The path made and where to go: trends in the neonatal mortality rate. A cross-sectional study

Abstract

Introduction: Neonatal mortality is an indicator of maternal and child health, which reflects the level of pre- and post-natal care. The objective of the present study was to determine the neonatal mortality rate, its trend, and respective causes in a Neonatal Intensive Care Unit. Methods: Retrospective, descriptive observational study that included newborns who died between 1992 and 2020 in a differentiated perinatal support unit. Results: There were 390 deaths (mortality rate 5.7%). Fifty per cent of deaths occurred in the early neonatal period; 77% in premature infants. The trend in neonatal mortality decreased over the decades, mainly due to early and late neonatal mortality. Post-neonatal mortality remained stable. The main causes of death were prematurity-related organ dysfunction (39%), infections (24%), and congenital anomalies (16%). There was a decrease in the proportion of deaths from congenital anomalies and an increase in the proportion of infections. An autopsy was performed in 176 newborns (45%). Discussion: This study offers a long period of analysis of mortality rates with more extent data from a particular neonatal population. The decrease in neonatal mortality rates and deaths due to congenital anomalies reflect the progress achieved in prenatal diagnosis and differentiated prenatal and postnatal healthcare. On the other hand, infection remained one of the main causes of late neonatal and post-neonatal death. Analysis of neonatal mortality has the potential to enable a refined clinical practice. Focus on post-neonatal and infection-related mortality should be the next priorities in the improvement of neonatal care.

Keywords

• Early-neonatal mortality. Post-neonatal mortality. Neonatal intensive care. Prematurity.