Osorno CL, Acosta MA, Dávila VJ, Gómez GM, Diego RN, Echeverría EM

Language: Spanish
References: 20
Page: 453-461
PDF size: 326.04 Kb.

ABSTRACT

Objective: To analyze the causes of neonatal mortality, its distribution, the moment of appearance and risk factors.
Patients and method: We studied a cohort of 46,297 live newborns born at the mentioned hospital, weighing 500 g or more. In a database we registered: birth weight, gestational age, days of hospital stay, discharged condition, one and five Apgar minute score, morbidity, death causes, moment of death, reducible death/reducible difficult death rate presented in less than 24 hours, 1 to 6 days, and 7 to 27 postnatal days. We compared morbidity, mortality, and risk factors in a three-year period to facilitate the analysis.
Results: Mortality increased with the lesser one minute Apgar score: 0.2, 9.7 and 42.9% when score was 7-10, 4-6, or 0-3, respectively, and 0.6, 41.9 and 62.9% at five minute Apgar score. Malformations were the first cause of death, which increased from 28.6 to 40.3%. Respiratory distress syndrome mortality decreased 34% and that of meconium aspiration syndrome 53%. Reducible death/hardly reducible death rate occurred from 1 to 6 days decreased 67%, from 5.2 to 1.7 (reference value 1).
Conclusions: Preventable causes of death decreased significantly, particularly those related to perinatal causes, although they are still high compared with developed countries.

REFERENCES

1. Sami S, Baloch SN. Perinatal mortality rate in relation to gender. J Coll Physicians Surg Pak 2004;14:545-8.

2. Elsmen E, Hansen Pupp I, Hellstrom-Westas L. Preterm male infants need more initial respiratory and circulatory support than female infants. Acta Paediatr 2004;93:447-8.

3. Domenech-Martinez E, Fuster-Jorge P, Leon-Quintana C, Cortabarria-Bayona C, et al. Neonatal morbidity and mortality according to intrauterine growth pattern. An Pediatr (Barc) 2005;63:300-6.

4. McIntire DD, Bloom SL, Casey BM, Leveno KJ. Birth weight in relation to morbidity and mortality among newborn infants. N Engl J Med 1999;340:1234-8.

5. Casey BM, McIntire DD, Leveno KJ. The continuing value of the Apgar score for the assessment of newborn infants. N Engl J Med 2001;344:467-71.

6. Whitsett JA, Pryhuber GS, Rice Wr, Warner BB, Wert SE. Acute respiratory disorders. In: Avery GB, Fletcher MA, MacDonald MG, editors. Neonatology, pathophysiology and management of the newborn. 4th ed. Philadelphia: JP Lippincott Co, 1994;pp:436.

7. Cloherthy JP, Eichenwald EC, Stark AR. Manual of neonatal care. 5th ed. Philadelphia: Lippincott Williams and Wilkins, 2004;pp:402.

8. Stoll BJ, Kliegman RM, Gotoff SM. The fetus and neonatal infant. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 16th ed. Philadelphia: WS Saunders Co, 2000;pp:497-543.

9. Iriondo M. Encefalopatía hipóxico-isquémica. http://www.se-neonatal.es/se-neonatal/VU2OLQASant.pdf.

10. Lukacs SI, Schoendorf KC, Schuchat A. Trends in sepsis-related neonatal mortality in the United States, 1985-1998. Pediatr Infect Dis J 2004;23(7):599-603.

11. Lozano R, Suárez A. Mortalidad neonatal. Bol Med Hosp Infant Mex 2004;61:275-9.

12. 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.

13. Tinoco-Favila ML, Guerrero-Romero F, Rodríguez-Mora 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;4:282-8.

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

15. Estadísticas de la región de Latinoamérica y el Caribe. Vínculos al Banco Mundial -OPS- (SHA) -UNICEF- United Nations -WHOSM- World Health Report. Disponible en línea URL: www.clap.ops-oms.org/web_2005/estadisticas%20de%20la%20reg...les.%20Primer%20d%EDa.htm

16. Dani C, Reali MF, Bertini G, Wieschmann L, et al. Risk factors for the development of respiratory distress syndrome and transient taquipnea in newborn infant. Italian Group of Pneumology. Eur Respir J 1999;14:155-9.

17. Perelman RH, Palta M, Kirby R, Farrel PM. Discordance between male and female deaths due to respiratory distress. Pediatrics 1986;78:238-44.

18. Hegyi T, Carbone T, Anwar M, Ostfeld B, et al. The Apgar score and its components in the preterm infant. Pediatrics 1998;101(1pt1):77-81.

19. Finster M, Wood M. The Apgar score has survived the test of time. Anesthesiology 2005;102:855-7.

20. Salazar-Hernández AC, Martínez-Torres J, Hernández-Montesinos AR. Mortalidad neonatal en un hospital general de zona. Rev Med IMSS 2001;39:359-64.