Neonatal mortality and morbidity in a neonatal unit: impact of improved perinatal care in recent 10 years.
Analysis of the neonatal mortality record at the neonatal unit of Changhua Christian Hospital for the five-year period from 1989 to 1993 (period 2) is presented and compared with that of the period 1979-1983 (period 1). This retrospective study is to evaluate whether the mortality rate and causes of neonatal death are affected by the changing perinatal care environment in Changhua area. This study shows that the mortality rate of the all admitted babies was dramatically decreased in period 2 (18% vs 12.35%, P < 0.01) and the mortality rate of delivered babies in our hospital was significantly decreased in period 2, too. (32.74% vs 11.61%, P < 0.001). However, the mortality rate of the babies referred from other hospitals was not different between the two periods (12.30% vs 12.72%, P > 0.05). These results can be explained by the higher quality of prenatal and delivery care, higher standard of neonatal intensive care for the sick neonates in period 2 and a comprehensive transport system which was established in 1987. RDS, prematurity, sepsis, asphyxia (particularly MAS with PPHN) and congenital malformations were still the main causes of neonatal death in period 2. We suggested that prevention, early diagnosis and intervention of these disorders and regionalization of perinatal care with a more comprehensive transport system are mandatory in Changhua area.
Tsao
L Y
LY
Department of Pediatrics, Changhua Christian Hospital, Taiwan, R.O.C.
Chen
S N
SN
Chang
B L
BL
Chaou
W J
WJ
D002423:Cause of Death; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D009017:Morbidity; D018743:Perinatal Care; D011247:Pregnancy; D011787:Quality of Health Care; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors