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  • Title: Rates of perinatal mortality and low birth weight among 3367 consecutive births in south of Beirut.
    Author: Bittar Z.
    Journal: J Med Liban; 1998; 46(3):126-30. PubMed ID: 10095842.
    Abstract:
    3367 consecutive births were reviewed prospectively. Population belongs mainly to a community with relatively underprivileged living conditions. Perinatal mortality was found at a rate of 22.4/1000 B. Early neonatal mortality formed 6.66/1000 B and stillbirth formed 15.83/1000 B. Low birth weight rate was 5.43% of live birth. Analysis of our findings suggests the need to improve follow-up during gestation to avoid complications resulting in macerated stillbirths, and to review the routine of follow-up and care in the immediate period before delivery, during delivery, in the immediate post partum period including resuscitation procedures, and care in the ICN. The aim is to prevent and appropriately treat intrauterine asphyxia, fetal distress, obstetric complications, and in the post partum period to appropriately resuscitate the newborn and improve ICN procedures. These measures are expected to reduce fresh stillbirth and early neonatal mortality and consequently infant mortality. Lowering rate of low birth weight is of less urgent nature in this population as it is relatively not high, but because a larger portion of early neonatal mortality is among low birth weight infants, with weights below 2000 gms, improving ICN care provided to these neonates is expected to sharply reduce neonatal mortality. In Lebanon we have a growing number of ICN units with wide variability of the quality of medical supervision and facilities. Insufficient number of neonatologists and nurses who are specialized in neonatal intensive care is leaving the chance for sick neonates to be attended by general pediatricians and insufficiently trained nurses. Our medical schools are called to encourage pediatricians to specialize in neonatal intensive care and to create more opportunities for this specialty to meet the national requirement. It is suggested, too, to subject ICN units in Lebanon to standardized requirements concerning attendance and facilities before obtaining official recognition. Centralization of care given to severely sick neonates and to women with high risk pregnancy in optimal conditions is most needed. Infant mortality (IM) is an important indicator of health status and of the socioeconomic condition of a particular community. In addition, IM is also a sensitive indicator of the availability, utilization and effectiveness of health care, particularly perinatal care. This study was undertaken to determine the rates of perinatal mortality (PM) and low birth weight (LBW) among 3367 consecutive births delivered during 1992-94 in south Beirut. Population belongs mainly to a community with relatively underprivileged living conditions caused by overcrowding, pollution, and diminished water supply. The PM rate was 22.4/1000 births; the early neonatal mortality (ENM) rate, 6.66/1000 births; the stillbirth (SB) rate, 15.83/1000 births; and the LBW rate, 5.43% of live births. Analysis of the findings concerning ENM revealed that a larger portion of deaths was among LBW infants who have a BW in the range of 1000-2000 g. Moreover, high PM revealed a larger portion of SBs occurring close to the time of delivery, while the smaller portion consisted of macerated SBs, indicating earlier death during gestation. Therefore, improvement of antenatal, intrapartum and neonatal care, especially following birth could reduce PM and ENM among infants with LBW.
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