Turlington A, Hodgman J E, Barton L
USC Division of Newborn Medicine, Department of Pediatrics, Women's and Children's Hospital, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
J Perinatol. 2008 Mar;28(3):188-91. doi: 10.1038/sj.jp.7211910. Epub 2008 Jan 24.
The objective was to evaluate the postneonatal mortality rate at our institution from 1999 to 2006 as a follow-up to a previous report from our hospital covering 1993 to 1998 and to investigate the causes of death in infants dying in the postneonatal period.
We identified all infant deaths before discharge from the nursery aged > or =28 days. Clinical data for all cases and autopsy records where available were reviewed and the cause of death was determined for each infant.
Total nursery deaths for the 7 years were 211, of which 14 (6.6%) occurred after the neonatal period. This represents a decreasing trend from the 12% reported in 1993 to 1998. Causes of death were the complications of prematurity and congenital defects. The five infants whose cause of death was the complications of prematurity had chronic lung disease, four had abdominal surgery for perforation and resection and two had intraventricular hemorrhage (IVH) Gr IV. All infants had multiple organ failure by the time of death and the final event was infection and/or renal failure. The nine congenital defects included two trisomy 21 with complications, one CHARGE association with heart defects, one hypertrophic cardiomyopathy and two others with multiple congenital heart defects. Of the three remaining infants, the anomalies included one with hydranencephaly, one with caudal regression and one with multiple vascular liver tumors.
Along with the general decrease in infant mortality, postneonatal mortality is decreasing as a percentage of nursery deaths. The causes of death include complications of prematurity and congenital defects.
对我院1999年至2006年的新生儿后期死亡率进行评估，作为我院之前一份涵盖1993年至1998年报告的后续研究，并调查新生儿后期死亡婴儿的死因。
我们确定了所有年龄≥28天且在新生儿室出院前死亡的婴儿。对所有病例的临床数据以及可用的尸检记录进行了回顾，并确定了每个婴儿的死因。
7年中新生儿室的总死亡人数为211人，其中14人（6.6%）发生在新生儿期之后。这代表了从1993年至1998年报告的12%呈下降趋势。死因是早产并发症和先天性缺陷。死因是早产并发症的5名婴儿患有慢性肺病，4名因穿孔和切除术接受了腹部手术，2名患有IV级脑室内出血（IVH）。所有婴儿在死亡时均有多器官功能衰竭，最终事件为感染和/或肾衰竭。9例先天性缺陷包括2例伴有并发症的21三体综合征、1例伴有心脏缺陷的CHARGE综合征、1例肥厚型心肌病以及另外2例伴有多种先天性心脏缺陷。其余3名婴儿的异常情况包括1例积水性无脑畸形、1例尾端退化和1例多发性肝血管肿瘤。
随着婴儿死亡率总体下降，新生儿后期死亡率占新生儿室死亡人数的百分比也在下降。死因包括早产并发症和先天性缺陷。
