Perinatal and Neonatal Mortality in Jordan

et al. 2020

Front. Public Health

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Background: It has been estimated that 27.8 million neonates will die worldwide between 2018 and 2030 if no improvements in neonatal and maternal care take place. The aim of this study was to determine the rate, risk factors, and causes of neonatal mortality in Jordan.Methods: In August 2019, an electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in in three large cities through five hospitals. Data on all births, neonatal mortality and their causes, and other characteristics in the period between August 2019 and January 2020 were exported from the JSANDS and analyzed.Results: A total of 10,328 births [10,226 live births (LB) and 102 stillbirths] were registered in the study period, with a rate of 14.1 deaths per 1,000 LBs; 76% were early neonatal deaths and 24% were late deaths. The odds of deaths in the Ministry of Health hospitals were almost 21 times (OR = 20.8, 95% CI: 2.8, 153.1) higher than that in private hospitals. Low birthweight and pre-term babies were significantly more likely to die during the neonatal period compared to full-term babies. The odds of neonatal mortality were significantly higher among babies born to housewives compared to those who were born to employed women (OR = 2.7; 95% CI: 1.2, 6.0). Main causes of neonatal deaths that occurred pre-discharge were respiratory and cardiovascular disorders (43%) and low birthweight and pre-term (33%). The main maternal conditions that attributed to these deaths were complications of the placenta and cord, complications of pregnancy, and medical and surgical conditions. The main cause of neonatal deaths that occurred post-discharge were low birthweight and pre-term (42%). Conclusions:The rate of neonatal mortality have not decreased since 2012 and the majority of neonatal deaths occurred could have been prevented. Regular antenatal

Section: Discussionmentioning

confidence: 99%

Rate, Risk Factors, and Causes of Neonatal Deaths in Jordan: Analysis of Data From Jordan Stillbirth and Neonatal Surveillance System (JSANDS)

Al-Sheyab

et al. 2020

Front. Public Health

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“…Maternal contributing conditions of intrapartum stillbirths included complications of the placental cord and membranes. The majority of these deaths could be prevented with reasonably priced interventions [24]. Bhutta and others proposed a basic package of antenatal interventions to reduce the incidence of antepartum and intrapartum stillbirths.…”

Section: Discussionmentioning

confidence: 99%

Rate, determinants, and causes of stillbirth in Jordan: Findings from the Jordan Stillbirth and Neonatal Deaths Surveillance (JSANDS) system

BMC Pregnancy Childbirth

Alyahya

et al. 2020

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Background Annually, 2.6 million stillbirths occur around the world, with approximately 98% occurring in low- and middle-income countries. The stillbirth rates in these countries are 10 times higher than the rates in high-income countries. Methods An electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in five large hospitals located in three of the largest cities in Jordan in August 2019. JSANDS was developed as a secure on-line data entry system to collect, organize, analyze, and disseminate data on stillbirths, neonatal deaths, and their contributing conditions. Data on births, stillbirths and their contributing conditions, and other demographic and clinical characteristics in the period between August 2019 – January 2020 were extracted and analyzed. Results A total of 10,328 births were registered during the reporting period. Of the total births, 102 were born dead (88 antepartum stillbirths and 14 intrapartum stillbirths), with a rate of 9.9 per 1000 total births. The main contributing fetal conditions of antepartum stillbirths were antepartum death of unspecified cause (33.7%), acute antepartum event (hypoxia) (33.7%), congenital malformations and chromosomal abnormalities (13.3%), and disorders related to the length of gestation and fetal growth (10.8%). The main contributing maternal conditions of antepartum stillbirths included complications of the placental cord and membranes (48.7%), maternal complications of pregnancy (23.1%), and maternal medical and surgical conditions (23.1%). Contributing fetal conditions of intrapartum stillbirths included congenital malformations, deformations and chromosomal abnormalities, other specified intrapartum disorders, and intrapartum death of unspecified cause (33.3% each). Contributing maternal conditions of intrapartum stillbirths included complications of the placental cord and membranes. In the multivariate analysis, small for gestational age (SGA) pregnancies were associated with a significant 3-fold increased risk of stillbirth compared to appropriate for gestational age (AGA) pregnancies. Conclusions Although the rate of stillbirth is lower than that in other countries in the region, there is an opportunity to prevent such deaths. While the majority of stillbirths occurred during the antepartum period, care should be taken for the early identification of high-risk pregnancies, including the early detection of SGA pregnancies, and ensuring adequate antenatal obstetric interventions.

“…Maternal contributing conditions of intrapartum stillbirths included complications of placental cord and membranes. The majority of these deaths could be prevented with reasonably priced interventions (25). Bhutta and others proposed a basic package of antenatal interventions to reduce the incidence of antepartum and intrapartum stillbirths.…”

Section: Discussionmentioning

confidence: 99%

Rate, determinants, and causes of stillbirth in Jordan: Findings from the Jordan Stillbirth and Neonatal Deaths Surveillance (JSANDS) system

Alyahya

et al. 2020

Preprint

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Background: Annually, 2.6 million stillbirths occur around the world, with about 98% occur in low and middle-income countries. The stillbirth rates in these countries are 10 times higher than the rates in high-income countries. Methods: An electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in five large hospitals located in three of the largest cities in Jordan in August 2019. JSANDS was developed as a secure on-line data entry system to collect, organize, analyse, and disseminate data on stillbirths, neonatal deaths, and their contributing conditions. Data on births, stillbirths and their contributing conditions contributing, and other demographic and clinical characteristics in the period between August 2019 – January 2020 were extracted and analysedResults: A total of 10328 births were registered during the reporting period. Of the total births, 102 were born dead (88 antepartum stillbirths and 14 intrapartum stillbirths) with a rate of 9.9 per 1000 total births. The main contributing fetal conditions of antepartum stillbirths were antepartum death of unspecified cause (33.7%), acute antepartum event (hypoxia) (33.7%), congenital malformations and chromosomal abnormalities (13.3%), and disorders related to the length of gestation and fetal growth (10.8%). The main contributing maternal conditions of antepartum stillbirths included complications of placental cord and membranes (48.7%), maternal complications of pregnancy (23.1%), and maternal medical and surgical conditions (23.1%). Contributing fetal conditions of intrapartum stillbirths included congenital malformations deformations and chromosomal abnormalities, other specified intrapartum disorder, intrapartum death of unspecified cause (33.3% each). Contributing maternal conditions of intrapartum stillbirths included complications of placental cord and membranes. In the multivariate analysis, the odds of stillbirth for very low birth weight (<1500 gm) babies and for low birthweight babies (1500-2499 gm) were 14.1 times 4.3 times that odds for babies born with normal birth weight, respectively. The stillbirth rate was significantly higher among preterm deliveries compared to full-term deliveries (OR = 5.6). Conclusions: Although the rate of stillbirth is lower than that in other countries in the region, there is an opportunity to prevent such deaths. While the majority of stillbirths occurred during the antepartum period, care should be taken for early identification of high-risk pregnancies and ensuring adequate antenatal obstetric interventions.