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Manipal Journal of Medical Sciences

Abstract

Background: Malaysia being an emerging economy has done well in the health sector. The perinatal mortality is reduced significantly but a slight upward trend was seen after 2015 in less developed states. This prompted us to conduct a review of perinatal, stillbirth, and neonatal deaths in Malaysia and compare them with other developing and developed countries. Aims and objectives: To find out: (1) Perinatal, neonatal and stillbirth rates from 2010 to 2018 in Malaysia, and (2) Compare it with developed and developing countries for the same duration. (3) To study contributary factors responsible for perinatal mortality, stillbirths and neonatal deaths and recommend the action plan to reduce it. Materials and Methods: Data related to perinatal, stillbirths and early neonatal mortality was searched from September 2020 to October 2020 using PubMed, Google, Google Scholar, Embase, EBSCO, Elsevier, and NIH/National Library of Medicine. Statistical Analysis: Analysis was done using Excel and StatCalc. Results: Mean perinatal mortality, stillbirth, and early neonatal mortality rates in Malaysia are 7.8, 4.72, 3 per 1000 respectively, which are almost half as that of Brazil which has PMR 17/1000, SBR 9.11/1000, ENMR 7.15/1000 live births. However, these values are twice as high as Singapore and Netherlands. Singapore has the lowest mortality rates; PMR 3.2, SBR 2.33 and ENMR 1.21 per 1000. Comparatively, India had the highest PMR of 26/1000 and ENMR of 22/1000 live births. Regional variations are seen in Malaysia, Brazil, India, and Netherlands. Main causes of perinatal mortality include pre-term births, hypertensive disorders of pregnancy, asphyxia, prematurity and low birth weight, congenital malformations in developing and emerging countries. Whereas, in developed nations, congenital malformation, aneuploidy, asphyxia and antepartum haemorrhage (APH) constitute the main causes. Major risk factors were maternal age, primigravida, obesity and diabetes. Conclusion: PMR, ENMR, SBR are high in low-income states in Malaysia, India, and Brazil. Contributory factors can be low income, poor education, lack of health-seeking behaviour. Mortalities can be reduced by educating women regarding pregnancy, nutrition, spacing of pregnancies, immunisation. Making essential health care in obstetrics and neonatal for all and everywhere.

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