Related Experiment Videos
Irish neonatal mortality--12 years on
A Foran1, E Dempsey, A Watters
1Department of Paediatrics, Our Lady of Lourdes Hospital, Drogheda, Co Louth.
Insights
Neonatal mortality in Ireland significantly decreased from 1987 to 1999, with fewer deaths from prematurity and asphyxia. However, congenital malformations remain a leading cause, highlighting the need for improved neonatal care and morbidity tracking.
Area of Science:
- Neonatalogy
- Public Health
- Pediatrics
Background:
- Neonatal mortality rates in Ireland have historically been a concern.
- Previous studies, such as Counahan and Clarke (1987), established baseline data for neonatal deaths.
Purpose of the Study:
- To assess trends in neonatal mortality in Ireland between 1987 and 1999.
- To identify the primary causes of neonatal death in Ireland for the year 1999.
- To compare current neonatal mortality data with historical data to evaluate changes in care and outcomes.
Main Methods:
- A nationwide questionnaire survey was distributed to all pediatricians in Ireland.
- Data collected pertained to live-born infants over 500g birth weight who died within 28 days of life in 1999.
- Deaths were categorized using the Wigglesworth Classification; data was compared to 1987 figures.
Main Results:
- A response rate of 91% was achieved, with 186 neonatal deaths reported in 1999, a decrease from 310 in 1987.
- Congenital malformations (39%) and prematurity (37%) were the leading causes of death in 1999.
- The overall Neonatal Mortality Rate decreased from 5.3/1000 in 1987 to 3.48/1000 in 1999.
Conclusions:
- A significant reduction in neonatal mortality in Ireland is evident, with notable decreases in deaths attributed to prematurity and asphyxia.
- Congenital malformations remain a persistent major cause of neonatal death, indicating areas for targeted intervention.
- Despite reduced mortality, the need for comprehensive data on long-term outcomes for surviving preterm and asphyxiated infants is critical, suggesting the exploration of a national neonatal morbidity register.
Abstract:
All Paediatricians in Ireland were requested to fill a questionnaire which dealt with data pertaining to all live-born infants over 500 g birth weight who died within the first 28 days of life in 1999. Deaths were categorized according to Wigglesworth Classification into Lethal Malformation, Immaturity (Prematurity), Asphyxia and "Specific". Each hospital and patient was assigned a unique ID number. Data from questionnaires was entered into a database. Results were compared with those previously published by Counahan and Clarke for 1987. Twenty one of the 23 paediatric centres in Ireland replied giving a response rate of 91%. The over-all number of neonatal deaths for 1999 was 186 compared to 310 for 1987. One hundred and two (55%) were < 1500 grams and 61 (33%) < 1000 g. The principal causes of death for 1999 were Congenital Malformations 39%, (n=72), Prematurity 37% (n=69) and Asphyxia 3% (n=5). This compares to figures of 39%, 40% and 8%, respectively for 1987. The overall Neonatal Mortality Rate for 1999 was 3.48/1000 with a Corrected Neonatal Mortality Rate of 2.1/1000. The Neonatal Mortality Rate and Corrected Neonatal Mortality Rate for 1987 were 5.3/1000 and 3.3/1000 respectively. The decrease in Neonatal Mortality in the past 12 years in Ireland is to be applauded. However it can lead to a false sense of security regarding standards of neonatal care. While the death of Extremely Low-Birth-Weight infants can now often be prevented, in many cases it is merely deferred to the post-neonatal period. Furthermore, no national data is available on the long term outcome and neurodevelopmental status of preterm or asphyxiated infants who survive. The possibility of establishing an Irish Neonatal Morbidity Register, aimed at improving the effectiveness and efficiency of medical care for newborn infants, must now be explored.