Estimation of high risk pregnancy contributing to perinatal morbidity and mortality from a birth population-based regional survey in 2010 in China

Abstract

BackgroundNeonatal mortality reduction in China over past two decades was reported from nationwide sampling surveys, however, how high risk pregnancy affected neonatal outcome is unknown. The objective of this study was to explore relations of pregnancy complications and neonatal outcomes from a regional birth population.MethodsIn a prospective, cross-sectional survey of complete birth population-based data file from 151 level I-III hospitals in Huai’an region in 2010, pregnancy complications were analyzed for perinatal morbidity and mortality in association with maternal and perinatal characteristics, hospital levels, mode of delivery, newborn birth weight and gestational age, using international definition for birth registry and morbidities.ResultsPregnancy complications were found in 10% of all births, in which more than 70% were delivered at level II and III hospitals associated with higher proportions of fetal and neonatal death, preterm birth, death at delivery and congenital anomalies. High Cesarean section delivery was associated with higher pregnancy complications, and more neonatal critical illnesses. The pregnancy complications related perinatal morbidity and mortality in level III were 2–4 times as high as in level I and II hospitals. By uni- and multi-variate regression analysis, impact of pregnancy complications was along with congenital anomalies and preterm birth, and maternal child-bearing age and school education years contributing to the prevalence.ConclusionsThis survey revealed variable links of pregnancy complications to perinatal outcome in association with very high Cesarean section deliveries, which warrants investigation for causal relations between high risk pregnancy and neonatal outcome in this emerging region.

Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China

“…Approximately 10% of pregnancies have complications from a birth population-based regional survey of estimation of high-risk pregnancy contributing to perinatal morbidity and mortality in 2010 in China. [15] Moreover, multivariate logistic regression of this study revealed that pregnancy complications as well as multiple births, birth defects, and mothers’ biological and social status were significantly associated with the neonatal outcome, indirectly reflecting the influence of pregnancy complications and other perinatal risks. Home birth with lack of sterilization, warming, resuscitation and other resources is another high-risk factor related to neonate death.…”

Óbitos fetais e neonatais de filhos de pacientes classificadas com near miss

“…A study conducted in Latin America and the Caribbean with women in prenatal care and a number of consultations of less than six due to pregnancy complications and interruption of pregnancy found higher mortality rates and greater frequency of NM cases and fetal and neonatal deaths (15) . In other studies in China and Brazil, it has been shown that complications in pregnancy result in higher rates of fetal and neonatal death, prematurity and death at birth (5,20) . In this study, the history of previous stillbirths was a risk factor for AFNO, with a statistically significant result.…”

“…Although studies on near miss (NM) are frequent in recent years, there are few studies on perinatal complications among these patients, as well as studies that relate MNM to early fetal and neonatal death. Recent research in Brazil and China on such a relation shows that mothers who have had obstetric complications have an increased risk for fetal and neonatal death as well as for neonatal prematurity and asphyxia (3,5) . In this context, fetal and neonatal adverse outcome (FNAO) among NM patients has yet to be explored.…”

Prenatal risk score in high risk pregnancy cases and perinatal outcome: a study from South India

“…3 Clear trend was observed in a study in China between higher pregnancy complications and fetal deaths (including stillbirth) and early neonatal death. 8 Apgar score had better scores in low risk group. 58 cases were observed in with score more than 7, and 14 cases with score less than 4.…”

“…In a study in China, average length of hospital stay in high risk group was 8.5±6.3 days, and, 99.2% of babies received antibiotics. 8 It was further observed that, this trend should have been more prominent and relevant in the emerging regions, requiring advanced perinatal care system emphasizing on routine…”