Neonatal Mortality and Morbidity in a Neonatal Unit: Impact of Improved Perinatal Care in Recent 10 Years

新生兒死亡原因：相隔十年之統計比較研究

曹龍彥(Lon-yen Tsao) ； 陳曉能(Shiau-Neing Chen) ； 張寶倫(Boa-Luen Chang) ； 趙文崇(Wun-Jsong Chaou)

《Acta Paediatrica Sinica》 36卷6期 (1995/12) Pp. 405-410

https://doi.org/10.7097/APS.199512.0405

摘要

Analysis of the neonatal mortality record at the neonatal unit of Changhua Christian Hospital for the five-year period from 1989 to 1993 (period 2) is presented and compared with that of the period 1979- 1983 (period 1). This retrospective study is to evaluate whether the mortality rate and causes of neonatal death are affected by the changing perinatal care environment in Changhua area. This study shows that the mortality rate of the all admitted babies was dramatically decreased in period 2 (18% vs 12.35%, P＜0.01) and the mortality rate of delivered babies in our hospital was significantly decreased in period 2, too. (32.74% vs 11.61%, P＜0.001). However, the mortality rate of the babies referred from other hospitals was not different between the two periods (12.30% vs 12.72%, P＞0.05). These results can be explained by the higher quality of prenatal and delivery care, higher standard of neonatal intensive care for the sick neonates in period 2 and a comprehensive transport system which was established in 1987. RDS, prematurity, sepsis, asphyxia (particularly MAS with PPHN) and congenital malformations were still the main causes of neonatal death in period 2. We suggested that prevention, early diagnosis and intervention of these disorders and regionalization of perinatal care with a more comprehensive transport system are mandatory in Changhua area.

關鍵字

新生兒死亡 ； 呼吸窘迫症 ； 敗血症 ； 新生兒窒息 ； 先天性畸形

並列摘要

Analysis of the neonatal mortality record at the neonatal unit of Changhua Christian Hospital for the five-year period from 1989 to 1993 (period 2) is presented and compared with that of the period 1979- 1983 (period 1). This retrospective study is to evaluate whether the mortality rate and causes of neonatal death are affected by the changing perinatal care environment in Changhua area. This study shows that the mortality rate of the all admitted babies was dramatically decreased in period 2 (18% vs 12.35%, P＜0.01) and the mortality rate of delivered babies in our hospital was significantly decreased in period 2, too. (32.74% vs 11.61%, P＜0.001). However, the mortality rate of the babies referred from other hospitals was not different between the two periods (12.30% vs 12.72%, P＞0.05). These results can be explained by the higher quality of prenatal and delivery care, higher standard of neonatal intensive care for the sick neonates in period 2 and a comprehensive transport system which was established in 1987. RDS, prematurity, sepsis, asphyxia (particularly MAS with PPHN) and congenital malformations were still the main causes of neonatal death in period 2. We suggested that prevention, early diagnosis and intervention of these disorders and regionalization of perinatal care with a more comprehensive transport system are mandatory in Changhua area.

並列關鍵字

neonatal death ； RDS ； sepsis ； asphyxia ； congenital malformation