Title: Perinatal Fetal Losses, Burden and Indentifiable Risk Factors
Authors: Dr Bindu K.M, Dr C.P Vijayan, Dr Lalduhchhungi
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.30
Abstract
Introduction: - Perinatal period is the interval between the birth of an infant- born after 20wks gestation, and the 28 completed days after that birth. When perinatal rates are based on birth weight rather than gestational age, it is recommended that the perinatal period be defined as commencing at 500gms.
Death during perinatal period has become a public health problem. Perinatal mortality is high in developing countries even when infant mortality has declined.
Objective:-
1. To calculate the current-perinatal mortality rate in the institution under study.
2. To find out the identifiable risk factors
3. To segregate the modifiable risk factors among the identifiable risk factors.
Materials & Methods: This is a prospective observational study conducted for a period of one year from 1st July 2014-30th June 2015 on all cases of still born and early neonatal death ( from 28th week of gestation onwards upto first 7 postnatal day), in the department of Obstetrics and Gynecology, Medical College Hospital, Kottayam.
Results: During the study period of 1 year there were 5,546 deliveries among which 159 perinatal death, 109 (68%) were still births and 50 (31%) cases were early neonatal death (ENND)
Perinatal mortality rate- 28.66 per 1000 total births. There are various identifiable risk factors. Among that prematurity and low Birth weight are the most common cause for perinatal mortality. Prevalance of neonatal diseases like Hypertension and Diabetes are high among the population under study.
Conclusion: Current perinatal mortality in the institution under study is 28. 66 deaths per 1000 total birth. There are various risk factors, including modifiable risk factors for the same. So individualize each woman not only at the time of pregnancy, from preconceptional period itself, if not possible, periconceptional screening and early detection of risk factors and timely proper intervention is a key to achieve optimal, perinatal outcome and to reduce perinatal fetal losses.
Keywords:- perinatal mortality; risk factors; perinatal out come.
References
1. WHO (2006) Neonatal and perinatal mortality: country, regional and global estimates. WHO, Geneva.
2. Perinatal Mortality Rate, Mortality in infancy and childhood, Parks Textbook of Preventive and Social Medicine , Ed. 22, Page 521.
3. SarkaLisonkova et al-The Effect of Maternal Age on Adverse Birth Outcomes: Does Parity Matter? J ObstetGynaecol Can 2010; 32(6):541–548.
4. VandanaSharma et al: Young Maternal Age and the Risk of Neonatal Mortality in Rural NepalArchPediatrAdolesc Med. 2008 September; 162-9.
5. J. Morrison et al: Socio-Economic Status and Pregnancy Outcome: An Australian Study British Journal of Obstetrics and Gynaecology (1989) 96 (3): 298-307.
6. McDermott J et al -Perinatal mortality in rural Malawi.
7. Gezehagn et al- Perinatal Outcome in Women with Hypertensive Disorders of Pregnancy: A Retrospective Cohort Study International Scholarly Research Notices Volume 2015 (2015), Article ID 208043, 8 pages.
8. C. V. Ananth et al-“Impact of pregnancy-induced hypertension on stillbirth and neonatal mortality,” Epidemiology, vol. 21, no. 1, pp. 118–123, 2010.
9. Cundy T et al. Perinatal mortality in Type 2 diabetes mellitus. Diabet Med 2000; 17: 33-9.
10. Rackham et al -Cause of death in infants of women with pregestational diabetes mellitus and the relationship with glycemic control. Postgrad Med. 2009 Jul; 121(4):26-32.
11. Emmyvan den et al: Significance of (sub) clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review Human Reproduction Update, Vol.17, and No.5 pp. 605–619, 2011.
12. Umber et al - Relationship between maternal hemoglobin and perinatal outcome From Department of Obstetrics and Gynecology Islamic International Medical College Trust, Railway Hospital, Rawalpindi. Received: February 8, 2007 Accepted: June 18, 2007.
13. Faranak Firoozi et al: Effect of maternal moderate to severe asthma on perinatal 15 April 2010 page no -127950. .Acute asthma during pregnancy. Thorax 1996 Apr; 51(4):411e4.
14. Guy ES et al: Acute asthma in pregnancy. Crit CareClin 2004 Oct; 20(4):731e45.
15. Shamini etal : Risk of recurrent adverse pregnancy outcome in women with diabetes, Archives of disease in childhood-fetal and Neonatal Edition –ARCH DIS CHILD-FET:AL neonatal 01/2011; 96 (1).
16. Lt Col G Singh et al: Bad Obstetric History: A Prospective Study MJAFI, Vol. 66, No. 2, 2010.
17. Fischer R et al; Breech Presentation, Medscape, Jul 2012.
18. ShwetaAnand et al: Perinatal Outcome in Growth Retarted Babies Born to Normotensive and Hypertensive Mothers: A Prospective Study People’s Journal of Scientific Research Vol. 5(1), Jan. 2012.
19. Kristensen, et al; SGA subtypes and mortality risk among singleton births. Early Hum Dev. 2006 Jul 11.
20. SohelyYasmin et al: Neonatal mortality of low-birth-weight infants in Bangladesh World Health Organization 2001 Bulletin of the World Health Organization, 2001:79.
21. Kari Klungsøyr et al: Birth weight and perinatal mortality: paradoxes, social class, and siblingdependencies International Journal of Epidemiology 2003;32:625–632
22. Rees JM et al: Pediatrics. 1996 Dec; 98(6 Pt 1):1161-6.Birth weight associated with lowest neonatal mortality: infants of adolescent and adult mothers.
23. Jason H Collins -Umbilical cord accidents Collins BMC Pregnancy and Childbirth 2012, 12(Suppl 1):A7.
24. V bangal et al - Umbilical cord accidents: predictable and preventable J MGIMS, September 2011, Vol 16, No (ii), 54-58.