title: Nationwide Birth Weight and Gestational Age-specific Neonatal Mortality Rate in Taiwan.
abstract: BACKGROUND
  There are limited nationwide data relating to neonatal mortality rate in Taiwan. This study aims to provide updated national birth weight/gestational age-specific neonatal mortality reference rates.
  
  
  METHODS
  We abstracted the birth registration database from the Ministry of Interior in Taiwan from 1998 to 2002 and linked the data to the death registration database from the Ministry of Health and Welfare in Taiwan between 1998 and 2003. We included 1,331,785 infants born between 20 weeks and 44 weeks of gestation and weighing within the median ± 2 interquartile ranges in their age group in this study. We calculated the birth weight/gestational age-specific neonatal mortality rates of different genders by birth weight increments of 250 g and at gestational age intervals of 1 week. A Poisson regression model was used in modeling the mortality data.
  
  
  RESULTS
  A total of 4,169 deaths occurred within 28 days of life out of a total of 1,331,785 live births between 20 weeks and 44 weeks of gestation, giving a neonatal mortality rate (0-27 days) of 3.39 per 1000 live births for males and 2.80 per 1000 for females. The infant mortality rate remained higher in the male (5.91 per 1000) than the female (5.10 per 1000) population within the 1(st) year of life. Birth weight/gestational age-specific neonatal mortality rates were plotted with curves representing the 10(th) and 90(th) birth weight percentiles. The risk of an early neonatal death (0-6 days) does not exceed 50% except for female neonates < 500 g and ≤ 23 weeks, which implies that the limit of viability is now at 23 weeks for females.
  
  
  CONCLUSIONS
  We have provided an easy-to-use birth weight/gestational age-specific neonatal mortality rate chart as a reference document that physicians and parents can use to make decisions based on ethical considerations relating to whether to give palliative care or further invasive management. The normative data are crucial for public health policies on neonatal care in Taiwan.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
authors.forename: Shuo-Tse
authors.initials: ST
authors.lastname: Hsu
authors.affiliation: Department of Public Health, Tzu Chi University, Hualien, Taiwan.
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Hsieh
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Hung-Wen
authors.initials: HW
authors.lastname: Chen
authors.affiliation: School and Graduate Institute of Physical Therapy, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Suh-Fang
authors.initials: SF
authors.lastname: Jeng
authors.affiliation: Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Wu
authors.affiliation: Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
authors.forename: Mei-Huei
authors.initials: MH
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Chien-Yi
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Hung-Chieh
authors.initials: HC
authors.lastname: Chou
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Po-Nien
authors.initials: PN
authors.lastname: Tsao
authors.affiliation: Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: pchen@ntu.edu.tw.
authors.forename: Pau-Chung
authors.initials: PC
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hsiehws@ntu.edu.tw.
authors.forename: Wu-Shiun
authors.initials: WS
authors.lastname: Hsieh
mesh_terms: D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D012306:Risk; D013624:Taiwan / Q000453:epidemiology
keywords: low birth weight; neonatal mortality; preterm birth