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Early child health in Lahore, Pakistan: IX. Perinatal events
Author(s) -
Jalil F,
Lindblad BS,
Hanson LÅ,
Khan SR,
Yaqoob M,
Karlberg J
Publication year - 1993
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1993.tb12910.x
Subject(s) - medicine , odds ratio , birth weight , low birth weight , pediatrics , pregnancy , obstetrics , gestational age , gestation , infant mortality , odds , demography , population , logistic regression , environmental health , genetics , sociology , biology
In Pakistan there are a number of acute problems related to maternal and infant health in the perinatal period. There is also lack of reliable data needed for the formulation of action strategies. To provide a database 1490 women have been followed from the 5th month of pregnancy in four different areas at various levels of urbanization and socio‐economic development. After adjusting for gestational age, the proportion of newborns with weight for length < ‐2SDS in relation to the Swedish National Standard was 12–31% for boys and 12–25% for girls, the figure being highest in the most deprived area. Preterm birth was infrequent compared with IUGR. The overall prevalence rate of birth defects was 21% out of which 8% were severe defects. The overall perinatal mortality rate was 56/1000 births, with rates of 60, 75, 36 and 33/1000 births for the village, periurban slum, urban slum and the upper middle class. Two thirds of the deaths were related to either a continuation of intrauterine disturbances or severe congenital defects incompatible with life. One third of the deaths were due to infection; mostly diarrhoea, clinical sepsis and ARI. Neonatal mortality was significantly related to birth length (<‐2SDS, odds ratio 5.5) and length of gestation (<37 weeks, odds ratio 5.6) and was to a lesser extent related to weight (<‐2SDS, odds ratio 2.0) and weight for length (<‐2SDS, odds ratio 1.3). Forty percent of the mothers had weight for height below ‐2SDS, 23–35% had height <‐2SDS. Forty percent of mothers from a subset within the cohort had a hemoglobin < 10 gm/dl and 20% showed signs of pre‐eclampsia. This presentation raises the issue of expanding the current Child Survival Programs into the perinatal period as well.