[Impact of maternal antecedents on neonatal mortality in a regional perinatal hospital].
OBJECTIVE
Determine the prevalence of maternal risk factors and evaluate their impact on neonatal mortality in a regional perinatal center.


METHODS
A cohort of 25,365 live newborns was studied between January 1st 2000 and December 31st 2004. Maternal antecedents were registered in a data base: sociodemographic; medical history; obstetric antecedents of previous pregnancies; as well as evolution of current pregnancy and birth. Newborn birth weight, gestational age and condition at discharge were registered too. Neonates who died were considered cases and controls those discharged alive. Mortality was compared to the presence or absence of risk factors in maternal medical history. Prevalence, odds ratio (OR) with 95% confidence interval, and attributable fraction in the exposed and the population were calculated with the SPSS 8.0 and Epi Info 6.4 programs.


RESULTS
The most notable maternal factors associated with newborn mortality were maternal age > or = 30 years OR 1.5 (1.37-2.0), less than 7 prenatal exams OR 2.17 (1.52-3.09) (53.5% attributable fraction in the exposed and 23.3% in population), eclampsia OR 4.66 (2.82-7.64), type-II diabetes OR 5.41 (2.11-12.99), urinary tract infection OR 1.98 (1.40-2.78), positive serology to human immunodeficiency virus OR 41.75 (5.77-230.9), membrane rupture > or = 48 hours OR 22.99 (13.10-40.2), polyhydramnios OR 31.53 (19.12-51.6) and abruptio placentae OR 42.18 (21.06-83.1).


CONCLUSIONS
Transpartum risk factors had a larger impact on mortality than pregnancy or pregestational factors.
Departamento clínico de Neonatología, Hospital de Gineco Pediatría del Centro Médico Nacional Ignacio García Téllez, IMSS Mérida, Yucatán, México. osornol@prodigy.net.mx
Lorenzo
L
Osorno Covarrubias
Carolina
C
Watty Cáceres
Felipe
F
Alonzo Vázquez
Jorge
J
Dávila Velázquez
Manuel
M
Echeverría Eguiluz
D005260:Female; D006761:Hospitals; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D008297:Male; D008800:Mexico; D011247:Pregnancy; D011248:Pregnancy Complications; D012307:Risk Factors