Neonatal mortality rate: is further improvement possible?

Area of Science:

• Neonatalogy
• Perinatology
• Public Health

Background:

• Neonatal and infant mortality rates remain critical public health indicators.
• Understanding trends and causes of death is essential for targeted interventions.
• Regional neonatal intensive care units play a vital role in managing high-risk newborns.

Purpose of the Study:

• To evaluate the possibility and likelihood of improving neonatal and infant mortality rates.
• To analyze mortality trends over a decade in a regional neonatal intensive care unit.
• To identify factors contributing to neonatal and infant deaths.

Main Methods:

• Retrospective analysis of a decade (1982-1991) of neonatal intensive care unit data.
• Determination of postnatal age at death, birth weight-specific, and gestational age-specific mortality rates.
• Categorization of neonatal deaths as 'possibly preventable' or 'probably unpreventable'.

Main Results:

• A significant decrease in the gestational age for 50% survival (from 26 to 24 weeks).
• Improved survival rates for very low birth weight (VLBW; <1500 gm) infants post-surfactant therapy introduction.
• Congenital malformations were a major cause of death, particularly in higher birth weight groups.
• Extreme prematurity and malformations were key factors in extremely low birth weight (ELBW; <1000 gm) infant mortality.

Conclusions:

• The number of possibly preventable neonatal deaths has significantly decreased.
• Substantial further impact on mortality rates necessitates reducing VLBW and ELBW rates.
• Continued advancements in neonatal care and prevention strategies are crucial.