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Neonatal death at the University Hospital of the West Indies



Neonatal death at the University Hospital of the West Indies



West Indian Medical Journal 27(3): 130-136



Neonatal deaths were investigated at the University Hospital of the West Indies (UHWI) over a 4-year period (1974-77). Principal pathological diagnosis at autopsy was compared with clinical diagnosis according to the following criteria: intrapartum hypoxia, hypoxia, respiratory distress syndrome (RDS), infection and congenital malformation. Babies were classified according to the place of birth: "inborn" (born in UHWI) and "outborn" (born elsewhere). Neonatal mortality, mortality by weight, proportion of babies born at low birth weight, clinico-pathological agreement in principal cause of neonatal deaths, and comparison of first week neonatal deaths between 3 countries (Canada, United Kingdom and UHWI) were detailed in Tables 1-5. 49.6% of neonatal deaths occurred on the first day and 83.5% at the end of the first week; this confirmed the study of Lowry, Hall and Sparke (1976) which showed that 58% of neonatal deaths happen on the 1st extra-uterine day, and 89% within the 1st week. Neonatal mortality in the UHWI was attributed in part to the deficient neonatal care (limited nursing staff, equipment maintenance and supplies). For the period '74-'77, the neonatal mortality rate was 16.87/1000 live births; low-birthweight babies significantly accounted for this mortality. Common causes of death were congenital malformation, infection, RDS, intrapartum hypoxia and hypoxia in very immature babies. In Table 5, UHWI had the highest rate of infection which contributed to neonatal deaths. Prevention of neonatal infection, along with a general improvement in neonatal care would reduce neonatal mortality in UHWI.

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Accession: 040780686

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PMID: 706346


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