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EBHPME 2021, 5(1): 43-51 |
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Alimohammadzadeh K, Falahati F, Karami H, Parsa H, Shirvani Shiri M, Erami A, et al . Comparison of Factors Associated with the Neonatal Mortality Rate in Fars Province before and after Implementing the Health Section Evolution: A Retrospective Cross-Sectional Study. EBHPME 2021; 5 (1) :43-51
URL: http://jebhpme.ssu.ac.ir/article-1-311-en.html
URL: http://jebhpme.ssu.ac.ir/article-1-311-en.html
Khalil Alimohammadzadeh 
, Farshad Falahati * , Hassan Karami , Hamidreza Parsa , Maryam Shirvani Shiri , Atila Erami , Zahra Eskandari Kootahi , Maliheh Erfani
, Farshad Falahati * , Hassan Karami , Hamidreza Parsa , Maryam Shirvani Shiri , Atila Erami , Zahra Eskandari Kootahi , Maliheh Erfani
1.Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran 2.Deputy of Treatment, Shiraz University of Medical Sciences, Shiraz, Iran , Farshad349@yahoo.com
Abstract: (2138 Views)
Background: The neonatal period or the first 28 days after birth is a critical and vulnerable time for a child period, and the mortality rate is high
due to the severe problems which might happen during this period. The goal of this study was to compare the risk factors associated with the neonatal mortality rate (NMR) before and after the implementation of the health sector evolution plan (HSEP) in Fars Province, Iran.
Methods: This study was a retrospective cross-sectional study. This research was conducted using the census method, and 275951 newborns’ files were studied. Variables are expressed as percentage and frequency. The chi-square test and Fisher tests was used to measure the significance level of variables. A multivariate logistic regression model was also used to estimate the odds ratio of neonatal mortality and risk factors associated with neonatal mortality. All statistical tests were performed bilaterally with P-value < 0.05 considered as significant. All tests were conducted using the software SPSS19.
Results: After HSEP, risk factors of pregnancy and delivery complications were significantly reduced, and abnormalities were significantly increased (P-value < 0.001). Using multivariate logistic regression analysis, the risk of death is nine times more in gestational age below 37 weeks compared to gestational age over 37 weeks. The chances of neonatal mortality among neonates weighing less than 1000 grams are much more, and it is about 140 times more than normal weight (over 2500 grams). There was not a significant relationship between the chance of neonatal mortality and the implementation of HSEP (P-value > 0.05).
Conclusion: Neonates with abnormal weight and premature neonates had the highest chance of death. Therefore, the prevention of preterm labor and low-birth-weight infants are essential factors in reducing neonatal mortality. This study suggests that improved health service quality is determinative to decrease neonatal mortality rate.
due to the severe problems which might happen during this period. The goal of this study was to compare the risk factors associated with the neonatal mortality rate (NMR) before and after the implementation of the health sector evolution plan (HSEP) in Fars Province, Iran.
Methods: This study was a retrospective cross-sectional study. This research was conducted using the census method, and 275951 newborns’ files were studied. Variables are expressed as percentage and frequency. The chi-square test and Fisher tests was used to measure the significance level of variables. A multivariate logistic regression model was also used to estimate the odds ratio of neonatal mortality and risk factors associated with neonatal mortality. All statistical tests were performed bilaterally with P-value < 0.05 considered as significant. All tests were conducted using the software SPSS19.
Results: After HSEP, risk factors of pregnancy and delivery complications were significantly reduced, and abnormalities were significantly increased (P-value < 0.001). Using multivariate logistic regression analysis, the risk of death is nine times more in gestational age below 37 weeks compared to gestational age over 37 weeks. The chances of neonatal mortality among neonates weighing less than 1000 grams are much more, and it is about 140 times more than normal weight (over 2500 grams). There was not a significant relationship between the chance of neonatal mortality and the implementation of HSEP (P-value > 0.05).
Conclusion: Neonates with abnormal weight and premature neonates had the highest chance of death. Therefore, the prevention of preterm labor and low-birth-weight infants are essential factors in reducing neonatal mortality. This study suggests that improved health service quality is determinative to decrease neonatal mortality rate.
Type of Study: Original article |
Subject:
Healt care Management
Received: 2020/09/1 | Accepted: 2021/03/10 | Published: 2021/03/10
Received: 2020/09/1 | Accepted: 2021/03/10 | Published: 2021/03/10
References
1. Pathirana J, Munoz FM, Abbing-Karahagopian V, Bhat N, Harris T, Kapoor A, et al. Neonatal death: Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine. 2016; 34(49): 6027-37. [DOI:10.1016/j.vaccine.2016.03.040]
2. Kagitapu S, Alapati M, Baira S. A Study of Causes And Rate of Neonatal Mortality in A Teritiary Care Teaching Hospital. IOSR Journal of Dental and Medical Sciences. 2016; 15: 23-31. doi:10.9790/0853-1510022331. [DOI:10.9790/0853-1510022331]
3. Balaghafari A, Siamian H, Aligolbandi K. Ocular trauma: 2 years retrospective study in Sari, Iran. Materia Socio-Medica. 2013; 25: 230-2. doi: 10.5455/msm.2013.25.230-232. [DOI:10.5455/msm.2013.25.230-232]
4. Sankaran K, Chien L-Y, Walker R, Seshia M, Ohlsson A, Lee SK. Variations in mortality rates among Canadian neonatal intensive care units. Cmaj. 2002; 166(2): 173-8.
5. Sankar M, Neogi S, Sharma J, Chauhan M, Srivastava R, Prabhakar P, et al. State of newborn health in India. Journal of Perinatology. 2016; 36(3): 3-8. [DOI:10.1038/jp.2016.183]
6. Babaei H, Dehghan M. Study of Causes of Neonatal Mortality and its Related Factors in the Neonatal Intensive Care Unit of Imam Reza Hospital in Kermanshah, Iran during (2014-2016). International Journal of Pediatrics. 2018; 6: 7641-9.
7. Word health organization. The neonatal period is the most vulnerable time for a child [Online]. 2019. Available from URL: https://data. unicef. org/ topic/ child-survival/ neonatal-mortality- rate- (per- 1000- live- births). Last access: 12 June 2020.
8. Naghavi M, Abolhassani F, Pourmalek F, Lakeh MM, Jafari N, Vaseghi S, et al. The burden of disease and injury in Iran 2003. Population Health Metrics. 2009; 7(1): 9. [DOI:10.1186/1478-7954-7-9]
9. Edraki M, Paran M, Montaseri S, Nejad MR, Montaseri Z. Comparing the effects of swaddled and conventional bathing methods on body temperature and crying duration in premature infants: a randomized clinical trial. Journal of Caring Sciences. 2014; 3(2): 83. doi: 10.5681/jcs.2014.009.
10. Ahmadi S, Kazemi F, Masoumi SZ, Parsa P, Roshanaei G. Intervention based on BASNEF model increases exclusive breastfeeding in preterm infants in Iran: a randomized controlled trial. International Breastfeeding Journal. 2016; 11(1): 30. [DOI:10.1186/s13006-016-0089-2]
11. Chowdhury HR, Thompson S, Ali M, Alam N, Yunus M, Streatfield PK. Causes of neonatal deaths in a rural subdistrict of Bangladesh: implications for intervention. Journal of Health, Population, and Nutrition. 2010; 28(4): 375-82. doi: 10.3329/jhpn.v28i4.6044. [DOI:10.3329/jhpn.v28i4.6044]
12. Rezaeian A, Boskabadi H, Mazlom SR. Factors associated with perinatal mortality in preterm infants in NICU Ghaem Hospital, Mashhad. Journal of North Khorasan University of Medical Sciences. 2012; 4: 349-60. [In Persian] [DOI:10.29252/jnkums.4.3.349]
13. Moss W, Darmstadt GL, Marsh DR, Black RE, Santosham M. Research priorities for the reduction of perinatal and neonatal morbidity and mortality in developing country communities. Journal of Perinatology. 2002; 22(6): 484-95. [DOI:10.1038/sj.jp.7210743]
14. Oshvandi K, Soori E, Zamanian L. The rate and causes of neonatal mortality in Hamadan province, 2012. Avicenna J Nurs Midwifery Care. 2016; 24: 281-300. doi: 10.21859/nmj-24049. [DOI:10.21859/nmj-24049]
15. Aramesh MR, Malekian A, Dehdashtian M, Shahori A, Monjezi L. Determination of neonatal mortality causes among neonates admitted in NICU at Imam Khomeini Hospital, Ahwaz, 2011-2012. Razi Journal of Medical Sciences. 2014; 21(120): 36-43.
16. Mohaghighi P, Hashemzadeh Isfahani M, Mousavi Kani K. Determining the frequency of prenatal factors in infant mortality in Tehran during 2009-2010. Razi Journal of Medical Sciences. 2013; 19: 41-7.
17. Ghanbari A, Moaddab F, Heydarzade A, Jafaraghaee F, Barari F. Health system evolution plan; A new approach to health care delivery: The challenge ahead. Hakim Research Journal. 2017; 20(1): 1-8.
18. Arab-zozani M, Husseini barghazan S. Health Sector Evolution in Iran; A Short Review. Evidence Based Health Policy, Management and Economics. 2017; 1(3): 193-7.
19. Kakemam E, Dargahi H. The health sector evolution plan and the technical efficiency of public hospitals in Iran. Iranian Journal of Public Health. 2019; 48(9): 1681.
20. Nayeri F, Amini E, Yazdi ZO, Naieri AD. Evaluation of the cause and predisposing factors in neonatal mortality by using international coding diseases version 10 in Valiasr Hospital. Iranian Journal of Pediatrics. 2007; 17(1): 21-6.
21. Sareshtedari M, Shahamat H, Sadeghi T. Causes and Related Factors of Neonatal Mortality in Qazvin NICU, 2010. Hakim Health Systems Research Journal. 2012; 14: 227-32.
22. Sabzehei MK, Basiri B, Shokouhi M, Eghbalian F, Eslamian MH. Causes and risk factors associated to neonatal mortality in Neonatal Intensive Care Unit (NICU) in Besat Hospital Hamadan-Iran in 2015 to 2016. International Journal of Pediatrics. 2018; 6(9): 8185-94.
23. Gharavi AK, Shoraka H, Sofizadeh A, Katuli HE. Neonatal mortality risk factors in Maraveh Tapeh County in Golestan province, north of Iran (2011-13). Journal of Gorgan University of Medical Sciences. 2016; 18(1): 86-93. [In Persian]
24. Alijani Ranani H, Madhoshi S, Moghimzadeh F. Evaluation of the cause and predisposing factors in neonatal mortality based on international coding disease version10 in Aboozar Hospital of Ahvaz. Yafte. 2017; 19(1): 124-33. [In Persian]
25. Kujala S, Waiswa P, Kadobera D, Akuze J, Pariyo G, Hanson C. Trends and risk factors of stillbirths and neonatal deaths in Eastern Uganda (1982-2011): a cross‐sectional, population‐based study. Tropical Medicine & International Health. 2017; 22(1): 63-73. [DOI:10.1111/tmi.12807]
26. Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN. Determinants of neonatal mortality in Nigeria: evidence from the 2008 demographic and health survey. BMC Public Health. 2014; 14(1): 521-31. doi: 10.1186/1471-2458-14-521. [DOI:10.1186/1471-2458-14-521]
27. Selemani M, Mwanyangala MA, Mrema S, Shamte A, Kajungu D, Mkopi A, et al. The effect of mother's age and other related factors on neonatal survival associated with first and second birth in rural, Tanzania: evidence from Ifakara health and demographic surveillance system in rural Tanzania. BMC Pregnancy and Childbirth. 2014; 14: 240-9. doi: 10.1186/1471-2393-14-240. [DOI:10.1186/1471-2393-14-240]
28. Mirzarahimi M, Abedi A, Shahnazi F, Saadati H, Enteshari A. Causes and Rate of Mortality among the Newborns in NICU and Newborns Unit at Imam Khomeini and Alavi Hospitals in Ardabil from September 2006 to September 2007. J Ardabil Univ Med Sci. 2008; 8(4) :424-30.
29. Fallahi M, Joudaki N, Mohseni Bandpey H. Evaluation of Causes of Neonatal Mortality in Shohadaye Tajrish Hospital, during Years 2004-2007. Pajoohande. 2009; 14: 43-6.
30. Al-sadi Ek. Comparison study of causes and neonatal mortality rates of newborns admitted in neonatal intensive care unit of Al-Sadder Teaching Hospital in Al-Amara City, Iraq. International Journal of Pediatrics. 2017; 5: 4601-11.
31. Boskabadi H, Parvini Z, Barati T, Moudi A. Study of the causes and predisposing factors in neonatal mortality in Ghaem Hospital (March 2009 To May 2010). The Iranian Journal of Obstetrics, Gynecology and Infertility. 2012; 14(7): 6-14. [In Persian]
32. Subramanian S, Nandy S, Irving M, Gordon D, Lambert H, Davey Smith G. The mortality divide in India: the differential contributions of gender, caste, and standard of living across the life course. American Journal of Public Health. 2006; 96(5): 818-25. [DOI:10.2105/AJPH.2004.060103]
33. Molina G, Weiser TG, Lipsitz SR, Esquivel MM, Uribe-Leitz T, Azad T, et al. Relationship between cesarean delivery rate and maternal and neonatal mortality. Jama. 2015; 314(21): 2263-70. [DOI:10.1001/jama.2015.15553]
34. Signore C, Klebanoff M. Neonatal morbidity and mortality after elective cesarean delivery. Clinics in Perinatology. 2008; 35(2): 361-71. [DOI:10.1016/j.clp.2008.03.009]
35. Battin MR, Knight DB, Kuschel CA, Howie RN. Improvement in mortality of very low birthweight infants and the changing pattern of neonatal mortality: The 50‐year experience of one perinatal centre. Journal of Paediatrics and Child Health. 2012; 48(7): 596-9. [DOI:10.1111/j.1440-1754.2012.02425.x]
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