الفهرس 
NEONATAL MORTALITYOnly 14 pages are availabe for public view
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Abstract
Neonatal period is defined as up to first 28 days of life and further divided into very early (birth to <24 h), early (birth to <7 days), and late neonatal period (7 days to <28 days). Neonatal deaths may be subdivided into early neonatal deaths, occurring during the first seven days of life and late neonatal deaths, occurring after the seventh day but before the 28th day of life. Neonatal period is the most vulnerable period of life as it accounts for very high morbidities and mortalities due to different diseases, especially in preterm and low birth weight babies. These diseases are preventable in majority of cases. In a report published in Lancet, major direct cause of neonatal mortality were preterm birth (27%), infection(26%), asphyxia (23%), congenital anomaly (7%), others (7%), tetanus (7%) and diarrhea (3%).Since causes of neonatal death vary by country and with the availability and quality of health care, understanding neonatal mortality in relation to these factors is crucial. Neonatal mortality rates reflect a nation’s socioeconomic status, as well as the efficiency and effectiveness of their healthcare services. These important indicators are useful in planning for improved healthcare delivery. Neonatal morbidity and mortality pose a serious challenge in developing countries. The reasons are multi-factorial, including poverty; poor health status of women; lack of information regarding the availability of health services providers; lack of control on household resources and decision-making authority; poor antenatal and obstetric care both within the community and health facilities; absence of a trained attendant at delivery; inadequate referral system for emergency obstetric care; inadequacy/absence of transportation facilities; and absence of poor linkages of health centers with the communities. Neonatal mortality is taken as one of the most important determinants of children health status. The causes of neonatal mortality are complex and improvement of this health indicator is relatively gradual. According to WHO estimations, 130 million infants are born each year worldwide, 4 million die in the first 28 days of life. Three-quarters of neonatal deaths occur in the first week, and more than one-quarter occur in the first 24 hours. More than one million babies in Africa die in the first week of their life, half of them at the first day of life. It was reported that the most unseen and uncounted deaths occur at home. Neonatal deaths account for 40% of deaths under the age of 5 years worldwide. Epidemiological research is needed to make available more accurate data on risk factors and causes of neonatal mortality.So assessment of neonatal mortality can generate useful data for establishing targeted interventions to address these problem. The aim of this work was to assess risk factors for neonatal mortality in NICUs in Tanta city and estimate incidence risk of neonatal mortality in NICUs in Tanta city. This study was prospective Cohort study which done in neonatal intensive care units in Tanta city which is (5 public centers and 10 private centers). The duration was 6 months from August 2017 to January 2018. All the neonates who were admitted to participated NICUs in Tanta city. All neonates were followed up till their death or discharge. Collection of data: Data were obtained from: Review or maternal records, it included( Maternal age, Level of education, occupation of the parents, marital status, urban/rural residence, address , consanguinity ,medical history, history of antenatal care routine, parity, health status of the other siblings and family history). Review of neonatal records: any childbirth complications, Newborn care (neonatal resuscitation), vital signs, neonatal parameters , neonatal sex, place, mode of delivery and gestational age ,neonatal complications , presence of congenital anomalies, Initial diagnosis , any investigation done during incubation ,any operation or procedure done during incubation. This study showed that: Incidence risk of neonatal mortality among the studied sample during a period of 6 months was 27.7%. The most common cause of neonatal deaths among the study group was prematurity (39.4%). There was no statistically significant difference between survived and died neonates in relation to sex. Positive consanguinity was found in (52%) and had statistical significance on neonatal mortality. Mean value of gestational age was statistically significant lower among died than survived cases. Mean value of birth weight was statistically significant lower among died than survived cases. CS was among highest maternal risk factors (64.3%) among the study sample.