medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2006, Number 08

<< Back Next >>

Ginecol Obstet Mex 2006; 74 (08)

Neonatal mortality in a regional perinatal hospital in Merida, Yucatan, 1995-2004 I. Analysis of the gross, specific rates

Osorno CL, Acosta MA, Dávila VJ, Rodríguez CJ, Escamilla SM, Echeverría EM

Language: Spanish
References: 22
Page: 401-409
PDF size: 304.39 Kb.


ABSTRACT

Objective: To evaluate the neonatal mortality and the specific neonatal mortality rates by groups of birthweight and gestacional age, at the Ignacio García Téllez National Medical Center which is a reference tertiary perinatal center of the Social Security Mexican Institute for the Yucatan Peninsula, along the period of 1995-2004.
Material and methods: A cohort of 46,297 live newborns was studied with birtweight of 500 grams or more, that were discharged between January 1st 1995 and December 31st 2004. Birthweight, gestational age, length of hospitalization, condition at discharge were captured in a data base. Triennial analysis of mortality was done.
Results: The proportion of neonates with birthweight ‹2,500 g increased and 19% neonates ‹1,000 g 50%, the increment was 21% for preterm neonates, 46% for immature, and 40% for those extremely immature. The early neonatal mortality rate diminished from 7.0 to 6.9, the late mortality from 3.0 to 2.2, the neonatal from 10.0 to 9.2/1,000 live newborn, the survival increased 232% in neonates with birthweight between 500-749 g, 25% between 750-999 g, 5.8% between 1,000-1,249 g, 8.2% between 1,250-1,499 g. The neonatal mortality decreased 31.8% from the expected, because the adjusted neonatal mortality rate was 13.5 compared with the observed 9.2/1,000 live newborn.
Conclusions: There was a significant increase of the survival with lesser birthweight and gestational age, although it was not reflected in the brut neonatal mortality rate because there was an increase of the risk population.


REFERENCES

  1. Yu VY. Global, regional and national perinatal and neonatal mortality. J Perinat Med 2003;31:376-9.

  2. Estadísticas de la región de América Latina y Caribe – introducción - vínculos a banco mundial - OPS (SHA) – UNICEF- United Nations – WHOSM – World health report. Disponible en línea URL: www.clap.ops-oms.org/web_2005/estadisticas

  3. Salud Perinatal. Boletín del Centro Latinoamericano de Perinatología y Desarrollo Humano (CLAP) de la Organización Panamericana de Salud. Organización Mundial de la Salud 1998;6(16):1-8.

  4. Lemons JA, Bauer CR, Oh W, et al. Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 through December 1996. NICHD Neonatal Research Network. Pediatrics 2001;107(1):E1.

  5. Rivera-Rueda MA, Coria-Soto I, Zambrana-Castañeda M, Castelazo-Morales E, Ahued-Ahued JR. Tendencias de la mortalidad perinatal en el Instituto Nacional de Perinatología. Ginecol Obstet Mex 1999;67:578-86.

  6. Velasco-Murillo V, Palomares-Trejo A, Navarrete-Hernández E. Causalidad y tendencia de la mortalidad perinatal hospitalaria en el Instituto Mexicano del Seguro Social, 1998-2002. Cir Ciruj 2003;71:304-13.

  7. Lee-Santos I. Mortalidad perinatal en un hospital de segundo nivel de atención. Rev Med IMSS 2003;41:31-36.

  8. Tinoco-Favila ML, Guerrero-Romero F, Rodríguez-Morán M. Mortalidad neonatal temprana en un centro de segundo nivel de atención en recién nacidos mayores de 28 semanas de edad gestacional y peso al nacer igual o mayor de 1,000 g. Bol Med Hosp Infant Mex 2004;61:282-8.

  9. Kramer MS. Clinical epidemiology and biostatistics. Berlin: Springer-Verlag, 1988;pp:32-6.

  10. Joseph KS, Kramer MS. Recent trends in infant mortality rates and proportions of low-birth-weight live births in Canada. Can Med Assoc J 1997;157:535-41.

  11. Goldberg RL. The management of preterm labor. Obstet Gynecol 2002;100:1020-37.

  12. Lumley J. Defining the problem: the epidemiology of preterm birth. BJOG. 2003;110(suppl20):3-7.

  13. Alexander GR, Kogan M, Bader D, et al. US birth weight/gestational age-specific neonatal mortality: 1995-1997 rates for whites, hispanics, and blacks. Pediatrics 2003;111:e61-e66.

  14. Rivera-Rueda MA, Hernández-Trejo M, Hernández-Peláez G, et al. Análisis de la mortalidad neonatal precoz en el Instituto Nacional de Perinatología (1999-2001). Perinatol Reprod Hum 2005;19:13-21.

  15. Ahued-Ahued JR. Prematurez un enfoque perinatal. México: Editores de Textos Mexicanos, 2004;p:1.

  16. Echeverría-Eguiluz M, Sauri-Pat RA, Osorno-Covarrubias L, Aguilar-Vivas I. Mortalidad perinatal en un hospital regional de tercer nivel. Bol Med Hosp Infant Mex 1994;51:765-70.

  17. Fernández-Carrocera LA, Salinas-Ramírez V, Guzmán-Bárcenas J, et al. Análisis de la mortalidad neonatal en un centro de tercer nivel de atención. Bol Med Hosp Infant Mex 2003:60:459-67.

  18. Del Olmo MH, Cardiel-Marmolejo lE, Reynoso E, Oslas LP, Acosta-Gómez Y. Morbilidad y mortalidad en el recién nacido prematuro del Hospital General de México. Rev Med Hosp Gral Mex 2003;66:22-28.

  19. Larroque B, Breart G, Kaminski M, et al. Epipage study group. Survival of very preterm infants: Epipage, a population based cohort study. Arch Dis Child Fetal Neonatal 2004;89:139-44.

  20. MacDorman MF, Martin JA, Mathews TJ, Hoyert DL, Ventura SJ. Explaining the 2001-02 infant mortality increase: data from the linked birth/infant death data set. Natl Vital Stat Rep 2005;53:1-22.

  21. Rankin J, Pearce MS, Bell R, Glinianaia SV, Parker L. Perinatal mortality rates: adjusting for risk factor profile is essential. Paediatr Perinat Epidemiol 2005;19:56-8.

  22. Martines J, Paul VK, Bhutta ZA, et al. Lancet Neonatal Survival Steering Team. Neonatal survival: a call for action. Lancet 2005;365(9465):1189-97.




2020     |     www.medigraphic.com