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Strategies for reduction of neonatal mortality
A Finan1, T A Clarke, T G Matthews
1Department of Paediatrics, Rotunda Hospital, Dublin.
Irish Journal of Medical Science
|January 7, 2000
Summary
Neonatal deaths, primarily from congenital malformations and prematurity, remain a concern in developed countries. Increased use of folate may reduce infant mortality through community-focused measures.
Area of Science:
- Perinatal Medicine
- Public Health
- Neonatology
Background:
- Infant mortality rates have declined in developed nations, yet neonatal deaths persist.
- A significant proportion of infant deaths occur during the neonatal period.
- Understanding causes of neonatal mortality is crucial for targeted interventions.
Purpose of the Study:
- To review the causes of neonatal deaths.
- To identify areas for potential improvement in reducing neonatal mortality.
- To analyze mortality data using the Wigglesworth classification.
Main Methods:
- A six-year review (1991-1996) of neonatal deaths.
- Inclusion criteria: live-born infants > 500g birthweight.
- Utilized the 1989 amended Wigglesworth classification for cause of death categorization.
Main Results:
- 153 neonatal deaths occurred among 34,375 births.
- Congenital malformations (51%) and prematurity (38%) were the leading causes.
- Neural tube defects comprised 10% of total neonatal mortality.
Conclusions:
- Reducing neonatal mortality is achievable through focused interventions.
- Community-based strategies, including preconception folate supplementation, show promise.
- Prematurity deaths were concentrated in infants < 1000g, with survival rates comparable internationally.