Document Detail


Deaths associated with intrapartum asphyxia in Jamaica.
MedLine Citation:
PMID:  8072895     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The Jamaican Perinatal Mortality Survey compared all 2069 perinatal deaths occurring during the 12 months between 1 September 1986 and 31 August 1987 with 10,086 survivors born in the 2 months of September and October 1986. The Wigglesworth classification identified 44% of the deaths as attributable to intrapartum asphyxia (IPA), and this grouping was largely confirmed by post-mortem examination where it had been carried out. About half of these babies weighted 2500 g+ and death should have been largely preventable. Comparison of the 813 IPA singleton deaths with 9919 singleton survivors using logistic regression showed independent associations with maternal employment status, the number of children in the household, maternal height, whether or not the mother was trying to get pregnant, or had ever used an intrauterine contraceptive device. Medical conditions such as syphilis, untreated vaginal infection, bleeding < 28 weeks, bleeding 28+ weeks, highest diastolic and first diastolic blood pressures and eclamptic fits antenatally were all strongly associated. Mothers who commenced antenatal care in the first trimester were at reduced risk as were those who took iron during pregnancy. There were substantial reductions in mortality in areas where better medical facilities were available. To this model, features of previous obstetric history were offered, but the only variables which entered were those relating to prior perinatal deaths and immediately preceding miscarriage and termination. Examination of specific features in the management of labour and delivery is a logical basis for the introduction of changes in practice. Caesarean section is unlikely to be appropriate but it is suggested that more active interventions in terms of use of forceps and/or vacuum extraction may be useful.
Authors:
C Escoffery; R Greenwood; D Ashley; K Coard; J Keeling; J Golding
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Paediatric and perinatal epidemiology     Volume:  8 Suppl 1     ISSN:  0269-5022     ISO Abbreviation:  Paediatr Perinat Epidemiol     Publication Date:  1994 Apr 
Date Detail:
Created Date:  1994-09-29     Completed Date:  1994-09-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8709766     Medline TA:  Paediatr Perinat Epidemiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  119-42     Citation Subset:  IM    
Affiliation:
University of the West Indies.
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MeSH Terms
Descriptor/Qualifier:
Asphyxia Neonatorum / epidemiology,  mortality*
Cohort Studies
Delivery, Obstetric
Female
Health Services Accessibility
Humans
Infant, Newborn
Jamaica / epidemiology
Labor Presentation
Labor, Obstetric
Male
Obstetric Labor Complications
Pregnancy
Risk Factors
Survival Analysis
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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