{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T08:20:52Z","timestamp":1778314852454,"version":"3.51.4"},"reference-count":46,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,10,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVES:<\/jats:title><jats:p>To characterize the incidence of, risk factors for, and neonatal morbidity and mortality associated with respiratory depression at birth and neonatal encephalopathy (NE) among term infants in a developing country.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>Data were collected prospectively in 2002\u20132006 during a community-based trial that enrolled 23 662 newborns in rural Nepal and evaluated the impact of umbilical-cord and skin cleansing on neonatal morbidity and mortality rates. Respiratory depression at birth and NE were defined on the basis of symptoms from maternal reports and study-worker observations during home visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Respiratory depression at birth was reported for 19.7% of live births, and 79% of cases involved term infants without congenital anomalies. Among newborns with probable intrapartum-related respiratory depression (N = 3465), 112 (3%) died before their first home visit (presumed severe NE), and 178 (5%) eventually developed symptoms of NE. Overall, 629 term infants developed NE (28.1 cases per 1000 live births); 2% of cases were associated with congenital anomalies, 25% with infections, and 28% with a potential intrapartum event. The incidence of intrapartum-related NE was 13.0 cases per 1000 live births; the neonatal case fatality rate was 46%. Infants with NE more frequently experienced birth complications and were male, of multiple gestation, or born to nulliparous mothers.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>In Sarlahi, the incidence of neonatal respiratory depression and NE, associated neonatal case fatality, and morbidity prevalence are high. Action is required to increase coverage of skilled obstetric\/neonatal care in this setting and to evaluate long-term impairments.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2010-3590","type":"journal-article","created":{"date-parts":[[2011,9,27]],"date-time":"2011-09-27T03:44:22Z","timestamp":1317095062000},"page":"e915-e924","source":"Crossref","is-referenced-by-count":19,"title":["Incidence of and Risk Factors for Neonatal Respiratory Depression and Encephalopathy in Rural Sarlahi, Nepal"],"prefix":"10.1542","volume":"128","author":[{"given":"Anne CC","family":"Lee","sequence":"first","affiliation":[{"name":"Department of International Health, International Center for Advancing Neonatal Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland;"},{"name":"Department of Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke C.","family":"Mullany","sequence":"additional","affiliation":[{"name":"Department of International Health, International Center for Advancing Neonatal Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M.","family":"Tielsch","sequence":"additional","affiliation":[{"name":"Department of International Health, International Center for Advancing Neonatal Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of International Health, International Center for Advancing Neonatal Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subarna K.","family":"Khatry","sequence":"additional","affiliation":[{"name":"Nepal Nutrition Intervention Project-Sarlahi, Kathmandu, Nepal; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven C.","family":"LeClerq","sequence":"additional","affiliation":[{"name":"Department of International Health, International Center for Advancing Neonatal Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland;"},{"name":"Nepal Nutrition Intervention Project-Sarlahi, Kathmandu, Nepal; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramesh K.","family":"Adhikari","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Tribhuvan University, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary L.","family":"Darmstadt","sequence":"additional","affiliation":[{"name":"Department of International Health, International Center for Advancing Neonatal Health, Bloomberg School of Public 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