Neonatal Mortality Risks Among Preterm Births in a Rural Bangladeshi Cohort

2014 ◽  
Vol 28 (6) ◽  
pp. 510-520 ◽  
Author(s):  
Rashed Shah ◽  
Luke C. Mullany ◽  
Gary L. Darmstadt ◽  
Radwanur Rahman Talukder ◽  
Syed Moshfiqur Rahman ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Preterm Births ◽  
Mortality Risks

scholarly journals Effects of Randomized Corruption Audits on Early-Life Mortality in Brazil

2020 ◽  
Author(s):  
Antonio Pedro Ramos ◽  
Robert Weiss ◽  
Simeon Nietcher ◽  
Leiwen Gao
Keyword(s):  
Health Disparities ◽  
Infant Mortality ◽  
Health Outcomes ◽  
Neonatal Mortality ◽  
Child Mortality ◽  
Early Life ◽  
Causal Effect ◽  
Preterm Births ◽  
The Impact ◽  
Improve Health

Background: Various studies suggest that corruption affects public health systems across the world. However, the extant literature lacks causal evidence about whether anti-corruption interventions can improve health outcomes. We examine the impact of randomized anti-corruption audits on early-life mortality in Brazil. Methods: The Brazilian government conducted audits in 1,949 randomly selected municipalities between 2003 and 2015. To identify the causal effect of anti-corruption audits on early-life mortality, we analyse data on health outcomes from individual- level vital statistics (DATASUS) collected by Brazil government before and after the random audits. Data on the audit intervention are from the Controladoria-Geral da Uniao, the government agency responsible for the anti-corruption audits. Outcomes are neonatal mortality, infant mortality, child mortality, preterm births, and prenatal visits. Analyses examine aggregate effects for each outcome, as well as effects by race, cause of death, and years since the intervention. Results: Anti-corruption audits significantly decreased early-life mortality in Brazil. Expressed in relative terms, audits reduced neonatal mortality by 6.7% (95% CI -8.3%, -5.0%), reduced infant mortality by 7.3% (-8.6%, -5.9%), and reduced child mortality by 7.3% (-8.5%, -6.0%). This reduction in early mortality was higher for nonwhite Brazilians, who face significant health disparities. Effects are greater when we look at deaths from preventable causes, and show temporal persistence with large effects even a decade after audits. In addition, analyses show that the intervention led to a 12.1% (-13.4%, -10.6%) reduction in women receiving no prenatal care, as well as a 7.4% (-9.4%, -5.5%) reduction in preterm births; these effects are likewise higher for nonwhites and are persistent over time. All effects are robust to various alternative specifications. Interpretation: Governments have the potential to improve health outcomes through anti-corruption interventions. Such interventions can reduce early-life mortality and mitigate health disparities. The impact of anti-corruption audits should be investigated in other countries, and further research should further explore the mechanisms by which combating corruption affects the health sector.

Fetal and Neonatal Mortality Risks of Multiple Births

2005 ◽  
Vol 32 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Greg R. Alexander ◽  
Martha Slay Wingate ◽  
Hamisu Salihu ◽  
Russell S. Kirby
Keyword(s):  
Neonatal Mortality ◽  
Multiple Births ◽  
Mortality Risks

Time Trends in Characteristics and Outcome of Twin Pregnancies

1991 ◽  
Vol 40 (2) ◽  
pp. 181-192 ◽  
Author(s):  
L. Moreault ◽  
S. Marcoux ◽  
J. Fabia ◽  
S. Tennina
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Low Birthweight ◽  
Preterm Births ◽  
Mortality Rates ◽  
Fetal Mortality ◽  
Neonatal Mortality Rate ◽  
Risk Of Death ◽  
Twin Pregnancies ◽  
Over Time

AbstractThis study describes the evolution in fetal and neonatal mortality rates among twin pairs born in 22 hospitals located in the eastern regions of the province of Quebec in 1976-1978 (n = 776 pairs) and 1982-1985 (n = 712 pairs). It also assesses the contribution of maternal factors, obstetrical care and characteristics of twins in the variation of the risk of death over time. The fetal mortality rate did not improve from 1976-1978 (22.6 per 1000) to 1982-1985 (28.1 per 1000). However, the neonatal mortality rate declined from 44.7 to 34.7 per 1000 liveborn first twins and from 56.8 to 36.1 per 1000 liveborn second twins. For first twins as for second twins, birthweight-specific neonatal mortality rates decreased within birth weight categories under 2500 g. In the second period, 96.9% of twin pregnancies were detected before confinement compared to 59.6% in the earlier period. The proportion of twins delivered by obstetricians, the percentage of twin births occurring in ultraspecialized perinatal units and the frequency of caesarean sections increased markedly. The proportion of preterm births increased over time (34.5% vs 43.1%) whereas the percentage of low birthweight twins decreased but not significantly (54.3% 51.6%). In this study, changes in maternal age, parity, educational level, sex of pairs, qualification of the physician, and level of care available at the hospital of birth, did not account for the decrease in neonatal mortality rates among twins. The increase in the frequency of caesarean sections seemed to explain only a small proportion of the decrease in the neonatal mortality rate among second twins. In the second as well as in the first period, the neonatal mortality rate for twins was six times higher than that for singletons.

Maternal Cancer During Pregnancy and Risks of Stillbirth and Infant Mortality

2017 ◽  
Vol 35 (14) ◽  
pp. 1522-1529 ◽  
Author(s):  
Donghao Lu ◽  
Jonas F. Ludvigsson ◽  
Karin E. Smedby ◽  
Katja Fall ◽  
Unnur Valdimarsdóttir ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Fetal Growth ◽  
Preterm Births ◽  
Positive Association ◽  
Spontaneous Preterm Birth ◽  
Rate Ratios ◽  
Birth Preterm ◽  
Number Of Births

Purpose To examine whether maternal cancer during pregnancy is associated with increased risks of stillbirth and infant mortality. Methods On the basis of nationwide health registers, we conducted a study of 3,947,215 singleton births in Sweden from 1973 through 2012. Exposure was defined as maternal cancer diagnosed during pregnancy (number of births = 984) or during the year after pregnancy (number of births = 2,723). We calculated incidence rate ratios (IRRs) for stillbirth and infant mortality, comparing exposed births to unexposed births. Small-for-gestational-age (SGA) and preterm births were examined as secondary outcomes. Results Maternal cancer diagnosed during pregnancy was positively associated with stillbirth (IRR, 2.5; 95% CI, 1.2 to 5.0), mainly stillbirths assessed as SGA (IRR, 4.9; 95% CI, 2.2 to 11.0), and with preterm SGA births (relative risk 3.0; 95% CI, 2.1 to 4.4). Positive associations of maternal cancer diagnosed during pregnancy or the year after pregnancy were noted for both neonatal mortality (deaths within 0 to 27 days; IRR, 2.7; 95% CI, 1.3 to 5.6 and IRR, 2.0; 95% CI, 1.2 to 3.2, respectively) and preterm birth (IRR, 5.8; 95% CI, 5.3 to 6.5 and IRR, 1.6; 95% CI, 1.4 to 1.8, respectively). The positive association with preterm birth was due to iatrogenic instead of spontaneous preterm birth. Preterm birth explained 89% of the association of maternal cancer during pregnancy with neonatal mortality. Conclusion Maternal cancer during pregnancy is associated with increased risks of rare but fatal outcomes, including stillbirth and neonatal mortality. This may be due to conditions associated with fetal growth restriction and iatrogenic preterm birth. Careful monitoring of fetal growth and cautious decision making on preterm delivery should therefore be reinforced.

Birthweight, preterm births and neonatal mortality in Belgium and the United States

1995 ◽  
Vol 9 (3) ◽  
pp. 273-280 ◽  
Author(s):  
Pierre Buekens ◽  
Allen J Wilcox ◽  
John Kiely ◽  
Godelieve Masuy-Stroobant
Keyword(s):  
United States ◽  
Neonatal Mortality ◽  
Preterm Births ◽  
The United States
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