title: Rapid decrease of neonatal mortality in Turkey.
abstract: Our aim was to assess trends in neonatal mortality in 2009, evaluate advances in health policy, determine new goals to preserve a higher quality health service, and to prevent neonatal deaths. Data were gathered from the system of the General Directorate of Mother and Child and Family Planning. Maternal age, birth weight, gestational week, delivery at a health center, delivery by trained assistant, antenatal visits, and cause of death were evaluated. The neonatal mortality rate was 10/1,000 in Turkey in 2009, significantly better than rates of 26 in 1998, 17 in 2003, and 13 in 2008. The percentage of pregnant women making a minimum of four antenatal visits was around 80 %. Most deaths were attributable to prematurity and its complications, including 47.2 % of early neonatal mortality (ENM) and 36.1 % of late neonatal mortality (LNM). In ENM, the next-most common causes of death were congenital anomalies other than heart and genetic disorders (17.5 %), infections (6.5 %), asphyxia (6.1 %), and congenital heart disease (4.0 %), whereas in LNM, they were infections (19.9 %), congenital anomalies other than heart and genetic disorders (13.1 %), congenital heart disease (7.7 %), and asphyxia (3.8 %). Neonatal mortality in Turkey has declined within 8 years to level similar to that reached by Organisation for Economic Co-operation and Development countries over 30 years. Our findings show that each of the major causes of the neonatal death can be prevented by available interventions. Interventions to prevent prematurity, early diagnosis of congenital anomalies, and the prevention of infections would contribute to further reductions in neonatal mortality in Turkey.
authors.affiliation: Division of Neonatology, Samsun Maternal and Child Health Hospital, Samsun, Turkey. kgamze@hotmail.com
authors.forename: Gamze
authors.initials: G
authors.lastname: Demirel
authors.forename: Basak
authors.initials: B
authors.lastname: Tezel
authors.forename: Sema
authors.initials: S
authors.lastname: Ozbas
authors.forename: Serife Suna
authors.initials: SS
authors.lastname: Oguz
authors.forename: Omer
authors.initials: O
authors.lastname: Erdeve
authors.forename: Nurdan
authors.initials: N
authors.lastname: Uras
authors.forename: Ugur
authors.initials: U
authors.lastname: Dilmen
mesh_terms: D000328:Adult; D001238:Asphyxia Neonatorum; D002423:Cause of Death / Q000639:trends*; D002648:Child; D005260:Female; D006291:Health Policy; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008423:Maternal Age; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult