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Causes of perinatal death at a Saudi maternity hospital.

https://arctichealth.org/en/permalink/ahliterature60080
Source
Acta Paediatr Scand Suppl. 1988;346:70-9
Publication Type
Article
Date
1988
Author
F. Serenius
A R Swailem
A W Edressee
A. Ohlsson
Author Affiliation
Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Source
Acta Paediatr Scand Suppl. 1988;346:70-9
Date
1988
Language
English
Publication Type
Article
Keywords
Adult
Demography
Female
Humans
Infant mortality
Obstetrics and Gynecology Department, Hospital
Pregnancy
Pregnancy Complications
Saudi Arabia
Socioeconomic Factors
Abstract
The time, cause and avoidability of perinatal deaths were analyzed in infants who were delivered in the main Maternity hospital in Riyadh and who represented a large proportion of all births in the city. The crude perinatal mortality rate was 39.8 per 1000 births. Of all deaths 53 percent occurred either intrapartum or within 24 hours of birth. The mortality rate in this time period was 9 times higher, and the intrapartum mortality rate 16 times higher than the corresponding Swedish rates. The causes of death were classified according to Wigglesworth. Of all deaths, 37 percent were due to asphyxial conditions in labor, 32 percent to conditions associated with preterm birth, and 17 percent to malformations. The perinatal mortality rates caused by asphyxia, preterm birth and malformations were 14.7, 12.6 and 6.7 per 1000 births, respectively. 75 percent of infants who died from asphyxia were born at term, and nearly half of the preterm deaths were associated with severe asphyxia at birth. Avoidable factors were found in 74 percent of the deaths. The high rate of asphyxia indicated deficiences in the obstetric management and a high priority should be given to the strengthening of the obstetric service.
PubMed ID
3227851 View in PubMed
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Cause-specific stillbirth and neonatal death in Sweden: a catchment area-based analysis.

https://arctichealth.org/en/permalink/ahliterature58581
Source
Acta Paediatr. 2001 Sep;90(9):1054-61
Publication Type
Article
Date
Sep-2001
Author
F. Serenius
I. Winbo
G. Dahiquist
B. Källén
Author Affiliation
Department of Paediatrics, Umeå University, Sweden.
Source
Acta Paediatr. 2001 Sep;90(9):1054-61
Date
Sep-2001
Language
English
Publication Type
Article
Keywords
Cause of Death
Female
Fetal Death - epidemiology - etiology
Gestational Age
Humans
Infant mortality
Infant, Newborn
Male
Mortality
Pregnancy
Quality of Health Care
Sweden - epidemiology
Abstract
A register-based study of the impact of obstetric and neonatal care on stillbirth and neonatal death rate was performed on all births in Sweden in 1983-1995. Each birth was assigned to a primary delivery hospital where the mother with a term singleton pregnancy was most likely to have been delivered (not possible for 25% of the deliveries), and the catchment areas of each hospital were classified according to the level of care of that hospital. Only small differences in total mortality existed between the different levels of care of the primary hospital: areas served by primary hospitals with obstetric service and resources for neonatal intensive care including continuous positive airway pressure but without facilities for ventilator treatment for prolonged periods showed a 7% excess risk of stillbirth or neonatal death. Conclusion: In areas with the lowest level of care of the primary delivery hospitals (with no or only basic neonatal care) the total mortality was not increased, indicating that the referral system works well. When the analysis was repeated for specific causes of death, more marked differences were noted, especially for death due to obstetric complications where the death risk increased with decreasing level of care of the primary delivery hospital. Even though no marked differences in total mortality were seen, a further reduction can be obtained by increasing referral for some specific conditions.
PubMed ID
11683195 View in PubMed
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Extremely preterm cesarean delivery: a clinical study.

https://arctichealth.org/en/permalink/ahliterature165432
Source
Acta Obstet Gynecol Scand. 2006;85(12):1442-7
Publication Type
Article
Date
2006
Author
U. Högberg
S. Håkansson
F. Serenius
P A Holmgren
Author Affiliation
Obstetrics and Gynecology, Umeå University, Umeå, Sweden. ulf.hogberg@obgyn.umu.se
Source
Acta Obstet Gynecol Scand. 2006;85(12):1442-7
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Asphyxia Neonatorum - epidemiology
Cesarean Section - methods - statistics & numerical data
Female
Gestational Age
Humans
Infant mortality
Infant, Newborn
Infant, newborn, diseases - epidemiology
Infant, Premature - growth & development
Perinatal care
Perioperative Care
Postoperative Complications - epidemiology
Pregnancy
Pregnancy Complications - surgery
Pregnancy outcome
Abstract
To describe indications for cesarean section for extremely preterm delivery, peri- and postoperative complications and perinatal outcome.
A case-referent study with clinical follow-up.
A tertiary perinatal center.
All deliveries at gestational age
PubMed ID
17260219 View in PubMed
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Maternal risk factors for cause-specific stillbirth and neonatal death.

https://arctichealth.org/en/permalink/ahliterature58674
Source
Acta Obstet Gynecol Scand. 2001 Mar;80(3):235-44
Publication Type
Article
Date
Mar-2001
Author
I. Winbo
F. Serenius
G. Dahlquist
B. Källén
Author Affiliation
Department of Paediatrics, Umeå University, Sweden.
Source
Acta Obstet Gynecol Scand. 2001 Mar;80(3):235-44
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Adult
Cause of Death
Educational Status
Female
Fetal Death - epidemiology - etiology
Humans
Infant mortality
Infant, Newborn
Infant, Small for Gestational Age
Maternal Age
Middle Aged
Obstetric Labor Complications - epidemiology - etiology
Odds Ratio
Parity
Pregnancy
Risk factors
Smoking
Socioeconomic Factors
Sweden - epidemiology
Abstract
BACKGROUND: To study specific effects of four maternal risk factors: age, parity, educational level, smoking, for specific causes of stillbirth and neonatal death according to a previously described hierarchic classification. METHODS: The study is based on 9,785 stillbirths or neonatal deaths among infants born in Sweden, 1983-1995 (n=1,412,754) and identified with various Swedish health registers. Statistical analysis is performed using Mantel-Haenszel analysis. RESULTS: Some risk factors, known from the literature, were confirmed and could be quantified. In addition, high parity was shown to increase the risk for death associated with multiple births (OR=2.49, 95% CI 2.07-3.01) and low educational level seems to be protective for such death (OR=0.75, 95% CI 0.60-0.93). If the infant is SGA, the risk for death is higher at high than at low parity (1.70, 95% CI 1.19-2.43, and 1.0, 95% CI 1.06-1.15, respectively). Maternal smoking seems to aggravate the placental abruption because the death risk in the presence of abruption increases when the mother smoked (OR = 1.74, 95% CI 45-2.08). CONCLUSIONS: The study shows that the groups of the classification system used (NICE) differ in their association with known risk factors for stillbirth and neonatal deaths and an analysis based on specific causes of death can therefore unravel risk factors hidden when total mortality is used. The computerized method of classification and the cause-of-death classification developed by us is clearly useful for such analyses which requires large materials.
PubMed ID
11207489 View in PubMed
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Neurosensory outcome and growth at three years in extremely low birthweight infants: follow-up results from the Swedish national prospective study.

https://arctichealth.org/en/permalink/ahliterature33592
Source
Acta Paediatr. 1998 Oct;87(10):1055-60
Publication Type
Article
Date
Oct-1998
Author
O. Finnström
P. Otterblad Olausson
G. Sedin
F. Serenius
N. Svenningsen
K. Thiringer
R. Tunell
G. Wesström
Author Affiliation
Department of Paediatrics, University Hospitals of Linköping, Sweden.
Source
Acta Paediatr. 1998 Oct;87(10):1055-60
Date
Oct-1998
Language
English
Publication Type
Article
Keywords
Birth weight
Central Nervous System Diseases - etiology
Cerebral Hemorrhage - complications
Cerebral Palsy - etiology
Developmental Disabilities
Follow-Up Studies
Gestational Age
Humans
Infant, Newborn
Infant, Very Low Birth Weight - growth & development
Prospective Studies
Sweden
Abstract
A prospective national investigation comprising 633 extremely low birthweight (ELBW) infants born alive in the 2-y period 1990-1992 with a birthweight of or = 23 completed weeks was conducted regarding neurosensory outcome and growth. Three-hundred and sixty-two (98%) surviving ELBW infants were assessed at a median age of 36 months, using a specially designed protocol. At follow-up, mean height, weight and head circumference in both boys and girls were significantly lower than the reference values. The incidence of cerebral palsy was 7% among all children and 14%, 10% and 3% in children born at 23-24, 25-26 and > or = 27 gestational weeks, respectively. At least one obvious handicap was present in 14%, 9% and 3% of these three groups of children, respectively. After adjustment for gestational age, a significantly increased risk of handicap was found in children with intraventricular haemorrhage grade > or = 3 and/or periventricular leucomalacia and in children with retinopathy of prematurity stage > or = 3. The results show that more than 90% of ELBW children born at > or = 25 completed gestational weeks were without neurosensory handicap at 36 months of corrected age. In infants born at 23-24 weeks of gestation, both survival and long-term outcome were less favourable.
PubMed ID
9825972 View in PubMed
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Regional differences in stillbirth and neonatal death rate in Sweden with a cause-of-death specific analysis.

https://arctichealth.org/en/permalink/ahliterature58580
Source
Acta Paediatr. 2001 Sep;90(9):1062-7
Publication Type
Article
Date
Sep-2001
Author
F. Serenius
I. Winbo
G. Dahlquist
B. Källén
Author Affiliation
Department of Paediatrics, Umeå University, Sweden.
Source
Acta Paediatr. 2001 Sep;90(9):1062-7
Date
Sep-2001
Language
English
Publication Type
Article
Keywords
Cause of Death
Comparative Study
Female
Fetal Death - epidemiology - etiology
Gestational Age
Humans
Infant mortality
Infant, Newborn
Male
Mortality
Pregnancy
Registries
Risk factors
Sweden - epidemiology
Abstract
Regional differences in stillbirth and neonatal death rates in Sweden were studied and a cause-of-death analysis was done in the 4 counties (among 24) with an increased mortality. The study is based on a computerized evaluation of infant cause of death, using a slightly modified Wigglesworth classification and a hierarchical classification (NICE: Neonatal and Intrauterine death Classification according to Etiology). Differences between the identified counties with respect to specific causes of death were demonstrated. Conclusion: There are differences between Swedish counties with respect to the risk for stillbirth or neonatal death. The NICE cause-of-death classification can be used for the routine surveillance of stillbirths and neonatal deaths in a population and can help in pinpointing weak elements in antenatal, delivery and neonatal care.
PubMed ID
11683196 View in PubMed
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Short-term outcome after active perinatal management at 23-25 weeks of gestation. A study from two Swedish perinatal centres. Part 3: neonatal morbidity.

https://arctichealth.org/en/permalink/ahliterature58235
Source
Acta Paediatr. 2004 Aug;93(8):1090-7
Publication Type
Article
Date
Aug-2004
Author
F. Serenius
U. Ewald
A. Farooqi
P A Holmgren
S. Håkansson
G. Sedin
Author Affiliation
Department of Paediatrics, Umeå University, Umeå, Sweden. fredrik.serenius.us@vll.se
Source
Acta Paediatr. 2004 Aug;93(8):1090-7
Date
Aug-2004
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Female
Humans
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Intensive Care, Neonatal
Logistic Models
Male
Morbidity
Perinatal care
Pregnancy
Research Support, Non-U.S. Gov't
Retrospective Studies
Sweden - epidemiology
Abstract
AIM: To determine major neonatal morbidity in surviving infants born at 23-25 weeks, and to identify maternal and infant factors associated with major morbidity. METHODS: The medical records of 224 infants who were delivered at two tertiary care centres in 1992-1998 were reviewed retrospectively. At these centres, policies of active perinatal and neonatal management were universally applied. Of the 213 liveborn infants, 140 (66%) survived to discharge. Data were analysed by gestational age and considered in three time periods. Logistic regression models were used to identify factors associated with morbidity. RESULTS: Of the survivors, 6% had intraventricular haemorrhage grade > or = 3 (severe IVH) or periventricular leukomalacia (PVL), 15% retinopathy of prematurity > or = stage 3 (severe ROP) and 36% bronchopulmonary dysplasia (BPD). On logistic regression analysis, severe IVH or PVL was associated with duration of mechanical ventilation (odds ratio, OR: 1.53 per 1-wk increment in duration; 95% confidence interval, CI: 1.01-2.33). Severe ROP was associated with the presence of a patent ductus arteriosus (PDA) (OR: 3.31; 95% CI: 1.11-9.90) and birth in time period 3 versus time periods 1 and 2 combined (OR: 6.28; 95% CI: 2.10-18.74). BPD was associated with duration of mechanical ventilation (OR: 2.71 per 1-wk increment in duration; 95% CI: 1.76-4.18) and with the presence of any obstetric complication (OR: 2.67; 95% CI: 1.07-6.65). Gestational age and birthweight were not associated with major morbidity. Of all survivors, 81% were discharged home without severe IVH, PVL or severe ROP. CONCLUSIONS: Increased survival as a result of active perinatal and neonatal management was associated with favourable morbidity rates compared with those in recent studies. Among survivors born at 23-25 weeks, neither gestational age nor birthweight was a significant determinant of major morbidity.
Notes
Comment In: Acta Paediatr. 2004 Aug;93(8):1027-815456188
PubMed ID
15456201 View in PubMed
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Short-term outcome after active perinatal management at 23-25 weeks of gestation. A study from two Swedish tertiary care centres. Part 1: maternal and obstetric factors.

https://arctichealth.org/en/permalink/ahliterature58251
Source
Acta Paediatr. 2004 Jul;93(7):945-53
Publication Type
Article
Date
Jul-2004
Author
F. Serenius
U. Ewald
A. Farooqi
P A Holmgren
S. Hakansson
G. Sedin
Author Affiliation
Department of Paediatrics, Urmea University, Umeå, Sweden.
Source
Acta Paediatr. 2004 Jul;93(7):945-53
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Adult
Delivery, obstetric - statistics & numerical data
Female
Gestational Age
Humans
Infant, Newborn
Infant, Premature
Logistic Models
Maternal Age
Multivariate Analysis
Parity
Pregnancy
Pregnancy outcome
Pregnancy Trimester, Second
Research Support, Non-U.S. Gov't
Retrospective Studies
Sweden
Time Factors
Abstract
AIMS: To provide descriptive data on women who delivered at 23-25 wk of gestation, and to relate foetal and neonatal outcomes to maternal factors, obstetric management and the principal reasons for preterm birth. METHODS: Medical records of all women who had delivered in two tertiary care centres in 1992-1998 were reviewed. At the two centres, policies of active perinatal and neonatal management were universally applied. Logistic regression models were used to identify prenatal factors associated with survival. RESULTS: Of 197 women who delivered at 23-25 wk, 65% had experienced a previous miscarriage, 15% a previous stillbirth and 12% a neonatal death. The current pregnancy was the result of artificial reproduction in 13% of the women. In 71%, the pregnancy was complicated either by pre-eclampsia, chorioamnionitis, placental abruption or premature rupture of membranes. Antenatal steroids were given in 63%. Delivery was by caesarean section in 47%. The reasons for preterm birth were idiopathic preterm labour in 36%, premature rupture of membranes in 41% and physician-indicated deliveries in 23% of the mothers. Demographic details, use of antenatal steroids, caesarean section delivery and birthweight differed between mothers depending on the reason for preterm delivery. Of 224 infants, 5% were stillbirths and 63% survived to discharge. On multivariate logistic regression analysis comprising prenatally known variables, reasons for preterm birth were not associated with survival. Advanced gestational duration (OR: 2.43 per wk; 95% CI: 1.59-3.74), administration of any antenatal steroids (OR: 2.21; 95% Cl: 1.14-4.28) and intrauterine referral from a peripheral hospital (OR: 2.93; 95% CI: 1.5-5.73) were associated with survival. CONCLUSIONS: Women who deliver at 23-25 wk comprise a risk group characterized by a high risk of reproductive failure and pregnancy complications. Survival rates were similar regardless of the reason for preterm birth. Policies of active perinatal management virtually eliminated intrapartum stillbirths.
Notes
Comment In: Acta Paediatr. 2004 Aug;93(8):1027-815456188
PubMed ID
15303811 View in PubMed
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Short-term outcome after active perinatal management at 23-25 weeks of gestation. A study from two Swedish tertiary care centres. Part 2: infant survival.

https://arctichealth.org/en/permalink/ahliterature51952
Source
Acta Paediatr. 2004 Aug;93(8):1081-9
Publication Type
Article
Date
Aug-2004
Author
F. Serenius
U. Ewald
A. Farooqi
P A Holmgren
S. Håkansson
G. Sedin
Author Affiliation
Department of Paediatrics, Umeå University, Umeå, Sweden.
Source
Acta Paediatr. 2004 Aug;93(8):1081-9
Date
Aug-2004
Language
English
Publication Type
Article
Keywords
Apgar score
Birth weight
Female
Humans
Infant mortality
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Intensive Care, Neonatal
Logistic Models
Multivariate Analysis
Perinatal care
Pregnancy
Pregnancy outcome
Research Support, Non-U.S. Gov't
Retrospective Studies
Survival Rate
Sweden - epidemiology
Abstract
AIM: To determine neonatal survival rates based on both foetal (stillborn) and neonatal deaths among infants delivered at 23-25 wk, and to identify maternal and neonatal factors associated with survival. METHODS: The medical records of 224 infants who were delivered in two tertiary care centres in 1992-1998 were reviewed retrospectively. At these centres, policies of active perinatal and neonatal management were universally applied. Data were analysed by gestational age groups and considered in three time periods. Logistic regression models were used to identify factors associated with survival. RESULTS: The rate of foetal death was 5%. Of infants born alive, 63% survived to discharge. Survival rates including foetal deaths in the denominator at 23, 24 and 25 wk were 37%, 61% and 74%, respectively, and survival rates excluding foetal deaths were 43%, 63% and 77%, respectively. Of infants born with 1-min Apgar scores of 0-1, 43% survived. In the total cohort, survival rates including foetal deaths in the denominator increased from 52% in time period 1 to 61% in time period 2 and 74% in time period 3 (p
Notes
Comment In: Acta Paediatr. 2004 Aug;93(8):1027-815456188
PubMed ID
15456200 View in PubMed
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12 records – page 1 of 2.