[Evaluation of neonatal mortality in very low birth weight infants in four maternity hospitals in the Municipality of Rio de Janeiro, Brazil].

The objective of this study was to describe the causes of neonatal mortality in four maternity hospitals in the Municipality of Rio de Janeiro, Brazil. The study included all very low birth weight newborns during the first complete 27 days of life. The distribution of live newborns and all very low birth weight newborns as well as the percentage of deaths per hospital and the totals were described. The study estimated total and specific neonatal mortality coefficients and assessed viability, time, and causes of death. The study sample consisted of 487 newborns. We found an 11.3 neonatal mortality rate (8.3 early neonatal and 2.9 late neonatal). Viability for all very low birth weight newborns was above 26 weeks' gestation and birth weight of 749 g. Mortality was low in the first three days of life, mainly in the first day, and higher from the fourth to the 28th day. Sepsis was the main cause of neonatal mortality. Health systems managers should focus on: diagnosis and control of perinatal infections; decreasing neonatal hospital infection by reducing overcrowding in the nursery; and routine pathological investigation on all placentas in very low birth weight newborns as well as routine autopsies in case of death.