Perinatal and Neonatal Mortality Rates

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3.7.1 Perinatal and Neonatal Mortality Rates

These are important indicators of both obstetric and neonatal outcomes. The births are obtained by records of all births in the hospitals of each neonatal unit and the mortality rates are calculated pertaining to that for inborn babies only. Perinatal mortality rate = No stillbirths + neonatal deaths 7 days BW 500gm and above or gestation 22 weeks and above x 1000 TBs No total births TBs Early Neonatal mortality rate No neonatal deaths 7 days BW 500gm and above or gestation 22 weeks and above x 1000 LBs No live births LBs Neonatal mortality rate No neonatal deaths 28 days BW 500gm and above or gestation 22 weeks and above x 1000 LBs No live births LBs Fig 14 shows the number of total births and neonatal deaths in all the centres in the study. The perinatal, early neonatal and neonatal mortality rates were calculated to be 14.3 per 1000 TBs, 4.8 and 6.2 per 1000 LBs respectively . Fig. 15. Total births and neonatal deaths and mortality rates, 2004 Total Births 196824 No Stillbirths 1884 No Live births 194940 Inborn deaths 7 days early neonatal deaths 934 Inborn deaths 28 days neonatal deaths 1209 Perinatal mortality rate 14.3 per 1000 TBs Early neonatal mortality rate 4.8 per 1000TBs Neonatal mortality rate 6.2 per 1000 LBs These rates are high when compared to the overall national figures which were 10.0, 3.9 and 4.9 respectively. Health Management and Information System HMIS Ministry of Health 2002 data. This is expected as these NICUs are tertiary centres handling high risk pregnancies and sick babies. 33 3.7.2 Discharge Babies are usually discharged straight home from the participating NICUs in the hospital. Some may have been discharged from a paediatric ward following extended care after NICU stay e.g. babies with prolonged oxygen requirement or rarely transferred elsewhere. The duration of hospital stay is dependent on many factors especially gestational age and birth weight and whether babies survived. Of all the babies 1726 who died 642 37.2 died within 24 hours. For those who died after the 1 st day mean duration of hospital stay were 15.0 +- 26.2 days. Of the survivors some stayed for 24 hours either discharged at own risk or had very mild illnesses. Of the other survivors the mean duration of hospital stay was 26.3 +- 25.0 days. Table 29 and Table 30 The duration of hospital stay for survivors decreased with increasing gestation and BWs. Fig 16. Fig 16. Mean duration of hospital stay for survivors who stayed beyond 24 hours according to gestational age and BW group, 2004 20 40 60 80 100 120 22 501 24 701 26 901 28 110 1 30 130 1 32 150 1 34 Stay in days Gestation in weeks BW groups in grams Foot note BW group 1501-2500g BW group 2501g and above 34

4. Tables