Anne C C Lee|Luke C. Mullany|James M. Tielsch|Joanne Katz|Subarna K. Khatry|Steven C. LeClerq|Ramesh Adhikari|Shardaram Shrestha|Gary L. Darmstadt
Risk Factors for Neonatal Mortality Due to Birth Asphyxia in Southern Nepal: A Prospective, Community-Based Cohort Study
Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Tribhuvan University|Johns Hopkins University
goal identify antepartum intrapartum infant risk factors birth asphyxia mortality rural lowresource populationbased cohort southern nepaldata collected prospectively clusterrandomized communitybased trial evaluating impact newborn skin umbilical cord cleansing neonatal mortality morbidity sarlahi nepal total 23662 newborn infants enrolled september 2002 january 2006 multivariable regression modeling performed determine adjusted relative risk estimates birth asphyxia mortality antepartum intrapartum infant risk factorsbirth asphyxia deaths 9710000 live births accounted 30 neonatal mortality antepartum risk factors birth asphyxia mortality included low paternal education madeshi ethnicity primiparity facility delivery maternal fever maternal swelling face hands feet multiple births significant intrapartum risk factors birth asphyxia mortality premature infants 37 weeks higher risk combination maternal fever prematurity resulted 7fold elevation risk birth asphyxia mortality compared term infants afebrile mothersmaternal infections prematurity multiple births important risk factors birth asphyxia mortality lowresource communitybased setting low socioeconomic status highly associated birth asphyxia mechanisms leading mortality need elucidated interaction maternal infections prematurity may important target future communitybased interventions reduce global impact birth asphyxia neonatal mortality