OBJECTIVE: Using a low-cost community surveillance system, we aimed to estimate intrapartum stillbirth and intrapartum-related neonatal death rates for a low-income community setting. PATIENTS AND METHODS: From 2005 to 2008, information on all deliveries in 18 unions of 3 districts of Bangladesh was ascertained by using traditional birth attendants as key informants. Outcomes were measured using a structured interview with families 6 weeks after delivery. RESULTS: We ascertained information on 31 967 deliveries, of which 26 173 (82%) occurred at home. For home deliveries, the mean cluster-adjusted stillbirth rate was 26 (95% confidence interval [CI[: 24-28) per 1000 births, and the perinatal mortality rate was 51 per 1000 births (95% CI: 47-55). The NMR was 33 per 1000 live births (95% CI: 30-37). There were 3186 (12.5%) home-born infants who did not breathe immediately. Of these, 53% underwent some form of resuscitation. Of 1435 infants who were in poor condition at 5 minutes (5% of all deliveries), 286 (20%) died; 35% of all causes of neonatal mortality. Of 201 fresh stillbirths, 40 (14%) of the infants had major congenital abnormalities. Our estimate of the intrapartum-related crude mortality rate among home-born infants is 17 in 1000 (95% CI: 16-19), 6 in 1000 stillborn and 11 in 1000 neonatal deaths after difficulties at birth. CONCLUSIONS: Difficulty initiating respiration among infants born at home in rural Bangladesh is common, and resuscitation is frequently attempted. Newborns who remain in poor condition at 5 minutes have a 20% mortality rate. Evaluation of resuscitation methods, early intervention trials including antibiotic regimes, and follow-up studies of survivors of community-based resuscitation are needed.
OBJECTIVE: Using a low-cost community surveillance system, we aimed to estimate intrapartum stillbirth and intrapartum-related neonatal death rates for a low-income community setting. PATIENTS AND METHODS: From 2005 to 2008, information on all deliveries in 18 unions of 3 districts of Bangladesh was ascertained by using traditional birth attendants as key informants. Outcomes were measured using a structured interview with families 6 weeks after delivery. RESULTS: We ascertained information on 31 967 deliveries, of which 26 173 (82%) occurred at home. For home deliveries, the mean cluster-adjusted stillbirth rate was 26 (95% confidence interval [CI[: 24-28) per 1000 births, and the perinatal mortality rate was 51 per 1000 births (95% CI: 47-55). The NMR was 33 per 1000 live births (95% CI: 30-37). There were 3186 (12.5%) home-born infants who did not breathe immediately. Of these, 53% underwent some form of resuscitation. Of 1435 infants who were in poor condition at 5 minutes (5% of all deliveries), 286 (20%) died; 35% of all causes of neonatal mortality. Of 201 fresh stillbirths, 40 (14%) of the infants had major congenital abnormalities. Our estimate of the intrapartum-related crude mortality rate among home-born infants is 17 in 1000 (95% CI: 16-19), 6 in 1000 stillborn and 11 in 1000 neonatal deaths after difficulties at birth. CONCLUSIONS: Difficulty initiating respiration among infants born at home in rural Bangladesh is common, and resuscitation is frequently attempted. Newborns who remain in poor condition at 5 minutes have a 20% mortality rate. Evaluation of resuscitation methods, early intervention trials including antibiotic regimes, and follow-up studies of survivors of community-based resuscitation are needed.
Authors: Katherine J Gold; Abdul-Razak S Abdul-Mumin; Martha E Boggs; Henry S Opare-Addo; Richard W Lieberman Journal: Int J Gynaecol Obstet Date: 2014-03-04 Impact factor: 3.561
Authors: Elizabeth M McClure; Sarah Saleem; Shivaprasad S Goudar; Janet L Moore; Ana Garces; Fabian Esamai; Archana Patel; Elwyn Chomba; Fernando Althabe; Omrana Pasha; Bhalachandra S Kodkany; Carl L Bose; Mabel Berreuta; Edward A Liechty; K Hambidge; Nancy F Krebs; Richard J Derman; Patricia L Hibberd; Pierre Buekens; Albert Manasyan; Waldemar A Carlo; Dennis D Wallace; Marion Koso-Thomas; Robert L Goldenberg Journal: Reprod Health Date: 2015-06-08 Impact factor: 3.223
Authors: Abdul Halim; Mamuda Aminu; Juan Emmanuel Dewez; Animesh Biswas; A K M Fazlur Rahman; Nynke van den Broek Journal: BMC Pregnancy Childbirth Date: 2018-06-13 Impact factor: 3.007
Authors: Sarah Saleem; Elizabeth M McClure; Shivaprasad S Goudar; Archana Patel; Fabian Esamai; Ana Garces; Elwyn Chomba; Fernando Althabe; Janet Moore; Bhalachandra Kodkany; Omrana Pasha; Jose Belizan; Albert Mayansyan; Richard J Derman; Patricia L Hibberd; Edward A Liechty; Nancy F Krebs; K Michael Hambidge; Pierre Buekens; Waldemar A Carlo; Linda L Wright; Marion Koso-Thomas; Alan H Jobe; Robert L Goldenberg Journal: Bull World Health Organ Date: 2014-06-05 Impact factor: 9.408