Basic causes of newborn child mortality in a tertiary level Maternity hospital: changes occurred in a decade
Keywords:
underlying cause of death, infant mortality, hospital mortaity, mortality registriesAbstract
Objective
Compare the profile of the basic causes of neonatal death in a tertiary hospital in two periods with an interval of 10 years.
Methods
This is a descriptive study of the basic causes of hospital neonatal death (n=147), distributed by weight groups and gestational age, occurring among live births weighing:::C:500g, in the maternity ward of the Centro de Assistência Integral a Women's Health at the State University of Campinas, from 1/1/1996 to 12/31/1997, comparing the data obtained with those (n=91) relating to the period 1986-1987. The underlying causes of death, defined after reviewing the patient's clinical and laboratory evolution and autopsy findings, were classified according to the criteria of the Quebec Perinatal Mortality Committee.
Results
There was a significant difference in the profile of neonatal deaths in the two periods. In more recent years, congenital malformations were the most frequent cause of deaths, corresponding to 46% of them, replacing asphyxia, the most common reason for cases in 1986-1987. There was no difference in the participation of hyaline membrane disease and infection and, in 1996-1997, fewer deaths were classified in the category that grouped all other causes.
Conclusion
Probably the improvement in the quality of perinatal care for pregnant women and newborns in the years 1996-1997, despite the worsening of the population's characteristics, reduced the number of deaths from preventable causes and those considered unknown or undetermined, thus assuming malformations capital importance. Therefore, the reduction of mortality rates in the service implies a re-discussion of care protocols for pregnancies of fetuses diagnosed with congenital anomalies.
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