Department of Humanities and Social Sciences, Indian Institute of Technology Kanpur, Kanpur 208016, India.
Postgrad Med J. 2011 Apr;87(1026):257-63. doi: 10.1136/pgmj.2010.102723. Epub 2011 Feb 4.
India contributes to one quarter of the total number of newborn deaths in the world. Less explored are the causes of these deaths, and household factors and decision makers for antenatal and postnatal care and their association with neonatal mortality.
This study estimated neonatal mortality rate due to tetanus and sepsis (TS) and tried to identify the risk factors for TS in a peri-urban area of India characterised by a high level of infant and neonatal mortality rate.
An intensive cross-sectional study was conducted during January to March 2008. A structured interview schedule was developed, after reviewing major demographic and health studies done in India, to collect data from all women selected in the sample villages, situated at a distance of 3-5 km from a primary health centre.
Of the 894 married women (<50 years of age), 109 reported their last pregnancy outcome as neonatal death, and 84 cases of TS were noted. Using forward conditional stepwise logistic regression the risk factors of TS identified were women's age, socioeconomic score, antenatal care, pregnancy complications, and treatment after delivery during the neonatal period.
Independent of social class there is high prevalence of neonatal mortality. There is a close association between utilisation of health care services during pregnancy, postnatal period and neonatal deaths due to TS. It is argued that there is a need for a two pronged approach to reduce neonatal mortality due to TS: (1) to train traditional birth attendants, and expand the reach of existing antenatal care and childbirth facilities; and (2) to empower women to increase their awareness to take decisions about seeking proper medical assistance during pregnancy and childbirth.
印度的新生儿死亡人数占全球新生儿死亡总数的四分之一。而这些死亡的原因以及围产期保健的家庭因素和决策者，及其与新生儿死亡率的关系，尚未得到充分的研究。
本研究旨在评估破伤风和败血症（TS）导致的新生儿死亡率，并试图确定印度城郊地区（该地区婴儿和新生儿死亡率较高）TS 的危险因素。
2008 年 1 月至 3 月期间进行了一项密集的横断面研究。在回顾印度进行的主要人口和健康研究之后，制定了一个结构化访谈方案，以便从样本村中选择的所有妇女收集数据，这些村庄距初级保健中心的距离为 3-5 公里。
在 894 名已婚妇女（<50 岁）中，有 109 人报告了她们最近的妊娠结局为新生儿死亡，有 84 例 TS 病例。使用前向条件逐步逻辑回归，确定的 TS 危险因素包括妇女的年龄、社会经济评分、产前护理、妊娠并发症以及新生儿期的产后治疗。
独立于社会阶层，新生儿死亡率仍然很高。在怀孕期间和新生儿期使用医疗保健服务与 TS 导致的新生儿死亡之间存在密切关联。有人认为，需要采取双管齐下的方法来降低 TS 导致的新生儿死亡率：（1）培训传统的接生员，并扩大现有的产前护理和分娩设施的覆盖范围；（2）赋予妇女权力，提高她们在怀孕期间和分娩时寻求适当医疗援助的意识。
