- Title
- Neonatal near miss in Australia: incidence, determinants, and its impact on child health outcomes
- Creator
- Hassen, Tahir Ahmed
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2022
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Behind every neonatal death, there are many other newborns narrowly surviving the neonatal period (neonatal near misses). The need to include studies on neonatal near miss (NNM) has emerged to improve the quality of newborn care. NNM is a condition in which a newborn nearly died but survived the neonatal period. Over a decade the NNM concept has been conceptualized in several countries particularly following the standardization of the maternal near miss (MNM) criteria by the World Health Organization in 2009. However, unlike MNM, there is no internationally accepted criteria for NNM. Studies from developing countries have indicated that investigating NNM has several advantages over studying neonatal mortality to evaluate the quality of newborn care, particularly where there is low neonatal mortality. In addition, it has also been suggested that the NNM concept could be used to predict future developmental and other health outcomes in children. Despite this recommendation, the NNM concept has not been applied in Australia. The purpose of this thesis therefore was to investigate NNM and its impact on child health outcomes in Australia. Data from the Australian Longitudinal Study on Women’s Health (ALSWH) and the Mothers and their Children’s Health study (MatCH) were linked to data from the Australian state-based Perinatal Data Collections (PDCs). The ALSWH is a longitudinal population-based survey that has been conducted since 1996 with three different cohorts: women born 1921–26, 1946–51, and 1973–78. The MatCH study is a sub-study of the ALSWH that aimed to investigate how maternal and family characteristics impact the health and development of the next generation. The PDCs are Australian state-based data collections for pregnancies and births which include both live births and stillbirths. Multilevel multivariable logistic regression was used to identify the determinants of NNM. Generalized Estimating Equations were applied to model the associations between the components of NNM and neurodevelopmental outcomes and health-related quality of life. The findings of the study indicated that although neonatal mortality is low in Australia, a sizable number of newborns experienced NNM events (17.2 NNM cases per 1000 live births). Older maternal age, caesarean section, and gestational hypertension were associated with increased risks of NNM (Chapter 5). Further, the findings indicated that the five-minute Apgar score was inversely associated with neurodevelopmental delay (Chapter 6), and birthweight was inversely associated with impaired health-related quality of life in children (Chapter 7). The findings indicate the need to include NNM to assist in the evaluation of the quality of newborn care. There is also a need to enhance the work on the care of pregnancy in advanced age, those with gestational hypertension, and a need to minimise unnecessary caesarean sections to reduce NNM. It is equally important to identify and provide timely interventions for newborns who experienced a near miss event, to reduce future health and health related problems in the neonatal period and beyond.
- Subject
- neonatal; near miss; child health outcomes; Australia; determinants; neonatal health; multilevel analysis; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1483282
- Identifier
- uon:51089
- Rights
- Copyright 2022 Tahir Ahmed Hassen
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 12 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 752 KB | Adobe Acrobat PDF | View Details Download |