ABSTRACT
Introducción y objetivos: La mortalidad neonatal (MNN) es un indicador de calidad asistencial básico. El objetivo primario de este estudio ha sido el análisis de la evolución la MNN en el Hospital Universitario La Fe de Valencia (HULF), unidad de nivel IIIc, desde su inauguración en 1971 hasta el año 2009. Objetivos secundarios han sido la valoración de la tasa de prematuridad (PR) y bajo peso al nacimiento (BPN). Material y métodos: En este periodo se produjeron 308.989 nacimientos, en los que hubo 2.135 muertes neonatales. Resultados: La MNN muestra un descenso significativo (10,18‰ en 1971 vs 6,24‰ en 2009, p<0,001) Este descenso es aún más significativo para los neonatos con peso al nacimiento entre 500-999 gramos (923,1‰ en 1980 vs 238,1‰ en 2009, p<0,0001) y menor para los prematuros con edad gestacional inferior a 28 semanas (403,8‰ en 1993 vs 287,9‰ en 2009, p<0,01). La tasa de PR paso de 8,7% (1993) al 14% (2009) p<0,001. La tasa de BPN ascendió del 5,3% (1979) al 12.8% (2009), p<0,001. Los varones representan el 58,2% de las muertes neonatales y estas se producen en las primeras 24 h de vida en el 48,2%. La patología respiratoria representa el 36,3% de las muertes neonatales, las malformaciones severas el 31,5%, la patología neurológica el 14,6% y las infecciones el 7,9%. Conclusiones: A pesar del aumento de la PR y BPN se ha conseguido un descenso significativo de la MNN en el HULF(AU)
Background and objectives: Neonatal mortality (NM) is a reliable marker of quality clinical care. The primary objective of this study was to analyse evolution of NM in the Division of Neonatology (level IIIc according to the Spanish Classification) University Hospital La Fe Valencia (HULF) from the beginning of its activity in 1971 until 2009. Secondary objectives were the evaluation of prematurity rate (PR) and low birth weight rate (LBWR). Material and methods: There was a total of 308,989 births, with 2.135 neonatal deaths (ND), during the period studied. Results: NM has shown a significant decrease (10.18% in 1971 vs. 6.24% in 2009; P<0.01). This decrease was even more significant for neonates with birth weight between 500-999g (923.1% in 1980 vs. 238.1% in 2009; P<0.0001) and less for preterm with gestational age less than 28 weeks (403.8% in 1993 vs. 287.9% in 2009; P<0.01). The Prematurity rate increased from 8.7% (1993) to 14% (2009) (P<0.01), and LBWR increased from 5.3% (1979) to 12.8% (2009) (P<0.001). Males represent 58.2% of ND, and these occurred in the first day of life in 48.2% of the cases. Respiratory conditions represent 36.3% of ND, severe congenital malformations 31.5%, neurologic conditions 14.6%, and infections 7.9%. Conclusions: In spite of the increase in LBWR and PR, a significant descent of NM has been achieved in the HULF in the last decades(AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant Mortality , Infant, Low Birth Weight/physiology , Fetal Mortality/trends , Infant, Premature, Diseases/mortality , Infant, Premature/physiology , /methods , Quality of Health Care/standards , Quality of Health Care , Respiratory Tract Diseases/complications , Respiratory Tract Diseases/mortality , Hospitals, University/statistics & numerical data , Hospitals, University , Infant, Very Low Birth Weight/physiology , Respiratory Tract Diseases/epidemiologyABSTRACT
BACKGROUND AND OBJECTIVES: Neonatal mortality (NM) is a reliable marker of quality clinical care. The primary objective of this study was to analyse evolution of NM in the Division of Neonatology (level IIIc according to the Spanish Classification) University Hospital La Fe Valencia (HULF) from the beginning of its activity in 1971 until 2009. Secondary objectives were the evaluation of prematurity rate (PR) and low birth weight rate (LBWR). MATERIAL AND METHODS: There was a total of 308,989 births, with 2.135 neonatal deaths (ND), during the period studied. RESULTS: NM has shown a significant decrease (10.18% in 1971 vs. 6.24% in 2009; P<.01). This decrease was even more significant for neonates with birth weight between 500-999g (923.1% in 1980 vs. 238.1% in 2009; P<.0001) and less for preterm with gestational age less than 28 weeks (403.8% in 1993 vs. 287.9% in 2009; P<.01). The Prematurity rate increased from 8.7% (1993) to 14% (2009) (P<.01), and LBWR increased from 5.3% (1979) to 12.8% (2009) (P<.001). Males represent 58.2% of ND, and these occurred in the first day of life in 48.2% of the cases. Respiratory conditions represent 36.3% of ND, severe congenital malformations 31.5%, neurologic conditions 14.6%, and infections 7.9%. CONCLUSIONS: In spite of the increase in LBWR and PR, a significant descent of NM has been achieved in the HULF in the last decades.
