[Neonatal mortality in a regional perinatal hospital in Merida, Yucatan, 1995-2004. II. Analysis of causes and risk factors].
OBJECTIVE
To analyze the causes of neonatal mortality, its distribution, the moment of appearance and risk factors.


METHODS
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.
Osorno Covarrubias
Lorenzo
L
Departamento Clínico de Neonatología, Hospital de Ginecopediatría, Mérida, Yucatán, México. osornol@prodigy.net.mx
Acosta Mass
Arlene
A
Dávila Velázquez
Jorge
J
Gómez García
Martha
M
Diego Rodríguez
Nidia
N
Echeverría Eguiluz
Manuel
M
D001034:Apgar Score; D001724:Birth Weight; D002423:Cause of Death; D005260:Female; D005865:Gestational Age; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D008800:Mexico / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors