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Perinatal mortality

Perinatal mortality

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Perinatal mortality (PNM), also perinatal death, refers to the death of a fetus
Fetus
A fetus is a developing mammal or other viviparous vertebrate after the embryonic stage and before birth. The plural is fetuses....

 or neonate and is the basis to calculate the perinatal mortality rate
Mortality rate
Mortality rate is a measure of the number of deaths in some population, scaled to the size of that population, per unit time. Mortality rate is typically expressed in units of deaths per 1000 individuals per year; thus, a mortality rate of 9.5 in a population of 100,000 would mean 950 deaths per...

. Variations in the precise definition of the perinatal mortality exist specifically concerning the issue of inclusion or exclusion of early fetal and late neonatal fatalities. Thus the WHO
Who
*Who is an English language interrogative pronoun.-In fiction:*Who? , a 1958 novel by science fiction author Algis Budrys, turned into a film with the same title in 1973*Doctor Who, a British science fiction television series...

 ‘s definition "Deaths occurring during late pregnancy (at 22 completed weeks gestation and over), during childbirth
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with birth of one or more newborn infants from a woman's uterus...

 and up to seven completed days of life" is not universally accepted. The perinatal mortality is the sum of the fetal mortality and the neonatal mortality.

Causes


  • Preterm birth is the most common cause of perinatal mortality, causing almost 30 percent of neonatal deaths. Infant respiratory distress syndrome
    Infant respiratory distress syndrome
    Infant respiratory distress syndrome , also called neonatal respiratory distress syndrome or respiratory distress syndrome of newborn, previously called hyaline membrane disease, is a syndrome caused in premature infants by developmental insufficiency of surfactant production and structural...

    , in turn, is the leading cause of death in preterm infants, affecting about 1% of newborn infants.

  • Birth defects cause about 21 percent of neonatal death.

Fetal mortality


Fetal mortality refers to stillbirth
Stillbirth
A stillbirth occurs when a fetus which has died, in the uterus or during labor or delivery, exits a woman's body. The term is often used in distinction to live birth or miscarriage. Most stillbirths occur in full term pregnancies....

s or fetal death. It encompasses any death of a fetus after 20 weeks of gestation or 500 gm. In some definitions of the PNM early fetal mortality (week 20-27 gestation) is not included, and the PNM may only include late fetal death and neonatal death. Fetal death can also be divided into death prior to labor
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with birth of one or more newborn infants from a woman's uterus...

, antenatal (antepartum) death, and death during labor, intranatal (intrapartum) death.

Neonatal mortality


Early neonatal mortality refers to a death of a live-born baby within the first seven days of life, while late neonatal mortality covers the time after 7 days until before 28 days. The sum of these two represents the neonatal mortality. Some definitions of the PNM include only the early neonatal mortality. Neonatal mortality is affected by the quality of in-hospital care for the neonate. Neonatal mortality and postneonatal mortality (covering the remaining 11 months of the first year of life) are reflected in the Infant Mortality Rate
Infant mortality
Infant mortality is defined as the number of infant deaths per 1000 live births. The most common cause worldwide has traditionally been due to dehydration from diarrhea...

.

Perinatal Mortality Rate


The PNMR refers to the number of perinatal deaths per 1,000 total births. It is usually reported on an annual basis. It is a major marker to assess the quality of health care delivery. Comparisons between different rates may be hampered by varying definitions, registration bias, and differences in the underlying risks of the populations.

PNMRs vary widely and may be below 10 for certain developed countries and more than 10 times higher in developing countries http://www.cih.uib.no/journals/EJHD/ejhdv14-n3/ejhd-14-3-page-335.htm. The WHO has not published contemporary data.

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