Perinatal, neonatal, infant and Childhood mortality Flashcards
define miscarriage
pregnancy loss less than 24 weeks
define still birth
baby born greater than 24/40 weeks showing no signs of life
define neonatal death
aby born alive but dies within the first 28 days of life
what are the two types of neonatal death and the weeks defining them
Early neonatal death 0-7 completed days
Late neonatal death 7-28 days
define infant foetal death
– all deaths in the first year of life
what is post neonatal infant death
deaths 28 days to 1 year
what are child deaths
- Deaths under 5 year (UN)
- Between 1 and 15 years (office on national stasticis)
What has seen an decrease in still birth, perinatal and early neonatal mortality
- improvements of obstetric care and neonatal care
what are useful markers of population health
o Maternal well-being during pregnancy
o Conditions in which babies are born.
What are useful markers of healthcare effectiveness
o Maternity services
o Neonatal Care
o Primary and secondary care
o Public health and social care
What is the difference in decrease between neonatal mortality and post neonatal mortality
Neonatal mortality has decreased relatively steadily,
Post neonatal mortality has decreased rapidly in the first half of the 20th century (due to decline in fatality from communicable diseases).
what factors that explain the International differences in child death
- Maternal health
- Nutrition both to the mother and child
- Access to healthcare services
- Income
- Family size – already a bigger family often there will be higher rates of under 5 morality
- Birthweight
- Prematurity
What does antepartum mean
occurring shortly before childbirth
what does intrapartum mean
- during the act of birth
What are the causes of stillbirth death
- Remaining antepartum deaths (unexplained) = 51.4%
- Asphyxia, anoxia or trauma (antepartum) = 22.5%
- Congenital anomalies (4.5%)
- Other specific conditions (5.8%) and other conditions (2.5%).
- Asphyxia, anoxia or trauma (intrapartum) (2.3%).
- Antepartum infections (0.8%).
What is the dentition of perinatal
relating to the time, usually a number of weeks, immediately before and after birth.
What are the causes of perinatal mortality
- Immaturity related conditions (58.5%) - (surfactant deficiency, periventricular haemorrhage, necrotising enterocolitis, infection)
- Congenital anomalies (26.1%)(congenital heart disease, chromosomal, neural tube, diaphragmatic hernia)
- Asphyxia, anoxia or trauma (10.2%)
- Antepartum infections (1.9%)
- Infections (0.9%). (congenital, intrapartum and acquired)
What are the causes of neonatal mortality
- Immaturity related conditions (55%)
- Congenital anomalies (28.8%)
- Asphyxia, anoxia or trauma (9.1%)
- Antepartum infection (2.3%)
- Infections (1.3%)
- Sudden infant deaths (0.8%)
What are the causes of post-neonatal mortality
- Congenital anomalies (28.9%)
- Other conditions (21.9%)
- Immaturity related conditions (15.0%).
- Sudden infant deaths (13.7%)
- Infections (11.9%)
- External conditions (3.1%)
- Other specific conditions (3.0%)
- Asphyxia, anoxia or trauma (2.0%)
- Antepartum infections (0.3%).
What are the causes of child morality
- Neoplasms/cancers (21%)
- Diseases of the Nervous System (14.2%)
- External causes of morbidity and mortality (14.2%)
- Diseases of the respiratory system (11.1%).
- Congenital malformation, deformation and chromosomal abnormalities (9.6%).
overall what are the 4 main causes of death for children under 5 years
- Preterm birth complications
- Pneumonia.
- Intrapartum related events.
- Diarrhea.
What is the major association with perinatal deaths
- rates of perinatal death are higher in babies that are born small = Just over half of all infant deaths of babies were born under 32 weeks.
- social class can also influence events as well as jobs
- maternal ethnicity - children born to mothers in India, Pakistan and Bangladesh origin have a higher rate of death
- Maternal parity - lowest morality rates is during the 2nd pregnancy when there are more than 3 pregnancies then they have a higher rate of still births and neonatal deaths
What are the modifiable factors that can contribute to death
= Maternal health, access to maternity care and uteroplacental function all link to still brith outcome
= uteroplacental function, perinatal function, neonatal recussiation and effective neonatal care can prevent early neonatal death
= effective neonatal care and postnatal infection can prevent late neonatal death
= postnatal infection and SIDS can lead to post-neonatal infant death
name health services that can prevent early death
- detecting placental dysfunction
- antenatal diagnosis
- good intrapartum care
- effective treatment of neonatal conditions
= surfactant for RDS
= antibiotics for GBS
= thermal care - prematurity - breast-feeding
- immunisation
name things that the pubic health and the government can do to reduce early death
- maternal education
- reducing teenage pregnancy
- reduce maternal smoking
- promote breast-feeding
- safe sleeping position
- reduce child poverty
- improve housing
How do you reduce chance of pneumonia
- Breastfeeding promotion
* Hemophilus influenzae type b and pneumococcal vaccines
how do you reduce chance of diarrhoea
- Improved water and sanitation
- Rotavirus vaccine
- Zinc supplementation
- Oral rehydration solution
- Community case management
How do you reduce chance of malaria
- Insecticide treated bed, nets
- Intermittent preventive treatment in pregnancy
- Artemisinin based combination therapy
How do you reduce chance of neonatal death
Improved labour and delivery management
How do you improve preterm birth outcomes
- Antenatal steroids
* Kangaroo care
How do you reduce intrapartum deaths
- Neonatal resuscitation
* Comprehensive emergency obstetric care
What is SUDI
Sudden unexpected death in infancy
What has caused a drop in SUDI
= back to sleep campaign
- make sure that babies sleep on their back and not on their front in the first few months of life
