Causes of community stillbirths and early neonatal deaths in low-income countries using verbal autopsy: An International, Multicenter Study

C. Engmann, A. Garces, I. Jehan, J. Ditekemena, M. Phiri, M. Mazariegos, E. Chomba, Omrana Pasha, A. Tshefu, E. M. McClure, V. Thorsten, H. Chakraborty, R. L. Goldenberg, C. Bose, W. A. Carlo, L. L. Wright

Research output: Contribution to journalArticle

Abstract

Objective:Six million stillbirths (SB) and early neonatal deaths (END) occur annually worldwide, mostly in rural settings distant from health facilities. We used verbal autopsy (VA), to understand causes of non-hospital, community-based SB and END from four low-income countries.Study Design:This prospective observational study utilized the train-the-trainer method. VA interviewers conducted standardized interviews; in each country data were reviewed by two local physicians who assigned an underlying causes of deaths (COD).Result:There were 252 perinatal deaths (118 END; 134 SB) studied from pooled data. Almost half (45%) the END occurred on postnatal day 1, 19% on the second day and 16% the third day. Major early neonatal COD were infections (49%), birth asphyxia (26%), prematurity (17%) and congenital malformations (3%). Major causes of SB were infection (37%), prolonged labor (11%), antepartum hemorrhage (10%), preterm delivery (7%), cord complications (6%) and accidents (5%).Conclusion:Many of these SB and END were from easily preventable causes. Over 80% of END occurred during the first 3 days of postnatal life, and 90% were due to infection, birth asphyxia and prematurity. The causes of SB were more varied, and maternal infections were the most common cause. Increased attention should be targeting at interventions that reduce maternal and neonatal infections and prevent END, particularly during the first 3 days of life.

Original languageEnglish (US)
Pages (from-to)585-592
Number of pages8
JournalJournal of Perinatology
Volume32
Issue number8
DOIs
StatePublished - Aug 2012
Externally publishedYes

Fingerprint

Stillbirth
Multicenter Studies
Autopsy
Infection
Asphyxia
Cause of Death
Mothers
Parturition
Interviews
Perinatal Death
Health Facilities
Accidents
Observational Studies
Prospective Studies
Hemorrhage
Physicians

Keywords

  • cause of death
  • early neonatal death
  • perinatal death
  • stillbirth
  • verbal autopsy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Causes of community stillbirths and early neonatal deaths in low-income countries using verbal autopsy : An International, Multicenter Study. / Engmann, C.; Garces, A.; Jehan, I.; Ditekemena, J.; Phiri, M.; Mazariegos, M.; Chomba, E.; Pasha, Omrana; Tshefu, A.; McClure, E. M.; Thorsten, V.; Chakraborty, H.; Goldenberg, R. L.; Bose, C.; Carlo, W. A.; Wright, L. L.

In: Journal of Perinatology, Vol. 32, No. 8, 08.2012, p. 585-592.

Research output: Contribution to journalArticle

Engmann, C, Garces, A, Jehan, I, Ditekemena, J, Phiri, M, Mazariegos, M, Chomba, E, Pasha, O, Tshefu, A, McClure, EM, Thorsten, V, Chakraborty, H, Goldenberg, RL, Bose, C, Carlo, WA & Wright, LL 2012, 'Causes of community stillbirths and early neonatal deaths in low-income countries using verbal autopsy: An International, Multicenter Study', Journal of Perinatology, vol. 32, no. 8, pp. 585-592. https://doi.org/10.1038/jp.2011.154
Engmann, C. ; Garces, A. ; Jehan, I. ; Ditekemena, J. ; Phiri, M. ; Mazariegos, M. ; Chomba, E. ; Pasha, Omrana ; Tshefu, A. ; McClure, E. M. ; Thorsten, V. ; Chakraborty, H. ; Goldenberg, R. L. ; Bose, C. ; Carlo, W. A. ; Wright, L. L. / Causes of community stillbirths and early neonatal deaths in low-income countries using verbal autopsy : An International, Multicenter Study. In: Journal of Perinatology. 2012 ; Vol. 32, No. 8. pp. 585-592.
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abstract = "Objective:Six million stillbirths (SB) and early neonatal deaths (END) occur annually worldwide, mostly in rural settings distant from health facilities. We used verbal autopsy (VA), to understand causes of non-hospital, community-based SB and END from four low-income countries.Study Design:This prospective observational study utilized the train-the-trainer method. VA interviewers conducted standardized interviews; in each country data were reviewed by two local physicians who assigned an underlying causes of deaths (COD).Result:There were 252 perinatal deaths (118 END; 134 SB) studied from pooled data. Almost half (45{\%}) the END occurred on postnatal day 1, 19{\%} on the second day and 16{\%} the third day. Major early neonatal COD were infections (49{\%}), birth asphyxia (26{\%}), prematurity (17{\%}) and congenital malformations (3{\%}). Major causes of SB were infection (37{\%}), prolonged labor (11{\%}), antepartum hemorrhage (10{\%}), preterm delivery (7{\%}), cord complications (6{\%}) and accidents (5{\%}).Conclusion:Many of these SB and END were from easily preventable causes. Over 80{\%} of END occurred during the first 3 days of postnatal life, and 90{\%} were due to infection, birth asphyxia and prematurity. The causes of SB were more varied, and maternal infections were the most common cause. Increased attention should be targeting at interventions that reduce maternal and neonatal infections and prevent END, particularly during the first 3 days of life.",
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AU - Engmann, C.

AU - Garces, A.

AU - Jehan, I.

AU - Ditekemena, J.

AU - Phiri, M.

AU - Mazariegos, M.

AU - Chomba, E.

AU - Pasha, Omrana

AU - Tshefu, A.

AU - McClure, E. M.

AU - Thorsten, V.

AU - Chakraborty, H.

AU - Goldenberg, R. L.

AU - Bose, C.

AU - Carlo, W. A.

AU - Wright, L. L.

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N2 - Objective:Six million stillbirths (SB) and early neonatal deaths (END) occur annually worldwide, mostly in rural settings distant from health facilities. We used verbal autopsy (VA), to understand causes of non-hospital, community-based SB and END from four low-income countries.Study Design:This prospective observational study utilized the train-the-trainer method. VA interviewers conducted standardized interviews; in each country data were reviewed by two local physicians who assigned an underlying causes of deaths (COD).Result:There were 252 perinatal deaths (118 END; 134 SB) studied from pooled data. Almost half (45%) the END occurred on postnatal day 1, 19% on the second day and 16% the third day. Major early neonatal COD were infections (49%), birth asphyxia (26%), prematurity (17%) and congenital malformations (3%). Major causes of SB were infection (37%), prolonged labor (11%), antepartum hemorrhage (10%), preterm delivery (7%), cord complications (6%) and accidents (5%).Conclusion:Many of these SB and END were from easily preventable causes. Over 80% of END occurred during the first 3 days of postnatal life, and 90% were due to infection, birth asphyxia and prematurity. The causes of SB were more varied, and maternal infections were the most common cause. Increased attention should be targeting at interventions that reduce maternal and neonatal infections and prevent END, particularly during the first 3 days of life.

AB - Objective:Six million stillbirths (SB) and early neonatal deaths (END) occur annually worldwide, mostly in rural settings distant from health facilities. We used verbal autopsy (VA), to understand causes of non-hospital, community-based SB and END from four low-income countries.Study Design:This prospective observational study utilized the train-the-trainer method. VA interviewers conducted standardized interviews; in each country data were reviewed by two local physicians who assigned an underlying causes of deaths (COD).Result:There were 252 perinatal deaths (118 END; 134 SB) studied from pooled data. Almost half (45%) the END occurred on postnatal day 1, 19% on the second day and 16% the third day. Major early neonatal COD were infections (49%), birth asphyxia (26%), prematurity (17%) and congenital malformations (3%). Major causes of SB were infection (37%), prolonged labor (11%), antepartum hemorrhage (10%), preterm delivery (7%), cord complications (6%) and accidents (5%).Conclusion:Many of these SB and END were from easily preventable causes. Over 80% of END occurred during the first 3 days of postnatal life, and 90% were due to infection, birth asphyxia and prematurity. The causes of SB were more varied, and maternal infections were the most common cause. Increased attention should be targeting at interventions that reduce maternal and neonatal infections and prevent END, particularly during the first 3 days of life.

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