Duarte José Luiz Muniz Bandeira, Mendonça Gulnar Azevedo Silva
Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Cad Saude Publica. 2005 Mar-Apr;21(2):387-95. doi: 10.1590/s0102-311x2005000200005. Epub 2005 Mar 21.
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.
本研究的目的是描述巴西里约热内卢市四家妇产医院新生儿死亡的原因。该研究纳入了出生后最初完整27天内所有极低出生体重的新生儿。描述了活产新生儿和所有极低出生体重新生儿的分布情况，以及每家医院和总计的死亡百分比。该研究估计了总的和特定的新生儿死亡率系数，并评估了生存能力、死亡时间和原因。研究样本包括487名新生儿。我们发现新生儿死亡率为11.3%（早期新生儿死亡率为8.3%，晚期新生儿死亡率为2.9%）。所有极低出生体重新生儿的生存能力为妊娠26周以上且出生体重749克。出生后前三天死亡率较低，主要是在第一天，而从第四天到第28天死亡率较高。败血症是新生儿死亡的主要原因。卫生系统管理者应关注：围产期感染的诊断和控制；通过减少新生儿重症监护室的过度拥挤来降低新生儿医院感染率；对所有极低出生体重新生儿的胎盘进行常规病理检查，以及在死亡情况下进行常规尸检。
