Perinatal mortality

Not to be confused with abortion.

See also: Infant mortality

Perinatal mortality

Other names: Perinatal death, neonatal death
Infant, neonatal, and postneonatal mortality rates: United States, 1940–2005
Specialty| Public health

Perinatal mortality (PNM) refers to the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate.[1] 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. The World Health Organization defines perinatal mortality as the "number of stillbirths and deaths in the first week of life per 1,000 total births, the perinatal period commences at 22 completed weeks (154 days) of gestation,[2] and ends seven completed days after birth",[3] but other definitions have been used.[4]

The UK figure is about 8 per 1,000 and varies markedly by social class with the highest rates seen in Asian women. Globally, an estimated 2.6 million neonates died in 2013 before the first month of age down from 4.5 million in 1990.[5]

## Contents

* 1 Causes
* 2 Fetal mortality
* 3 Neonatal mortality
* 4 Perinatal mortality rate
* 5 Effects of neonatal nutrition on neonatal mortality
* 6 See also
* 7 References
* 8 External links

## Causes[edit | edit source]

Further information: Preterm birth § Specific risks for the preterm neonate

Preterm birth is the most common cause of perinatal mortality, causing almost 30 percent of neonatal deaths.[6] Infant respiratory distress syndrome, in turn, is the leading cause of death in preterm infants, affecting about 1% of newborn infants.[7] Birth defects cause about 21 percent of neonatal death.[6]

## Fetal mortality[edit | edit source]

Fetal mortality refers to stillbirths or fetal death.[8] 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, antenatal (antepartum) death, and death during labor, intranatal (intrapartum) death.

## Neonatal mortality[edit | edit source]

Neonatal mortality refers to death of a live-born baby within the first 28 days of life. Early neonatal mortality refers to the death of a live-born baby within the first seven days of life, while late neonatal mortality refers to death after 7 days until before 28 days. 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.

## Perinatal mortality rate[edit | edit source]

Top ten countries
with the highest perinatal mortality rates – 2012[9][10][11]

Rank | Country | PNMR | Rank | Country | PNMR
1 |  Pakistan | 40.7 | 6 |  Afghanistan | 29.0
2 |  Nigeria | 32.7 | 7 |  Bangladesh | 28.9
3 | Template:Country data Sierra Leone | 30.8 | 8 |  Democratic Republic of the Congo | 28.3
4 |  Somalia | 29.7 | 9 |  Lesotho | 27.5
5 | Template:Country data Guinea-Bissau | 29.4 | 10 |  Angola | 27.4
As per 2014 "Save the Children" report for intrapartum stillbirths
and neonatal deaths on first day of birth (per 1,000 total births)

The PNMR refers to the number of perinatal deaths per 1,000 total births. It is usually reported on an annual basis.[12] 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.[13] The WHO has not published contemporary data.

## Effects of neonatal nutrition on neonatal mortality[edit | edit source]

Probiotic supplementation of preterm and low birthweight babies during their first month of life can reduce the risk of blood infections, bowel sickness and death in low- and middle-income settings. However, supplementing with Vitamin A does not reduce the risk of death and increases the risk of bulging fontanelle, which may cause brain damage.[14]

## See also[edit | edit source]

* Maternal death
* Miscarriage
* Neonatal intensive care unit
* Neonaticide
* Pregnancy and Infant Loss Remembrance Day
* Stillbirth

## References[edit | edit source]

1. ↑ "Perinatal mortality rate (PMR) — MEASURE Evaluation". www.cpc.unc.edu. Archived from the original on 2016-09-14. Retrieved 2022-01-06.
2. ↑ "UpToDate". Archived from the original on 2021-04-28. Retrieved 2022-01-06.
3. ↑ "WHO – Maternal and perinatal health". www.who.int. Archived from the original on December 3, 2013.
4. ↑ Richardus JH, Graafmans WC, Verloove-Vanhorick SP, Mackenbach JP (January 1998). "The perinatal mortality rate as an indicator of quality of care in international comparisons". Medical Care. 36 (1): 54–66. doi:10.1097/00005650-199801000-00007. PMID 9431331.
5. ↑ GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
6. ↑ 6.0 6.1 March of Dimes --> Neonatal Death Archived 2014-10-24 at the Wayback Machine Retrieved on November 10, 2014
7. ↑ Rodriguez RJ, Martin RJ, and Fanaroff, AA. Respiratory distress syndrome and its management. Fanaroff and Martin (eds.) Neonatal-perinatal medicine: Diseases of the fetus and infant; 7th ed. (2002):1001–1011. St. Louis: Mosby.
8. ↑ "NVSS – Fetal Deaths". www.cdc.gov. 8 November 2017. Archived from the original on 2 December 2020. Retrieved 6 January 2022.
9. ↑ "Ending Newborn Deaths" (PDF). Archived (PDF) from the original on 2021-06-30. Retrieved 2022-01-06.
10. ↑ "Million babies die a year – charity – IOL". Archived from the original on 2015-09-24. Retrieved 2022-01-06.
11. ↑ "Nigeria, Pakistan, India lead the world in infant deaths – PM NEWS Nigeria". 25 February 2014. Archived from the original on 11 August 2020. Retrieved 6 January 2022.
12. ↑ "Miscarriage Risk by Week and What Affects Your Risks of Miscarriage". 23 August 2015. Archived from the original on 15 June 2020. Retrieved 6 January 2022.
13. ↑ "Centre for International Health". Archived from the original on 2007-05-28. Retrieved 2022-01-06.
14. ↑ Imdad, Aamer; Rehman, Faseeha; Davis, Evans; Ranjit, Deepika; Surin, Gamael S. S.; Attia, Suzanna L.; Lawler, Sarah; Smith, Abigail A.; Bhutta, Zulfiqar A. (2021). "Effects of neonatal nutrition interventions on neonatal mortality and child health and development outcomes: A systematic review". Campbell Systematic Reviews. 17 (1): e1141. doi:10.1002/cl2.1141. ISSN 1891-1803. S2CID 240864559. Archived from the original on 2021-10-29. Retrieved 2022-01-06.

## External links[edit | edit source]

Classification|

* DiseasesDB: 24405

|

* WHO 2005 report Archived 2022-01-19 at the Wayback Machine
* European Perinatal Health Report 2010 Archived 2022-01-19 at the Wayback Machine

* v
* t
* e

Death

In medicine|

| Cell death|

* Necrosis
* Avascular necrosis
* Coagulative necrosis
* Liquefactive necrosis
* Gangrenous necrosis
* Caseous necrosis
* Fat necrosis
* Fibrinoid necrosis
* Temporal lobe necrosis
* Programmed cell death
* AICD
* Anoikis
* Apoptosis
* Autophagy
* Intrinsic apoptosis
* Necroptosis
* Paraptosis
* Parthanatos
* Phenoptosis
* Pseudoapoptosis
* Pyroptosis
* Autolysis
* Autoschizis
* Eschar
* Immunogenic cell death
* Ischemic cell death
* Pyknosis
* Karyorrhexis
* Karyolysis
* Mitotic catastrophe
* Suicide gene

|

* Abortion
* Accidental death
* Autopsy
* Brain death
* Brainstem death
* Clinical death
* DOA
* Death by natural causes
* Death rattle
* Dysthanasia
* End-of-life care
* Euthanasia
* Lazarus sign
* Lazarus syndrome
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Lists|

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Mortality|

* Birthday effect
* Child mortality
* Excess mortality
* Gompertz–Makeham law of mortality
* Infant mortality
* Karoshi
* Maternal death
* Maternal mortality in fiction
* Memento mori
* Micromort
* Mortality rate
* RAMR
* Mortality salience
* Perinatal mortality

After death|

| Body|

| Stages|

* Pallor mortis
* Algor mortis
* Rigor mortis
* Livor mortis
* Putrefaction
* Decomposition
* Skeletonization
* Fossilization

|

Preservation|

* Cryopreservation
* Cryonics
* Neuropreservation
* Embalming
* Maceration
* Mummification
* Plastination
* Prosection
* Taxidermy

Disposal|

* Burial
* Natural burial
* Cremation
* Dismemberment
* Excarnation
* Promession
* Resomation

* Beating heart cadaver
* Body donation
* Cadaveric spasm
* Coffin birth
* Death erection
* Dissection
* Gibbeting
* Postmortem caloricity
* Post-mortem interval

Other aspects|

* Afterlife
* Carrion
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* Vigil

Paranormal|

* Ghosts
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* Near-death studies
* Necromancy
* Out-of-body experience
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* Séance

Legal|

* Abortion law
* Administration
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* Death row
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* Inquest
* Legal death
* Murder
* Necropolitics
* Prohibition of dying
* Right to die
* Suspicious death
* Trust law
* Will

Fields|

* Death tech [pt]
* Forensic pathology
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* Necrobiology
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* Taphonomy
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* Thanatology

Other|

* Apparent death
* Chinese burial money
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* Dark tourism
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* Psychopomp
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* human
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* Thanabot [ca]
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* Category
* Outline

* v
* t
* e

Conditions originating in the perinatal period / fetal disease

Maternal factors
complicating pregnancy,
labour or delivery|

| placenta|

* Placenta praevia
* Placental insufficiency
* Twin-to-twin transfusion syndrome

|

chorion/amnion|

* Chorioamnionitis

umbilical cord|

* Umbilical cord prolapse
* Nuchal cord
* Single umbilical artery

presentation|

* Breech birth
* Asynclitism
* Shoulder presentation

Growth|

* Small for gestational age / Large for gestational age
* Preterm birth / Postterm pregnancy
* Intrauterine growth restriction

Birth trauma|

* scalp
* Cephalohematoma
* Chignon
* Caput succedaneum
* Subgaleal hemorrhage
* Brachial plexus injury
* Erb's palsy
* Klumpke paralysis

Affected systems|

| Respiratory|

* Intrauterine hypoxia
* Infant respiratory distress syndrome
* Transient tachypnea of the newborn
* Meconium aspiration syndrome
* Pleural disease
* Pneumothorax
* Pneumomediastinum
* Wilson–Mikity syndrome
* Bronchopulmonary dysplasia

|

Cardiovascular|

* Pneumopericardium
* Persistent fetal circulation

Bleeding and
hematologic disease|

* Vitamin K deficiency bleeding

* HDN
* ABO
* Anti-Kell
* Rh c
* Rh D
* Rh E
* Hydrops fetalis
* Hyperbilirubinemia
* Kernicterus
* Neonatal jaundice

* Velamentous cord insertion
* Intraventricular hemorrhage
* Germinal matrix hemorrhage
* Anemia of prematurity

Gastrointestinal|

* Ileus
* Necrotizing enterocolitis
* Meconium peritonitis

Integument and
thermoregulation|

* Erythema toxicum
* Sclerema neonatorum

Nervous system|

* Perinatal asphyxia
* Periventricular leukomalacia

Musculoskeletal|

* Gray baby syndrome
* muscle tone
* Congenital hypertonia
* Congenital hypotonia

Infections|

* Vertically transmitted infection
* Neonatal infection
* rubella
* herpes simplex
* mycoplasma hominis
* ureaplasma urealyticum
* Omphalitis
* Neonatal sepsis
* Group B streptococcal infection
* Neonatal conjunctivitis

Other|

* Miscarriage
* Perinatal mortality
* Stillbirth
* Infant mortality
* Neonatal withdrawal

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