ABSTRACT
Objective:To investigate the mortality and causes of death in neonates from different medical institutions in Henan province.Methods:A retrospective analysis was performed on the death cases of 62 different medical institutions in 18 cities of Henan province in 2018, in order to compare the differences of neonatal mortality, age of death and the causes of death between maternal and child health care hospitals and general hospitals.Results:(1) A total of 80 780 newborns were admitted to 62 hospitals and 311 neonates died with a mortality rate of 3.85‰.A total of 33 339 newborns were admitted to 24 maternal and child health care hospitals, and 102 neonates died with a mortality rate of 3.06‰.Among them, 54 cases(52.9%) were premature infants and 48 cases(47.1%)were full-term infants.A total of 47 441 newborns were admitted to 38 general hospitals, and 209 neonates died with a mortality rate of 4.41‰.Among them, 111 cases(53.1%) were premature infants and 98 cases (46.9%) were full-term infants.Neonatal mortality in general hospitals was higher than that in maternal and child health care hospitals( P<0.05). (2) Neonatal death mainly occurred within one week after birth, especially within the first day.There were 67 cases of death(65.7%) in 24 maternal and child health care hospitals within the first day, including 34 cases (50.7%) of full-term infants and 33 cases (49.3%)of premature infants.And there were 87 cases of death(41.6%) in 38 general hospitals within the first day, including 50 cases (57.5%) of premature infants and 37 cases (42.5%) of full-term infants.Neonatal mortality within the first day after birth in maternal and child health care hospitals was higher than that in general hospitals( P<0.05). (3) The leading causes of neonatal death were non-infectious pulmonary diseases(128 cases, 41.2%), followed by birth asphyxia(73 cases, 23.5%) and infection(51 cases, 16.4%), but the causes of death in sequence varies from maternal and child health care hospitals and general hospitals.(4) For early death (within one week after birth) in both general hospitals and maternal and child health care hospitals, the main causes were birth asphyxia for full-term neonates, and pulmonary diseases(mainly respiratory distress syndrome)and birth asphyxia for premature infants.For late-stage death (2-4 weeks after birth) of neonates, infection was the leading cause in both term and preterm infants in general hospitals.For maternal and child health hospitals, the main causes of death for full-term infants were infection, and pulmonary diseases (mainly pulmonary hemorrhage and respiratory distress syndrome) for premature infants. Conclusion:There are some differences between maternal and child health care hospitals and general hospitals in neonatal mortality, mortality within the first day after birth, and causes of death.Therefore, it is necessary to strengthen the corresponding software and hardware constructions for newborns in different medical institutions to further reduce the neonatal mortality rate.
ABSTRACT
Objective@#To investigate the death status and cause of death of newborns in critical care centers at different levels in Henan province.@*Methods@#Retrospective analysis was performed on the death cases at 85 critical neonatal treatment centers in 18 cities of Henan province from January to December 2018, and the similarities and differences in neonatal mortality, age of death and causes of death among cities and county-level critical neonatal care centers were compared.@*Results@#(1) A total of 99 832 neonates were admitted to 85 hospitals, and 318 neonates died, with a mortality rate of 3.19‰.A total of 42 066 neonates were admitted to 21 municipal hospitals, and 194 neonates died, with a mortality rate of 4.6‰.Among them, 109 cases (56.2%) were premature infants (14 cases were of 28 weeks, 70 cases were of 28-34 weeks, 25 cases were of >34-37 weeks), and 85 cases (43.8%) were full-term infants.A total of 57 766 neonates were admitted to 64 county-level hospitals, with 124 deaths and a mortality rate of 2.1‰.Among them, 67 cases (54.0%) were full-term infants, 57 cases (46.0%) were premature infants (9 cases were of 28 weeks, 34 cases were of 28-34 weeks and 14 cases were of >34-37 weeks). The mortality rates at muni-cipal hospital were higher than those at the county-level hospitals, and the difference was statistically significant (χ2=46.589, P<0.05). (2) Neonatal death mainly occurred within 1 week after birth, especially within 1 day after birth.There were 81 deaths (41.8%) in 21 municipal hospitals within 1 day, including 50 premature infants (61.7%) and 31 full-term infants (38.3%). There were 75 deaths (60.5%) in 64 county-level hospitals within 1 day, including 34 premature infants (45.3%) and 41 full-term infants (54.7%). The mortality rate in county-level hospitals was higher than that in the municipal hospital within 1 day, and the difference was statistically significant(χ2=10.621, P< 0.05). (3)The top 5 causes of neonatal death in the municipal and the county-level hospitals were pulmonary diseases (130 cases, 40.8%), birth asphyxia (74 cases, 23.3%), infection (50 cases, 15.7%), congenital malformation (24 cases, 7.5%), and very-early premature/very-low birth weight infants (12 cases, 4.1%). (4)For early (within 1 week after birth) death of full-term infants, the main causes of death in municipal hospitals were lung diseases (mainly neonatal respiratory distress syndrome/acute respiratory distress syndrome), birth asphyxia, infection, congenital malformation.The leading causes of death at county-level hospitals were birth asphyxia, pulmonary diseases and infection.For premature infants who died within 1 week, the main causes of death at the municipal and the county-level hospitals were pulmonary diseases and birth asphyxia.For late-stage (2-4 weeks after birth) death of neonates, whether full-term infants or premature infants, the main cause of death in municipal and county-level hospitals was infection.@*Conclusions@#There are differences in neonatal mortality, mortality within 1 day after birth and the first cause of death at critical neonatal treatment centers at municipal and county-level hospitals.For the early-stage(within 1 week) neonates, the main causes of death in municipal and county-level hospitals are lung diseases (mainly neonatal respiratory distress syndrome/acute respiratory distress syndrome), birth asphyxia and infection.For the late-stage neonates, infection is the main cause of death in the municipal and the county-level hospitals.It is necessary to improve the neonatal care ability of critical neonatal treatment centers at different levels separately in order to reduce neonatal mortality.
ABSTRACT
Objective To investigate the death status and cause of death of newborns in critical care centers at different levels in Henan province.Methods Retrospective analysis was performed on the death cases at 85 critical neonatal treatment centers in 18 cities of Henan province from January to December 2018,and the similarities and differences in neonatal mortality,age of death and causes of death among cities and county-level critical neonatal care centers were compared.Results (1) A total of 99 832 neonates were admitted to 85 hospitals,and 318 neonates died,with a mortality rate of 3.19‰.A total of 42 066 neonates were admitted to 21 municipal hospitals,and 194 neonates died,with a mortality rate of 4.6‰.Among them,109 cases (56.2％) were premature infants (14 cases were of 28 weeks,70 cases were of 28-34 weeks,25 cases were of ＞ 34-37 weeks),and 85 cases (43.8 ％) were full-term infants.A total of 57 766 neonates were admitted to 64 county-level hospitals,with 124 deaths and a mortality rate of 2.1％o.Among them,67 cases (54.0％) were full-term infants,57 cases (46.0％) were premature infants (9 cases were of 28 weeks,34 cases were of 28-34 weeks and 14 cases were of ＞ 34-37 weeks).The mortality rates at municipal hospital were higher than those at the county-level hospitals,and the difference was statistically significant (x2 =46.589,P ＜0.05).(2) Neonatal death mainly occurred within 1 week after birth,especially within 1 day after birth.There were 81 deaths (41.8％) in 21 municipal hospitals within 1 day,including 50 premature infants (61.7％) and 31 full-term infants (38.3％).There were 75 deaths (60.5％) in 64 county-level hospitals within 1 day,including 34 premature infants (45.3％) and 41 full-term infants (54.7％).The mortality rate in county-level hospitals was higher than that in the municipal hospital within 1 day,and the difference was statistically significant(x2 =10.621,P ＜ 0.05).(3) The top 5 causes of neonatal death in the municipal and the county-level hospitals were pulmonary diseases (130 cases,40.8％),birth asphyxia (74 cases,23.3％),infection (50 cases,15.7％),congenital malformation (24 cases,7.5％),and very-early premature/very-low birth weight infants (12 cases,4.1％).(4)For early (within 1 week after birth) death of full-term infants,the main causes of death in municipal hospitals were lung diseases (mainly neonatal respiratory distress syndrome/acute respiratory distress syndrome),birth asphyxia,infection,congenital malformation.The leading causes of death at county-level hospitals were birth asphyxia,pulmonary diseases and infection.For premature infants who died within 1 week,the main causes of death at the municipal and the county-level hospitals were pulmonary diseases and birth asphyxia.For late-stage (2-4 weeks after birth) death of neonates,whether full-term infants or premature infants,the main cause of death in municipal and county-level hospitals was infection.Conclusions There are differences in neonatal mortality,mortality within 1 day after birth and the first cause of death at critical neonatal treatment centers at municipal and county-level hospitals.For the early-stage (within 1 week) neonates,the main causes of death in municipal and county-level hospitals are lung diseases (mainly neonatal respiratory distress syndrome/acute respiratory distress syndrome),birth asphyxia and infection.For the late-stage neonates,infection is the main cause of death in the municipal and the county-level hospitals.It is necessary to improve the neonatal care ability of critical neonatal treatment centers at different levels separately in order to reduce neonatal mortality.