Dangers of death on the first day of life by the minute.
OBJECTIVE
To evaluate mortality on the first day of life by minute and hour, and examine changes in major causes of death in the past three decades.


METHODS
We evaluated mortality on the first day of life by the hour (0, 1, …, 23 h), and in the first hour by 5-min block (0-4, 5-9, …, 55-59 min) using data on cause of death for 15,690 infants in Canada from 1981 to 2012.


RESULTS
Infant mortality on the first day declined from 2.60 per 1000 in the 1980s to 1.26 in the 2000s. The decline was greater at 6-23 h than at 0-5 h of life, and among infants with congenital anomalies compared with prematurity and birth asphyxia.


CONCLUSIONS
Infant mortality is highest on the first day of life. More focus on prematurity and birth asphyxia in the first 5 h of life is needed to improve infant mortality.
Institut national de santé publique du Québec, Montreal, Québec, Canada.|University of Montreal Hospital Research Centre, Montreal, Québec, Canada.
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http://orcid.org/0000-0002-2412-0459
N
Auger
Institut national de santé publique du Québec, Montreal, Québec, Canada.|Department of Demography, University of Montreal, Montreal, Québec, Canada.
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M
Bilodeau-Bertrand
Sainte Justine Hospital Research Centre, Montreal, Québec, Canada.
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AM
Nuyt
D001238:Asphyxia Neonatorum / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors