The Changing Pattern of Neonatal Mortality in a Regionalized System of Perinatal Care: A Current Update

Author:

Hein Herman A.1,Lofgren Maria A.1

Affiliation:

1. 1From the Department of Pediatrics, University of Iowa College of Medicine, Iowa City, Iowa.

Abstract

Objective. Our earlier studies about the changing pattern of neonatal mortality were based on data from 1978–1979 and 1982–1983. In this report, we provide a modern update of the causes of neonatal deaths to help focus prevention measures. Study Design. We reviewed neonatal deaths for the years 1995 and 1996 and assigned a clinical cause of death. Deaths were reviewed and analyzed by place of birth and death, according to level of care. We provided an estimate of the change in causes of death between 1982–1983 and 1995–1996 and calculated an idealized neonatal mortality rate for each level of care and for the entire state. Results. The major changes in causes of death occurred in the respiratory distress syndrome (RDS) and extremely low birth weight (ELBW) categories. RDS showed a substantial decline, but ELBW deaths increased by nearly the same amount that RDS declined. The idealized neonatal mortality rate calculations suggest that fewer potentially medically preventable deaths occur now than in 1982–1983. Currently, more neonatal deaths of level I births occur in level III facilities than in 1982–1983. However, at that time, Iowa had only one tertiary facility, and the level II regional hospitals were the site of more deaths. Conclusion. We believe that assigning deaths to a clinical category rather than to a catastrophic final event helps focus on sources of preventable death in the medical care system. To reduce neonatal mortality, the incidence of lethal congenital malformations and ELBW infants must be impacted.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference24 articles.

1. The changing pattern of neonatal mortality in a regionalized system of perinatal care.;Hein;Am J Dis Child,1986

2. Neonatal mortality review: a basis for improving care.;Hein;Pediatrics,1981

3. Classification of Newborns: Based on Maturity and Intrauterine Growth. Evansville, IN: Mead Johnson & Co; 1992. Adapted from: Lubchenco LO, Hansman C, Boyd E. Pediatrics. 1966;37:403 and Battaglia FC, Lubchenco LO.;Mead Johnson & Company;J Pediatr,1967

4. Outcomes of extremely low birth weight infants.;Hack;Pediatrics,1996

5. Very-low-birth-weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, May 1991 through December 1992.;Fanaroff;Am J Obstet Gynecol,1995

Cited by 24 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3