Saverio Bellizzi1, Quique Bassat2,3,4, Mohamed M Ali1, Howard L Sobel5, Marleen Temmerman6. 1. World Health Organization, Department of Reproductive Health and Research, Geneva, Switzerland. 2. ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain. 3. Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique. 4. ICREA, Barcelona, Spain. 5. World Health Organization, Western Pacific Regional Office, Manila, Philippines. 6. Department of Obstetrics and Gynaecology, Ghent University, Ghent, Belgium.
Abstract
BACKGROUND: Around 1.5 million annual neonatal deaths occur in the first week of life, and infections represent one of the major causes in developing countries. Neonatal sepsis is often strictly connected to infection of the maternal genital tract during labour. METHODS: The association between signs suggestive of puerperal infection and early neonatal mortality (<7 days of life) was performed using Demographic and Health Surveys (DHS) data of six countries, conducted between 2010 and 2013. The population attributable fraction (PAF) was generated using the estimates on early neonatal mortality of a 1990-2013 systematic analysis for the Global Burden of Disease Study. RESULTS: Signs of puerperal infection ranged from 0.7% in the Philippines to 16.4% in Honduras. Infection was associated with a 2.1 adjusted Risk Ratio (95% CI: 1.4-3.2) of early neonatal mortality. Around five percent of all deaths in the first week of life were attributable to signs suggestive of puerperal infections and varied from 13.9% (95% CI: 1.0-26.6) in Honduras to 3.6% (95% CI: 1.0-8.5) in Indonesia. CONCLUSIONS: Targeted interventions should be addressed to contain the burden of puerperal infections on early neonatal mortality. Consideration of the PAF will help in the discussion of the benefits of antenatal and perinatal measures.
BACKGROUND: Around 1.5 million annual neonatal deaths occur in the first week of life, and infections represent one of the major causes in developing countries. Neonatal sepsis is often strictly connected to infection of the maternal genital tract during labour. METHODS: The association between signs suggestive of puerperal infection and early neonatal mortality (<7 days of life) was performed using Demographic and Health Surveys (DHS) data of six countries, conducted between 2010 and 2013. The population attributable fraction (PAF) was generated using the estimates on early neonatal mortality of a 1990-2013 systematic analysis for the Global Burden of Disease Study. RESULTS: Signs of puerperal infection ranged from 0.7% in the Philippines to 16.4% in Honduras. Infection was associated with a 2.1 adjusted Risk Ratio (95% CI: 1.4-3.2) of early neonatal mortality. Around five percent of all deaths in the first week of life were attributable to signs suggestive of puerperal infections and varied from 13.9% (95% CI: 1.0-26.6) in Honduras to 3.6% (95% CI: 1.0-8.5) in Indonesia. CONCLUSIONS: Targeted interventions should be addressed to contain the burden of puerperal infections on early neonatal mortality. Consideration of the PAF will help in the discussion of the benefits of antenatal and perinatal measures.
Authors: Li Liu; Shefali Oza; Daniel Hogan; Jamie Perin; Igor Rudan; Joy E Lawn; Simon Cousens; Colin Mathers; Robert E Black Journal: Lancet Date: 2014-09-30 Impact factor: 79.321
Authors: Mercedes Bonet; Vicky Nogueira Pileggi; Marcus J Rijken; Arri Coomarasamy; David Lissauer; João Paulo Souza; Ahmet Metin Gülmezoglu Journal: Reprod Health Date: 2017-05-30 Impact factor: 3.223
Authors: Jennifer Hall; Nadine Hack Adams; Linda Bartlett; Anna C Seale; Theresa Lamagni; Fiorella Bianchi-Jassir; Joy E Lawn; Carol J Baker; Clare Cutland; Paul T Heath; Margaret Ip; Kirsty Le Doare; Shabir A Madhi; Craig E Rubens; Samir K Saha; Stephanie Schrag; Ajoke Sobanjo-Ter Meulen; Johan Vekemans; Michael G Gravett Journal: Clin Infect Dis Date: 2017-11-06 Impact factor: 9.079