[Dynamics and structure of neonatal mortality in Bulgaria - Part II. Dynamics and structure of neonatal deaths in the university maternity hospital "Maichin Dom"].
OBJECTIVE
To analyse the state and the structure of the neonatal lethality in the largest perinatal center of Bulgaria 'Maichin dom' during the last five years, and to compare them with the national data on neonatal mortality.


METHODS
A retrospective study on the evolution of neonatal lethality in the recent 5 years and on its structure during the last 2 years was fulfilled using the data of the Department of Neonatology of the University hospital 'Maichin dom' concerning the infants' lethality. The results were compared to the national data on infants' mortality (in 28 days of life) and presented graphically.


RESULTS
The level of neonatal lethality in the University hospital increased invariably until 1997, when it reached the highest peak (12.7@1000), after that it decreased to 10.3@1000 in 1998. This tendency is predominantly due to the early neonatal mortality, which raised from 6.7@1000 in 1994 to 8.5@1000 in 1998, and remained at the same level in the last two years. The leading causes of neonatal lethality in the perinatal center are the congenital malformations--40.6@1000, which is higher than in the country. The congenital anomalies of central nervous system account to 75@1000 of all lethal malformations. The perinatal asphyxia is the second cause of death--34.7@1000, which is considerably less than in the country--41.3@1000. The neonatal respiratory distress syndrome is the third main cause of death in the neonatal period--9.4@1000 in the hospital; 10.9@1000--in the country. The neonatal lethality is mainly due to the premature infants--82.5@1000 in 1997 and 90.6@1000 in 1998. The relative portion of the term infants considerably decreased in these two years--from 17.5@1000 to 9.4@1000. These numbers are 100 times less than the data of the whole country.


CONCLUSIONS
The evolution of the neonatal lethality in the University hospital 'Maichin dom' has a similar tendency of the neonatal mortality in Bulgaria, the increase being mostly due to the early neonatal mortality. The leading causes of death are the congenital malformations and predominantly the central nervous system defects. The perinatal asphyxia is the second most frequent lethal cause with a relative portion which is less than that in the country. The lethality of the premature infants in the hospital is 6 times less than that in the country and the neonatal lethality of term infants is practically discriminated.
Zhekova
N
N
Kalaikov
D
D
D002031:Bulgaria / Q000453:epidemiology; D002423:Cause of Death; D000013:Congenital Abnormalities / Q000401:mortality; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006783:Hospitals, State / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality; D007234:Infant, Premature; D012189:Retrospective Studies