stillbirths and newborn deaths in slum settlements in mumbai, india a prospective verbal autopsy study在孟买贫民窟定居点死产和新生儿死亡,印度未来的死因推断研究.pdfVIP

Bapat et al. BMC Pregnancy and Childbirth 2012, 12:39 /1471-2393/12/39 RESEARCH ARTICLE Open Access Stillbirths and newborn deaths in slum settlements in Mumbai, India: a prospective verbal autopsy study 1 2 1 1 1 2* Ujwala Bapat , Glyn Alcock , Neena Shah More , Sushmita Das , Wasundhara Joshi and David Osrin Abstract Background: Three million babies are stillborn each year and 3.6 million die in the first month of life. In India, early neonatal deaths make up four-fifths of neonatal deaths and infant mortality three-quarters of under-five mortality. Information is scarce on cause-specific perinatal and neonatal mortality in urban settings in low-income countries. We conducted verbal autopsies for stillbirths and neonatal deaths in Mumbai slum settlements. Our objectives were to classify deaths according to international cause-specific criteria and to identify major causes of delay in seeking and receiving health care for maternal and newborn health problems. Methods: Over two years, 2005–2007, births and newborn deaths in 48 slum areas were identified prospectively by local informants. Verbal autopsies were collected by trained field researchers, cause of death was classified by clinicians, and family narratives were analysed to investigate delays on the pathway to mortality. Results: Of 105 stillbirths, 65 were fresh (62%) and obstetric complications dominated the cause classification. Of 116 neonatal deaths, 87 were early and the major causes were intrapartum-related (28%), prematurity (23%), and severe infection (22%). Bereavement was associated with socioeconomic quintile, previous stillbirth, and number of antenatal care visits. We identified 201 individual delays in