[Causes of neonatal mortality 1981-1983: a regional analysis]

We studied perinatal care and causes of death in 182 newborn infants who died during the first 28 days of life in the children's hospitals of Bochum, Datteln, and Essen in 1981-1983. Birth weight was below 2 500 g in 73%, cerebral hemorrhage was found in 15% of the infants. Most common causes of death were cardiorespiratory maladaptation (60%), congenital malformation (27%), and severe infection (12%). 90 infants died on the first day, 138 within the first week of life. A matched pair analysis comparing 153 deaths above 750 g with survivors of similar birth weight demonstrated preventable factors in half of the neonatal deaths: hypothermia, acidosis, blindbuffer and volume therapy, and hyperglycemia. More infants survived when born during the daylight hours and when a pediatrician was present at birth. Mortality and incidence of hypothermia were higher in small maternity units. In order to reduce neonatal mortality further, regional perinatal centres for high risk deliveries should be developed in Nordrhein-Westfalen.