Mahmood Jamal, Nusrat Khan.
Neonatal morbidity and mortality in high risk pregnancies.
J Coll Physicians Surg Pak Jan ;12(11):657-61.

Objective: To study the relationship between maternal risk factors and early neonatal morbidity and mortality. Design: A prospective interventional study. Place and Duration of Study: It was a case-control study conducted at Children Hospital, Pakistan Institute of Medical Sciences, Islamabad during July-November, 2001. Subjects and Methods: Relevant information regarding mothers and their babies were filled in a pre-tested proforma for all consecutive live births. Out of 1280 live births, a total of 1124 babies were selected for analysis i.e. 239 cases and 885 controls. Univariate (chi square) and multivariate analyses were performed and association of maternal risk factors with neonatal morbidity and mortality was determined. Results: The maternal risk factors i.e. malnutrition, poor antenatal care, pregnancy-induced hypertension, antepartum haemorrhage, prolonged rupture of membranes, multiple pregnancies, and urogenital anomalies were significantly associated with increased early neonatal morbidity and mortality (p < 0.05). The common causes of morbidity were hyperbilirubinaemia (31%) followed by neonatal sepsis (30%), respiratory distress syndrome (14%) and congenital anomalies (11%). The total deaths during first week were 47 with early neonatal mortality rate of 41.8 per 1000 live births. Conclusion: Neonatal morbidity and mortality can be reduced by proper interventions i.e. screening and proper management of risk pregnancies.

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