Perinatal mortality

Not to be confused with embryo loss, abortion, infant mortality, or maternal mortality.

Perinatal mortality

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

Perinatal mortality (PNM) is the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate.[1] Perinatal means "relating to the period starting a few weeks before birth and including the birth and a few weeks after birth."[2]

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,[3] and ends seven completed days after birth",[4] but other definitions have been used.[5]

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.[6]

## 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

Preterm birth is the most common cause of perinatal mortality, causing almost 30 percent of neonatal deaths.[7] Infant respiratory distress syndrome, in turn, is the leading cause of death in preterm infants, affecting about 1% of newborn infants.[8] Birth defects cause about 21 percent of neonatal death.[7]

Some major causes of perinatal mortality rate is:

* Maternal diseases
* Pelvic diseases; endometriosis, ovarian tumor
* Anatomical defects; Uterine, Cervical anomalies
* Endocrine imbalance
* Blood incompatibilities
* Malnutrition
* Toxemias of pregnancy
* APH
* Congenital defects
* Advanced maternal age

## Fetal mortality

Fetal mortality refers to stillbirths or fetal death.[9] 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

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

Top ten countries
with the highest perinatal mortality rates – 2012[10][11][12]

Rank | Country | PNMR | Rank | Country | PNMR
1 |  Pakistan | 40.7 | 6 |  Afghanistan | 29.0
2 |  Nigeria | 32.7 | 7 |  Bangladesh | 28.9
3 |  Sierra Leone | 30.8 | 8 |  Democratic Republic of the Congo | 28.3
4 |  Somalia | 29.7 | 9 |  Lesotho | 27.5
5 |  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.[13] 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.[14] The WHO has not published contemporary data.

## Effects of neonatal nutrition on neonatal mortality

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.[15]

## See also

* Maternal death
* Miscarriage
* Neonatal intensive care unit
* Neonaticide
* Stillbirth

## References

1. ↑ "Perinatal mortality rate (PMR) — MEASURE Evaluation". 9 September 2020. http://www.cpc.unc.edu/measure/prh/rh_indicators/specific/nb/perinatal-mortality-rate-pmr.
2. ↑ Concise medical dictionary. Jonathan Law, E. A. Martin (10th ed.). Oxford. 2020. ISBN 978-0-19-187376-8. OCLC 1142355883.
3. ↑ "UpToDate". https://www.uptodate.com/contents/perinatal-mortality/print.
4. ↑ "WHO – Maternal and perinatal health". https://www.who.int/maternal_child_adolescent/topics/maternal/maternal_perinatal/en/.
5. ↑ "The perinatal mortality rate as an indicator of quality of care in international comparisons". Medical Care 36 (1): 54–66. January 1998. doi:10.1097/00005650-199801000-00007. PMID 9431331.
6. ↑ "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. 17 December 2014. doi:10.1016/S0140-6736(14)61682-2. PMID 25530442.
7. ↑ 7.0 7.1 March of Dimes / Neonatal Death Retrieved on November 10, 2014
8. ↑ 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.
9. ↑ "NVSS – Fetal Deaths". 8 November 2017. https://www.cdc.gov/nchs/nvss/fetal_death.htm.
10. ↑ "Ending Newborn Deaths". https://www.savethechildren.net/sites/default/files/libraries/ENDING-NEWBORN-DEATHS.pdf.
11. ↑ "Million babies die a year – charity – IOL". http://www.iol.co.za/lifestyle/family/birth/million-babies-die-a-year-charity-1.1653041#.Uw791uNUCKU.
12. ↑ "Nigeria, Pakistan, India lead the world in infant deaths – PM NEWS Nigeria". 25 February 2014. http://www.pmnewsnigeria.com/2014/02/25/nigeria-pakistan-india-lead-the-world-in-infant-deaths/.
13. ↑ "Miscarriage Risk by Week and What Affects Your Risks of Miscarriage". 23 August 2015. http://www.checkpregnancy.com/miscarriage-statistics/.
14. ↑ "Centre for International Health". http://www.cih.uib.no/journals/EJHD/ejhdv14-n3/ejhd-14-3-page-335.htm.
15. ↑ Imdad, Aamer; Rehman, Faseeha; Davis, Evans; Ranjit, Deepika; Surin, Gamael S. S.; Attia, Suzanna L.; Lawler, Sarah; Smith, Abigail A. et al. (2021). "Effects of neonatal nutrition interventions on neonatal mortality and child health and development outcomes: A systematic review" (in en). Campbell Systematic Reviews 17 (1). doi:10.1002/cl2.1141. ISSN 1891-1803. PMID 37133295.

## External links

Classification|

* DiseasesDB: 24405

|

* WHO 2005 report
* European Perinatal Health Report 2010

* v
* t
* e

Women's health

Reproductive
&Sexual health

| Reproductive health|

| Reproductive tract|

* External female genitalia (vulva)
* Clitoris
* Clitoral hood
* Labia minora
* Labia majora
* Vagina
* Cervix
* Uterus
* Fallopian tube
* Ovary
* Reproductive system disease

|

Maternal health|

* Pregnancy
* Unintended pregnancy
* Gravidity and parity
* Obstetrics
* Antenatal care
* Adolescent pregnancy
* Complications of pregnancy
* Hyperemesis gravidarum
* Ectopic pregnancy
* Miscarriage
* Obstetrical bleeding
* Gestational diabetes
* Hypertension
* Preeclampsia
* Eclampsia
* Childbirth
* Midwifery
* Preterm birth
* Multiple births
* Oxytocin
* Obstructed labor
* Cesarian section
* Retained placenta
* Obstetrical fistulae
* Vesicovaginal fistula
* Rectovaginal fistula
* Episiotomy
* husband stitch
* Postpartum care
* Postpartum confinement
* Maternal deaths
* Perinatal mortality
* Stillbirths
* Abortion
* Mother-to-child transmission
* Sterilization
* Compulsory sterilization
* Breastfeeding and mental health

Reproductive life plan|

* Infertility
* Childlessness
* Assisted reproductive technology
* In vitro fertilization
* Parenting
* Adoption
* Fostering

Contraception &
Family planning|

* Unsafe sex
* Intrauterine devices
* Oral contraceptives
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* Contraceptive prevalence
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* Planned parenthood
* Fertility awareness

Menstruation|

* Culture and menstruation
* Feminine hygiene
* Menarche
* Menstrual cycle
* Menstrual aids
* Cloth menstrual pad
* Menstrual cup
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* Dysmenorrhea
* Menorrhagia
* Amenorrhoea
* Menopause
* Hormone replacement therapy

Sexual health|

| Sexually transmitted
infections|

* HIV
* Human papilloma virus
* HPV vaccine
* Pelvic inflammatory disease

|

* Female genital mutilation
* Clitoridectomy
* Infibulation
* Breast ironing
* Child marriage
* Forced marriage
* Leblouh
* Polygamy
* Sexual intercourse
* Orgasm
* Dyspareunia

Other|

* Sex differences
* Sex education
* Puberty
* Breast health
* Gynaecological disorders

* Vaginitis

Non-reproductive health|

| Violence against women|

* Abuse during childbirth
* Domestic violence
* Intimate partner violence
* Misogyny
* Sexual harassment
* Sexual assault
* Rape
* Femicide
* Gender discrimination

|

Non-communicable diseases|

| Cancer|

* Lung cancer
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* Papanicolaou test
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|

* Cardiovascular disease
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* Mental health
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Sociocultural factors|

* Poverty
* Disadvantaged
* Gender equality
* Healthcare inequality
* Gender disparities in health
* Social determinants of health
* Reproductive justice
* Women's empowerment

Politics, Research
& Advocacy|

| United Nations|

* The Convention on the Elimination of All Forms of Discrimination against Women
* Declaration on the elimination of violence against women
* International Day of the Girl Child
* Commission on the Status of Women
* UN Women

|

United States|

* Office of Research on Women's Health
* Women's Health Initiative

* International Center for Research on Women
* Nurses' Health Study
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* Cartwright Inquiry
* Society for Women's Health Research

Women's health
by country|

* Women's health in China
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* Family planning

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Death

In medicine|

Cell death
Necrosis

Avascular necrosis
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Temporal lobe necrosis
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AICD
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* Abortion
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* Brainstem death
* Clinical death
* DOA
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Lists|

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Mortality|

* Birthday effect
* Child mortality
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* Holiday effect
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* Digital
* Infant mortality
* Karōshi
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* Maternal mortality in fiction
* Memento mori
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* Mortality rate
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* Perinatal mortality

After death|

| Body|

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

Preservation
Cryopreservation

Cryonics
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Maceration
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Plastination
Prosection
Taxidermy

Disposal
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Bed burial
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Excarnation
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Resomation

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

|

Other aspects|

Afterlife
Cemetery
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Customs
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Internet
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Vigil

Paranormal|

* Ghosts
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* Near-death studies
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* Reincarnation research
* Séance

Legal|

* Abortion law
* Administration
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* Cause of death
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* Coroner
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Fields|

* Forensic pathology
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Other|

* Apparent death
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* Death squad
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* Dignified death
* Extinction
* Fan death
* Festival of the Dead
* Fascination with death
* Hierarchy of death
* Homicide
* Last rites
* Martyr
* Megadeath
* Museum of Death
* Necronym
* Necrophilia
* Necrophobia
* The Order of the Good Death
* Predation
* Sacrifice
* human
* animal
* Social death
* Spiritual death
* Suicide
* Assisted suicide
* Thanatosensitivity
* Undead
* Voodoo death

* Category
* Outline

* v
* t
* e

Certain conditions originating in the perinatal period / fetal disease (P, 760–779)

Maternal factors and
complications of pregnancy,
labour and 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

Length of gestation
and fetal growth|

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

Birth trauma|

* scalp
* Cephalhematoma
* Chignon
* Caput succedaneum
* Subgaleal hemorrhage
* Brachial plexus lesion
* Erb's palsy
* Klumpke paralysis

By system|

| 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

Haemorrhagic 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

Digestive|

* 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

Infectious|

* Vertically transmitted infection
* Neonatal infection
* Congenital rubella syndrome
* Neonatal herpes simplex
* Mycoplasma hominis infection
* Ureaplasma urealyticum infection
* Omphalitis
* Neonatal sepsis
* Group B streptococcal infection
* Neonatal conjunctivitis

Other|

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

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