Changes in cause of neonatal death over a decade

Area of Science:

• Neonatalogy
• Perinatal Epidemiology
• Public Health

Background:

• Neonatal mortality remains a significant global health concern.
• Accurate classification of neonatal deaths is crucial for understanding trends and implementing targeted interventions.
• Wellington Hospital serves as a key site for monitoring neonatal health outcomes in New Zealand.

Purpose of the Study:

• To classify the causes of neonatal deaths at Wellington Hospital over a decade (1995-2004).
• To analyze changes in the causes of neonatal mortality over this 10-year period.
• To evaluate the utility of the PSANZ-NDC Classification guideline in tracking neonatal deaths.

Main Methods:

• A retrospective audit of live-born infants who died before 28 days of age, from 20 weeks gestation, between 1995 and 2004.
• Classification of deaths using the PSANZ-NDC guideline.
• Comparison of mortality data between two 5-year periods (1995-1999 and 2000-2004) to identify trends.

Main Results:

• A total of 219 neonatal deaths were recorded, with 154 in preterm infants and 67 in term infants.
• The autopsy rate was 62%, higher in term infants (76%).
• Significant decreases in deaths due to congenital anomalies and extreme prematurity were observed, alongside an increase in deaths attributed to infection.

Conclusions:

• The PSANZ-NDC death classification system provides an accurate method for determining the cause of most neonatal deaths.
• This classification system is effective for monitoring changes in neonatal mortality rates over time.
• The findings highlight evolving patterns in neonatal mortality, emphasizing the need for continued surveillance and intervention strategies.