Organ 2009 Feb;87(2);130-8.
6. Boskabadi H, Maamouri G, Sadeghin MH, Ghayour-Mobarhan M, Heidarzade M, Shakeri MT et al. Early diagnosis
of perinatal asphyxia by nucleated red blood cell count: a case-control study. Arch Iran Med 2010 Jul;13(4):275-81.
7. Lawn JE, Kerber K, Enweronu-Laryea C, Massee Bateman O. Newborn survival in low resource settings--are we
delivering? BJOG 2009 Oct:116(Supp1 1):49-59.
8. [Neonatal Status of Iran and provide solution to reduce neonates mortality]. Tehran:Ministry of Health;2008. [In
Persian].
9. Jing L, Jian-Hua S, Ping H. Intra-hospital neonatal mortality in level Ⅲ regional children medical center. Chinese J
Child Health Care 2008:4.
10. Joseph KS, Wilkins R, Dodds L, Allen VM, Ohlsson A, Marcoux S, et al. Customized birth weight for gestational
age standards: perinatal mortality patterns are consistent with separate standards for males and females but not for
blacks and whites. BMC Pregnancy and Childbirth 2005 Feb 20;5(1):3.
11. Esmailnasa N, Majdzadeh SR, Nadim A. [Epidemiology survey of stillbirth, neonatal mortality and affecting factor
on them in Kurdistan]. Hakim 2001;4(4):272-7.[ Article in Persian].
12. Couriel J. Assessment of the child with recurrent chest infections. British Medical Bulletin 2002;61: 115–132
13. Jurczak A, Kordek A, Grochans E, Giedrys-Kalemba S .Clinical forms of infections in neonates hospitalized in clinic
of obstetrics and perinatology within the space of one year. Advances in Medical Sciences 2007;52:23-25
14. Falahi M, Joudki N, Mohseni Bandpey H. [Causes neonatal mortality hospitaled in shohaday tajrish hospital in 1383-
1386]. Pajouhandeh 2009;14(1):43-6.[Article in Persian].
15. Bittar Z. Rates of perinatal mortality and low birth weight among 3367 consecutive births in south of Beirut. J Med
Liban 1998 May-Jun;46(3):126-30.
16. Namakin K, Sharifzadeh Q. Survey of infant mortality and related factors in the city of birjand. Isfahan Med Univ J
2009;27(95):275-82. [Article in Persian].
17. Zamani Kiasari A, Kabirzadeh A, Mohseni Saravi B, Rezazadeh A, Khademlou M, Biazar T. [Rate and causes of
perinatal mortality in Imam Hospital, Sari 2007]. Iran J Obstet Gynecol Infertil 2009;12(2):23-30. [Article in
Persian].
18. Baqui AH, Darmstadt GL, Williams EK, Kumar V, Kiran TU, Panwar D, et al. Rates, timing and causes of neonatal
deaths in rural India: implications for neonatal health programmes. Bull World Health Organ 2006 Sep;84(9):706-13.
19. Boskabadi H, Maamouri G, Afshari JT, Ghayour-Mobarhan M, Shakeri MT. Serum interleukin 8 level as a diagnostic
marker in late neonatal sepsis.Iranian Journal of Pediatrics .2010;20 (10): 41-47.
ٍ
20. Stoll BJ. Infectios of the neonatal infant In: Behrman RE, Kliegman RM. Jenson HB. Nelson textbook of pediatrics.
18th ed. Philadelphia: Philadelphia:Saunders;2008:794-810.
21. Ghazvini K, Rashed T, Boskabadi H, Yazdanpanah M, Khakzadan F, Safaee H, et al. [Neonatal intensive care unit
nosocomial bacterial infections]. Tehran Univ Med J 2008;5(66):349-54. [Article in Persian].
22. Kusuda S, Fujimura M, Sakuma I, Aotani H, Kabe K, Itani Y, et al. Morbidity and mortality of infants with very low
birth weight in Japan: center variation. Pediatrics 2006 Oct;118(4);e1130-8.