Participant Characteristics and Variability and Diversity
of the Early Neonatal Microbiome
For example, in MANA Stats there are such a small number
of early neonatal deaths that it wouldn't be impossible for a researcher to figure out who some of the mothers and babies are in the sample.
Not exact matches
Early clamping
of the umbilical cord at birth, a practice developed without adequate evidence, causes
neonatal blood volume to vary 25 % to 40 %.
It's just so ironic that the only
early neonatal death they could think
of was a CPM attended homebirth.
The authors chose to evaluate the results by creating an index
of primary events comprising intrapartum stillbirths,
early neonatal deaths,
neonatal encephalopathy [brain damage] meconium aspiration syndrome, brachial plexus injury, and fractured humerus or clavicle.
There was a low rate
of caesarean section, postpartum haemorrhage and third degree perinatal tears as well as low rates
of stillbirth and
early neonatal death in this sample
of women and babies.
MEND.org (Mommies Enduring
Neonatal Death)-- A Christian, non-profit organization that reaches out to families who have suffered the loss
of a baby through miscarriage, stillbirth, or
early infant death.
Indeed a paper published
earlier this year in the Journal
of Perinatology analyzed homebirths attended by a certified nurse midwife (CNM) and found that they had double the risk
of neonatal death
of CNM attended hospital births, even though the hospital birth cohort included high risk patients.
Intrapartum stillbirths and
early neonatal deaths accounted for 13 %
of events,
neonatal encephalopathy for 46 %, meconium aspiration syndrome for 30 %, brachial plexus injury for 8 %, and fractured humerus or clavicle for 4 % (see appendix 8 on bmj.com for distributions by planned place
of birth).
Main outcome measure A composite primary outcome
of perinatal mortality and intrapartum related
neonatal morbidities (stillbirth after start
of care in labour,
early neonatal death,
neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, or fractured clavicle) was used to compare outcomes by planned place
of birth at the start
of care in labour (at home, freestanding midwifery units, alongside midwifery units, and obstetric units).
It is a tragic fact
of neonatal nursing that many
of the babies I care for are born too sick or too
early to survive.
The primary outcome was a composite
of perinatal mortality and specific
neonatal morbidities: stillbirth after the start
of care in labour,
early neonatal death,
neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, and fractured clavicle.13 This composite measure was designed to capture outcomes that may be related to the quality
of intrapartum care, including morbidities associated with intrapartum asphyxia and birth trauma.
Rates were low for caesarean section, postpartum haemorrhage, third degree perineal tears, stillbirth and
early neonatal death in this sample
of women and babies.
Most studies
of homebirth in other countries have found no statistically significant differences in perinatal outcomes between home and hospital births for women at low risk
of complications.36, 37,39 However, a recent study in the United States showed poorer
neonatal outcomes for births occurring at home or in birth centres.40 A meta - analysis in the same year demonstrated higher perinatal mortality associated with homebirth41 but has been strongly criticised on methodological grounds.5, 42 The Birthplace in England study, 43 the largest prospective cohort study on place
of birth for women at low risk
of complications, analysed a composite outcome, which included stillbirth and
early neonatal death among other serious morbidity.
The rate
of stillbirth and
early neonatal mortality combined was 3.3 per 1000 births.
An additional analysis separating multiparous and primiparous women was undertaken as well as an analysis
of stillbirth and
early neonatal death.
The number you want for that is perinatal and
neonatal mortality — perinatal is fetal deaths during labor and
neonatal is deaths in either the first 8 days
of life («
early neonatal») or deaths between day 8 and day 28 («late
neonatal»).
The University
of Roehampton is researching the experience
of grief and counselling for fathers who have lost a baby due to late miscarriage, stillbirth or
early neonatal loss and who sought support for their bereavement in the form
of group, individual or couples counselling (even if they didn't continue with it).
Comparison
of Australian perinatal mortality (includes stillbirth and
early and late
neonatal mortality) between planned home births and all Australian births, 1985 - 90
Even if we just take
early and late
neonatal stats, leaving out HALF
of the homebirth deaths (22/44) it's 1.29 / 1000 for MANA's almost all white, majority college educated, mostly singleton, mostly low - risk healthy women in their 20s and 30s, vs. 0.81 for EVERYONE delivering at term in the hospital.
We have experiences
of early miscarriage, recurrent loss, stillbirth,
neonatal death, prematurity, preeclampsia, and twin loss.
[2] Our combined
early and late
neonatal death rates, or total
neonatal death rate,
of 0.77 per 1000 is statistically congruent with the rate reported by Hutton et al. [12]
Here are the mortality rates (excluding lethal anomalies) for babies born to low risk women that were confirmed to be alive at the start
of labor but die either during birth (intrapartum) or in the first week
of life (
early neonatal):
Their best survival is strongly linked to the
earliest and greatest amounts
of breast milk possible, even though this is often not encouraged in many
neonatal units.
Excessive infant weight loss in the
early neonatal period is often a reason for aggressive supplementation
of breastfeeding newborns.»
Main outcome measures were maternal outcomes (mortality; place and mode
of birth; perineal trauma; type
of management
of the third stage
of labor; post-partum hemorrhage; transfer to hospital); and
neonatal outcomes (
early mortality; Apgar score at 5 minutes; birth weight; breast - feeding initially and at 6 weeks; significant morbidity; transfer to hospital; admission to a special care nursery).
The authors concluded that the findings
of this study showed a significantly increased total and
early neonatal mortality for home births and even higher risks for women
of 41 weeks or longer and women having a first birth.
Similarly, in a secondary analysis
of 1,862 women enrolled in an
early versus delayed pushing trial, a longer duration
of active pushing was not associated with adverse
neonatal outcomes, even in women who pushed for more than 3 hours (28).
Maternal mortality (11 studies),
neonatal mortality (21 studies),
early (11 studies) and late (11 studies)
neonatal mortality, perinatal mortality (17 studies), stillbirths (15 studies), institutional deliveries (16 studies), and measures
of morbidity, and quality
of care
Protein and total energy intake, as well as the amount
of energy metabolised, are higher among formula - fed infants relative to breastfed (14,15), leading to increased body weight during the
neonatal period (10) and data suggests that both higher protein intake (16) and weight gain (17)
early in life is positively associated with the development
of obesity later in childhood.
The extra demands on the mother
of frequent suckling, coordinating the needs
of more than one infant or admission to the
neonatal intensive care unit can lead to delayed initiation or
early cessation.
An
earlier review examined the promotion and support
of breastfeeding in the
neonatal unit (Renfrew 2009).
Cesarean delivery, antenatal and intrapartum antibiotics, and formula feeding may interrupt the natural maternal - to -
neonatal bacterial transfer during the critical
early period
of neonatal immune development.
The mothers have a greater likelihood
of giving birth preterm and their babies being admitted to the
neonatal intensive care unit, which can lead to delayed starting or
early stopping
of breastfeeding.
There was one
early and one late
neonatal death, so a total
of 5 breech births.
You have to add up intrapartum (1.3),
early neonatal (0.41) and late
neonatal deaths (0.35) to get the total death rate
of 2.06 / 1000.
(
early neonatal death means the baby was born alive but died sometime in the first seven days), a baby is three times more likely to die at a home birth in the USA with a mortality rate
of 1.71 / 1000 versus only 0.64 / 1000 babies dying in the Netherlands.
Looking at that same study for a comparison
of total
neonatal mortality rate (
early plus late
neonatal for both studies)... Birth Center study shows their
neonatal mortality rate was 0.40 / 1000 excluding anomalies.
These data report intrapartum and
early neonatal death rates in full term women who intended to deliver out
of hospital (and subsequently deliver either out
of hospital or in hospital) at the start
of labor compared with women who intended a hospital birth (thus «higher risk» pregnancies are included in this group) in 2012.
Study shows significantly increased baby death after home births, especially for women
of 41 weeks or longer and first - time moms:
Early and total
neonatal mortality in relation to birth setting in the United States, 2006 - 2009
Findings are consistent with
earlier reports that planned home birth is associated with a tripling
of the
neonatal mortality rate.
More specifically, compared with women with no
early neonatal signs
of breastfeeding difficulty, we found that women who had negative feelings about breastfeeding and reported severe pain while nursing soon after birth were more likely to experience postpartum depression at 2 months.
In terms
of early infant behaviour, there is some suggestion that in the first few weeks
of life breastfed babies may be characterized by improved alertness28, 29 and other aspects
of neurobehavioural functioning.30 For example, Hart et al. 30 found that one - week - old breastfed infants obtained significantly higher scores on the orientation and motor scales on the Brazelton
Neonatal Behavioural Assessment Scale.
Dietary protein induced proctocolitis in exclusively breast fed infants is rarely taken into consideration as a cause
of rectal bleeding or blood streaked stool in the
neonatal period and
early infancy.
No studies have evaluated the role
of specific
neonatal breastfeeding experiences and postpartum depression.9 We therefore estimated the association between
early breastfeeding experiences and postpartum depression in a longitudinal sample
of women who initiated breastfeeding.
Effect
of early infant feeding practices on infection - specific
neonatal mortality: an investigation
of the causal links with observational data from rural Ghana Karen M Edmond, Betty R Kirkwood, Seeba Amenga - Etego, Seth Owusu - Agyei, and Lisa S Hurt Beginning Breastfeeding From First Day
of Life Reduces Infection Related Deaths in Newborns by 2.6 times.
I'm looking at birth statistics in Canada (rough, rough numbers)-- and it looks like the risk
of having a stillbirth (never mind
early neonatal death or those who transferred to hospital and had a subsequent still birth)-- is nearly double with home birth (81/6247 =.01296) compared to hospital birth (2734 / 380454).
Background: Delayed onset
of lactogenesis (OL) is most common in primiparas and increases the risk
of excess
neonatal weight loss, formula supplementation, and
early weaning.
«Our research indicates that insertion
of cervical pessary at around 22 weeks in both randomly selected women pregnant with twins and in patients with a short cervix
of less than 25 millimeters does not reduce the rate
of spontaneous
early preterm birth, perinatal death, adverse
neonatal outcome, or need for
neonatal therapy.»
«That they can detect this difference in connectivity so
early is something interesting,» says Hao Huang, who studies
neonatal brain development at the University
of Pennsylvania.