Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room...Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation Mother-Child University Hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p < 0.001). After birth, partum asphyxia was more likely to lead to death before 15 minutes of life than other causes (OR = 11 [6.1 - 18.9], p Conclusion: The causes of stillbirth and early neonatal mortality are dominated by maternal vascular pathologies. However, the proportion of childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.展开更多
The aim of this retrospective study was to investigate the causes and the effects of stillbirth on the number of days open and cow herd survival in subsequent lactation of Holstein Friesian cows. A total of 1371 calvi...The aim of this retrospective study was to investigate the causes and the effects of stillbirth on the number of days open and cow herd survival in subsequent lactation of Holstein Friesian cows. A total of 1371 calvings from research dairy farm were used. Stillbirth in calves was defined as the death of a fetus before or during calving at full term (≥270 days of gestation) or within 24 hours after calving. During the period from January 2006 to December 2017 a percent of 95.04% of the calvings were with live calves, and 4.96% of the calvings were stillbirths. The major causes of stillbirth identified were: calving difficulty, parity of the cows, and sex of the calves at calving. A five point scale was used to assess calving difficulties, and numbers 1, 2 and 3 were considered unassisted calvings and number 4 and 5 as assisted. The twin calvings were not taken into account. Days open were measured as days from first calving to conception, and cow herd survival from first calving to culling or death. Trend test and multivariate data analysis were used. The findings revealed that primiparous cows were at higher risk of having stillbirths compared with multiparous cows. Cows that were at calving male calves were at higher risk of having stillbirths compared with cows that had female calves at calving. Also, cows with assisted calving were at higher risk of having stillbirths compared with cows with unassisted calvings. Cows with stillbirths had a increase mean of days open with 32 days. Cow herd survival was better in the cows with live calves at calving compared with the cows that had stillbirth at calvings.展开更多
Statistical analysis was conducted on sow stillbirth traits of three mating types with 1686 litters including Erhualian, Large White and F1. The number of stillborn piglets per litter (NSB) in Erhualian,Large White an...Statistical analysis was conducted on sow stillbirth traits of three mating types with 1686 litters including Erhualian, Large White and F1. The number of stillborn piglets per litter (NSB) in Erhualian,Large White and Fl averaged 0.87, 0.32, 0.72, and the percentage born alive (PBA) averaged 95.1%,97.1%, 95.7%, respectively. The Erhualian pig with a higher litter size also had a higher stillbirth rate. The results of the variance analysis indicated that the mating type, parity, farrowing year × farrowing season interaction and the total number born had highly significant effects on both NSB and PBA in sows (P ＜ 0.001).Farrowing season had highly significant effects on NSB (P ＜ 0.01), and significant effects on PBA (P ＜0.05). Farrowing year had no significant effects on NSB ( P ＞ 0.05), and highly significant effects on PBA (P＜0.01). From parity 1 to parity 10, the least square means for NSB progressively increased with increasing parity, the least square means for PBA progressively decreased with increasing parity. The sows farrowed in winter had the highest NSB and the lowest PBA, the sows farrowed in autumn had the lowest NSB and the highest PBA. The least square means for NSB markedly increased with an increase in the total number born,indicating that the positive phenotypic correlation existed between them. The least square means for PBA markedly decreased with an increase in the total number born, indicating that the negative phenotypic correlation existed between them. The estimating results of the paternal half sib indicated that the heritabilities for NSB and PBA were 0.111 and 0.123, the genetic correlation, phenotypic correlation and environmental correlation between them were - 0.985, - 0.947 and - 0.942, respectively.展开更多
Introduction: In developing countries, many neonatal deaths still occur at home and the causes of these deaths are not ascertained. Objective: To identify the causes of stillbirths and neonatal deaths that occur at ho...Introduction: In developing countries, many neonatal deaths still occur at home and the causes of these deaths are not ascertained. Objective: To identify the causes of stillbirths and neonatal deaths that occur at home and the factors that have contributed to these deaths. Materials and Method: We have used the method of verbal autopsy to investigate the stillbirths and neonatal deaths in nine villages in the health area of Namsiguia, health district of Ouahigouya, Burkina Faso, during the period January 1, 2007 to December 8, 2012. Results: Over these six years, we have recorded 19 stillbirths and 36 neonatal deaths among 1507 live births, demonstrating a neonatal mortality rate of 28.8 per1000 and a rate of stillbirths of 12.6 per 1000. The average age of newborns at death was 5.6 days and the sex-ratio was 1.6. The major cause of stillbirths was antenatal hypoxia and birth asphyxia (42.1%). The direct causes of neonatal deaths were neonatal sepsis (41.7%), preterm birth (19.4%) and hypoxia and birth asphyxia (11.1%). There were 42.1% deliveries and 58.3% neonatal deaths, which occurred at home. We have noted 89.5% fresh stillbirths. Death occurred more often during the early neonatal period (55.5%). Factors significantly associated with neonatal death were, lack of school education of mothers (OR = 4), precocious marriage of the mother (OR = 8), poor follow-up of pregnancies (OR = 3), birth at home (OR = 4), low socioeconomic level (OR = 6), and low geographical access to the health facility (OR = 4). Conclusions: Strengthening of the health infrastructure and improving their accessibility, reinforcement of the staff for high quality care, and communication for a change in behavior in rural communities, will contribute toward reducing neonatal mortality in the area of health of Namsiguia.展开更多
Background: Low and middle income countries have the highest rates of stillbirths in the world. In Jordan, stillbirth and how it impacts on mothers who experience it is under-researched. The stories of mothers who hav...Background: Low and middle income countries have the highest rates of stillbirths in the world. In Jordan, stillbirth and how it impacts on mothers who experience it is under-researched. The stories of mothers who have had a stillbirth need to be told and the silence associated with stillbirth needs to be broken. The aim of this study is to explore and understand the meanings attributed by mothers’ to their experience of stillbirth in Jordan. Methods: The study will employ phenomenological qualitative research design. Semi-structured interview will be conducted with the mothers’ who will be recruited from three governmental hospitals in the north, middle and south of Jordan. Data will be transcribed, managed and analysed using interpretative, phenomenological analysis. The Jordanian Ministry of Health and Jordan University Ethics Committee approved the study on Nov. 2019, FEB 2020, respectively. Discussion: The findings of this study will make an original contribution to our knowledge about how stillbirth is experienced by mothers in Jordan. This finding will be useful to health care providers to improve the quality of health care provided to those mothers by adopting individualized and holistic care approach to meet the needs of each mother. Moreover, it will inform public health authorities and policy makers regarding the need for more awareness of stillbirth and a better bereavement care strategy for mothers in hospitals.展开更多
Background: Despite improvements in antenatal and intrapartum care, stillbirth still remains an important, largely understudied and pregnant problem in obstetrics. Most of the stillbirths occur in the developing world...Background: Despite improvements in antenatal and intrapartum care, stillbirth still remains an important, largely understudied and pregnant problem in obstetrics. Most of the stillbirths occur in the developing world and the majority of stillbirths are preventable. Objective: To determine the stillbirth rate, the identifiable risk factors and sociodemographic factors associated with stillbirths. Materials and Methods: This was a retrospective review of all deliveries conducted at UATH over a five-year period spanning from the January 2012 to December 2016. In this study, stillbirths were considered as foetal death at or after 28 weeks of gestation or a birth weight of 1000 g or more. The folders of cases that met the definition of stillbirth within the study period were retrieved and analyzed for sociodemographic factors, type of stillbirth, fetomaternal determinants of stillbirths and presumptive/identifiable risk factors for the stillbirth. Results: There were a total of 5714 deliveries within the period under review, of which 288 resulted in stillbirths giving an institutional stillbirth rate of 50.4/1000 deliveries. Out of the 288 stillbirths, 136 (47.2%) were fresh stillbirths while 152 (52.8%) were macerated. Macerated stillbirth (152, 52.8%) was slightly predominant, with obstructed labour 94 (32.6%) being responsible for most of the stillbirths. Most of the stillbirths were preterm (183, 63.5%). There were 6 congenitally malformed stillbirth foetuses and no autopsy was carried out on any of the 288 stillborn. However, majority of the parturients who had stillbirth were unemployed (137, 47.6%) and uneducated (110, 38.2%). Conclusion: The stillbirth rate within the study period appears. Complications of labour seem to be the leading risk factor for stillbirth in this study. Low socioeconomic status underscores the need to reduce factors related to social, educational, occupational and healthy inequalities in the developing world.展开更多
This study investigated the effects of different amounts of wheat aleurone(WA)(0,15%,30%)inclusion in gestation diets on the reproductive performance,postprandial satiety,stress status and stereotypic be-haviors of so...This study investigated the effects of different amounts of wheat aleurone(WA)(0,15%,30%)inclusion in gestation diets on the reproductive performance,postprandial satiety,stress status and stereotypic be-haviors of sows.A total of 84 Landrace×Yorkshire sows(parity 4.87±1.32)at breeding were randomly allotted to one of the three isoenergetic and isonitrogenous dietary treatments based on parity and body weight.The results showed that,compared with the control(0),sows fed the WA diet had a higher serum concentration of peptide YY(PYY)(P<0.05)and glucagon like peptide-1(GLP-1)(P<0.05)and a lower concentration of saliva cortisol(P<0.01).Importantly,compared with the control group,only the 15%WA group had a higher concentration of the total antioxidant capacity(T-AOC)(P<0.05),lower pro-portions of sitting(P=0.05)and stillbirth rates(P<0.01).Accordingly,the production cost per piglet born alive($6.9 vs.$7.6)or per piglet born healthy($7.4 vs.$7.9)declined in the 15%WA group versus the control group.Overall,15%WA inclusion in gestation diets contributed to enhancing postprandial satiety,alleviating stress status and decreasing stillbirth rate of sows.This study provides a reference for the application of WA as a partial substitute for conventional feed ingredients to improve sows'repro-ductive performance.展开更多
Stillbirth is a devastating pregnancy complication that still affects many women,particularly from low and middle-income countries.It is often labeled as“unexplained”and therefore unpreventable,despite the knowledge...Stillbirth is a devastating pregnancy complication that still affects many women,particularly from low and middle-income countries.It is often labeled as“unexplained”and therefore unpreventable,despite the knowledge that placental dysfunction has been identified as a leading cause of antepartum stillbirth.Currently,screening for pregnancies at high-risk for placental dysfunction relies on checklists of maternal risk factors and serial measurement of symphyseal-fundal height to identify small for gestational age fetuses.More recently,the first-trimester combined screening algorithm developed by the Fetal Medicine Foundation has emerged as a better tool to predict and prevent early-onset placental dysfunction and its main outcomes of preterm preeclampsia,fetal growth restriction and stillbirth by the appropriate use of Aspirin therapy,serial growth scans and induction of labour from 40 weeks for women identified at high-risk by such screening.There is currently no equivalent to predict and prevent late-onset placental dysfunction,although algorithms combining an ultrasound-based estimation of fetal weight,assessment of maternal and fetal Doppler indices,and maternal serum biomarkers show promise as emerging new screening tools to optimize pregnancy monitoring and timing of delivery to prevent stillbirth.In this review we discuss the strategies to predict and prevent stillbirths based on firsttrimester screening as well as fetal growth and wellbeing assessment in the second and third trimesters.展开更多
文摘Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation Mother-Child University Hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p < 0.001). After birth, partum asphyxia was more likely to lead to death before 15 minutes of life than other causes (OR = 11 [6.1 - 18.9], p Conclusion: The causes of stillbirth and early neonatal mortality are dominated by maternal vascular pathologies. However, the proportion of childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.
文摘The aim of this retrospective study was to investigate the causes and the effects of stillbirth on the number of days open and cow herd survival in subsequent lactation of Holstein Friesian cows. A total of 1371 calvings from research dairy farm were used. Stillbirth in calves was defined as the death of a fetus before or during calving at full term (≥270 days of gestation) or within 24 hours after calving. During the period from January 2006 to December 2017 a percent of 95.04% of the calvings were with live calves, and 4.96% of the calvings were stillbirths. The major causes of stillbirth identified were: calving difficulty, parity of the cows, and sex of the calves at calving. A five point scale was used to assess calving difficulties, and numbers 1, 2 and 3 were considered unassisted calvings and number 4 and 5 as assisted. The twin calvings were not taken into account. Days open were measured as days from first calving to conception, and cow herd survival from first calving to culling or death. Trend test and multivariate data analysis were used. The findings revealed that primiparous cows were at higher risk of having stillbirths compared with multiparous cows. Cows that were at calving male calves were at higher risk of having stillbirths compared with cows that had female calves at calving. Also, cows with assisted calving were at higher risk of having stillbirths compared with cows with unassisted calvings. Cows with stillbirths had a increase mean of days open with 32 days. Cow herd survival was better in the cows with live calves at calving compared with the cows that had stillbirth at calvings.
基金supported by the National Natural Science Foundation of China (No. 39730360).
文摘Statistical analysis was conducted on sow stillbirth traits of three mating types with 1686 litters including Erhualian, Large White and F1. The number of stillborn piglets per litter (NSB) in Erhualian,Large White and Fl averaged 0.87, 0.32, 0.72, and the percentage born alive (PBA) averaged 95.1%,97.1%, 95.7%, respectively. The Erhualian pig with a higher litter size also had a higher stillbirth rate. The results of the variance analysis indicated that the mating type, parity, farrowing year × farrowing season interaction and the total number born had highly significant effects on both NSB and PBA in sows (P ＜ 0.001).Farrowing season had highly significant effects on NSB (P ＜ 0.01), and significant effects on PBA (P ＜0.05). Farrowing year had no significant effects on NSB ( P ＞ 0.05), and highly significant effects on PBA (P＜0.01). From parity 1 to parity 10, the least square means for NSB progressively increased with increasing parity, the least square means for PBA progressively decreased with increasing parity. The sows farrowed in winter had the highest NSB and the lowest PBA, the sows farrowed in autumn had the lowest NSB and the highest PBA. The least square means for NSB markedly increased with an increase in the total number born,indicating that the positive phenotypic correlation existed between them. The least square means for PBA markedly decreased with an increase in the total number born, indicating that the negative phenotypic correlation existed between them. The estimating results of the paternal half sib indicated that the heritabilities for NSB and PBA were 0.111 and 0.123, the genetic correlation, phenotypic correlation and environmental correlation between them were - 0.985, - 0.947 and - 0.942, respectively.
文摘Introduction: In developing countries, many neonatal deaths still occur at home and the causes of these deaths are not ascertained. Objective: To identify the causes of stillbirths and neonatal deaths that occur at home and the factors that have contributed to these deaths. Materials and Method: We have used the method of verbal autopsy to investigate the stillbirths and neonatal deaths in nine villages in the health area of Namsiguia, health district of Ouahigouya, Burkina Faso, during the period January 1, 2007 to December 8, 2012. Results: Over these six years, we have recorded 19 stillbirths and 36 neonatal deaths among 1507 live births, demonstrating a neonatal mortality rate of 28.8 per1000 and a rate of stillbirths of 12.6 per 1000. The average age of newborns at death was 5.6 days and the sex-ratio was 1.6. The major cause of stillbirths was antenatal hypoxia and birth asphyxia (42.1%). The direct causes of neonatal deaths were neonatal sepsis (41.7%), preterm birth (19.4%) and hypoxia and birth asphyxia (11.1%). There were 42.1% deliveries and 58.3% neonatal deaths, which occurred at home. We have noted 89.5% fresh stillbirths. Death occurred more often during the early neonatal period (55.5%). Factors significantly associated with neonatal death were, lack of school education of mothers (OR = 4), precocious marriage of the mother (OR = 8), poor follow-up of pregnancies (OR = 3), birth at home (OR = 4), low socioeconomic level (OR = 6), and low geographical access to the health facility (OR = 4). Conclusions: Strengthening of the health infrastructure and improving their accessibility, reinforcement of the staff for high quality care, and communication for a change in behavior in rural communities, will contribute toward reducing neonatal mortality in the area of health of Namsiguia.
文摘Background: Low and middle income countries have the highest rates of stillbirths in the world. In Jordan, stillbirth and how it impacts on mothers who experience it is under-researched. The stories of mothers who have had a stillbirth need to be told and the silence associated with stillbirth needs to be broken. The aim of this study is to explore and understand the meanings attributed by mothers’ to their experience of stillbirth in Jordan. Methods: The study will employ phenomenological qualitative research design. Semi-structured interview will be conducted with the mothers’ who will be recruited from three governmental hospitals in the north, middle and south of Jordan. Data will be transcribed, managed and analysed using interpretative, phenomenological analysis. The Jordanian Ministry of Health and Jordan University Ethics Committee approved the study on Nov. 2019, FEB 2020, respectively. Discussion: The findings of this study will make an original contribution to our knowledge about how stillbirth is experienced by mothers in Jordan. This finding will be useful to health care providers to improve the quality of health care provided to those mothers by adopting individualized and holistic care approach to meet the needs of each mother. Moreover, it will inform public health authorities and policy makers regarding the need for more awareness of stillbirth and a better bereavement care strategy for mothers in hospitals.
文摘Background: Despite improvements in antenatal and intrapartum care, stillbirth still remains an important, largely understudied and pregnant problem in obstetrics. Most of the stillbirths occur in the developing world and the majority of stillbirths are preventable. Objective: To determine the stillbirth rate, the identifiable risk factors and sociodemographic factors associated with stillbirths. Materials and Methods: This was a retrospective review of all deliveries conducted at UATH over a five-year period spanning from the January 2012 to December 2016. In this study, stillbirths were considered as foetal death at or after 28 weeks of gestation or a birth weight of 1000 g or more. The folders of cases that met the definition of stillbirth within the study period were retrieved and analyzed for sociodemographic factors, type of stillbirth, fetomaternal determinants of stillbirths and presumptive/identifiable risk factors for the stillbirth. Results: There were a total of 5714 deliveries within the period under review, of which 288 resulted in stillbirths giving an institutional stillbirth rate of 50.4/1000 deliveries. Out of the 288 stillbirths, 136 (47.2%) were fresh stillbirths while 152 (52.8%) were macerated. Macerated stillbirth (152, 52.8%) was slightly predominant, with obstructed labour 94 (32.6%) being responsible for most of the stillbirths. Most of the stillbirths were preterm (183, 63.5%). There were 6 congenitally malformed stillbirth foetuses and no autopsy was carried out on any of the 288 stillborn. However, majority of the parturients who had stillbirth were unemployed (137, 47.6%) and uneducated (110, 38.2%). Conclusion: The stillbirth rate within the study period appears. Complications of labour seem to be the leading risk factor for stillbirth in this study. Low socioeconomic status underscores the need to reduce factors related to social, educational, occupational and healthy inequalities in the developing world.
基金the National Natural Science Foundation of China,China(31872985)the National Key Research and Development Program of China,China(2018YFD0500600)the China Scholarship Council.China(201907630006).
文摘This study investigated the effects of different amounts of wheat aleurone(WA)(0,15%,30%)inclusion in gestation diets on the reproductive performance,postprandial satiety,stress status and stereotypic be-haviors of sows.A total of 84 Landrace×Yorkshire sows(parity 4.87±1.32)at breeding were randomly allotted to one of the three isoenergetic and isonitrogenous dietary treatments based on parity and body weight.The results showed that,compared with the control(0),sows fed the WA diet had a higher serum concentration of peptide YY(PYY)(P<0.05)and glucagon like peptide-1(GLP-1)(P<0.05)and a lower concentration of saliva cortisol(P<0.01).Importantly,compared with the control group,only the 15%WA group had a higher concentration of the total antioxidant capacity(T-AOC)(P<0.05),lower pro-portions of sitting(P=0.05)and stillbirth rates(P<0.01).Accordingly,the production cost per piglet born alive($6.9 vs.$7.6)or per piglet born healthy($7.4 vs.$7.9)declined in the 15%WA group versus the control group.Overall,15%WA inclusion in gestation diets contributed to enhancing postprandial satiety,alleviating stress status and decreasing stillbirth rate of sows.This study provides a reference for the application of WA as a partial substitute for conventional feed ingredients to improve sows'repro-ductive performance.
文摘Stillbirth is a devastating pregnancy complication that still affects many women,particularly from low and middle-income countries.It is often labeled as“unexplained”and therefore unpreventable,despite the knowledge that placental dysfunction has been identified as a leading cause of antepartum stillbirth.Currently,screening for pregnancies at high-risk for placental dysfunction relies on checklists of maternal risk factors and serial measurement of symphyseal-fundal height to identify small for gestational age fetuses.More recently,the first-trimester combined screening algorithm developed by the Fetal Medicine Foundation has emerged as a better tool to predict and prevent early-onset placental dysfunction and its main outcomes of preterm preeclampsia,fetal growth restriction and stillbirth by the appropriate use of Aspirin therapy,serial growth scans and induction of labour from 40 weeks for women identified at high-risk by such screening.There is currently no equivalent to predict and prevent late-onset placental dysfunction,although algorithms combining an ultrasound-based estimation of fetal weight,assessment of maternal and fetal Doppler indices,and maternal serum biomarkers show promise as emerging new screening tools to optimize pregnancy monitoring and timing of delivery to prevent stillbirth.In this review we discuss the strategies to predict and prevent stillbirths based on firsttrimester screening as well as fetal growth and wellbeing assessment in the second and third trimesters.
