Related Experiment Videos
Postneonatal infant mortality in infants to a neonatal intensive care unit
Insights
Postneonatal infant mortality remains high, even in infants seemingly healthy at discharge from neonatal intensive care units. Key factors include congenital malformations, infections, SIDS, and socioeconomic status.
Area of Science:
- Neonatal intensive care
- Pediatric mortality
Background:
- Postneonatal infant mortality (PNIM) is significantly higher in neonatal intensive care unit (NICU) survivors compared to the general population.
- Congenital malformations, infections, sudden infant death syndrome (SIDS), and asphyxial brain damage are leading causes of PNIM.
Purpose of the Study:
- To investigate the causes and contributing factors of postneonatal infant mortality in infants who survived the neonatal period after NICU admission.
- To identify risk factors for PNIM in apparently healthy infants discharged from the NICU.
Main Methods:
- Retrospective analysis of 2,205 infants admitted to a NICU between January 1971 and December 1974.
- Examination of mortality data, causes of death, and infant characteristics.
Main Results:
- The PNIM rate was 44 per 1,000 neonatal survivors, approximately ten times the general population rate.
- Congenital malformations accounted for 59% of deaths; infections, SIDS, and asphyxial brain damage were also significant.
- An additional PNIM rate of 10 per 1,000 occurred in infants dismissed as apparently well, primarily due to SIDS and infections.
- Poor socioeconomic status and low birth weight were identified as significant contributing factors to mortality in this group.
Conclusions:
- Despite NICU care, a substantial proportion of infants face significant postneonatal mortality risk.
- Factors influencing high-risk births persist into the postneonatal period, impacting even seemingly healthy discharged infants.
- Further research and targeted interventions are needed to address PNIM in NICU survivors, particularly those dismissed as well.
Abstract:
The postneonatal infant mortality (PNIM) of 2,205 infants admitted to a neonatal intensive care unit from January 1971 to December 1974 was 44 in 1,000 infants who survived to age 28 days. This rate is approximately ten times that of the general population. Congenital malformations (59%), infections (12%), sudden infant death syndrome (10%), and asphyxial brain damage (10%) were the most common causes of death. One third (26) of the infants remained in the hospital whereas two thirds (52) had been dismissed prior to death. All who remained in the hospital plus 36 who had been dismissed died of severe illnesses that were incompatible with prolonged survival. The remaining PNIM was 10 in 1,000 neonatal survivors. This rate is still twice that of the general population. These deaths occurred in infants who were apparently well at the time of dismissal and subsequent examinations. Sudden infant death syndrome and infections constituted the largest portion of this mortality. Factors contributing to mortality in this group were poor socioeconomic status and low birth weight. Maternal age, race, marital status, and neonatal illnesses including apnea were not significantly related. Factors that appear to be important in the birth of high-risk infants continued to be operative in the postneonatal period, and contribute to a high mortality in apparently normal infants dismissed from the neonatal intensive care unit.