Finn Daragh, Collins Aedin, Murphy Brendan P, Dempsey Eugene M
Department of Paediatrics and Child Health, Neonatal Intensive Care Unit, University College Cork, Cork, Ireland,
Eur J Pediatr. 2014 Nov;173(11):1505-9. doi: 10.1007/s00431-014-2356-9. Epub 2014 Jun 11.
Modes of neonatal dying vary among maternity centres, both within and between countries. There have been few reports concerning mode of dying from countries with low rates of termination of pregnancy, such as Ireland. We conducted a retrospective chart review of all neonatal deaths, between January 2010 and January 2013, within a single Irish maternity centre. The mode of dying was classified as one of (1) withholding life-sustaining treatment (LST), (2) withdrawal of LST in moribund infants, (3) withdrawal of LST for quality of life reasons or (4) death despite maximal intensive care treatment. There were a total of 64 deaths during the study period. Congenital abnormalities accounted for 47 % of deaths and prematurity for 41 % of deaths. Withholding LST was the most frequent mode of dying, occurring in 38 % of all deaths. A total of 12 % of neonatal deaths occurred despite maximal intensive care treatment.
Congenital abnormalities were the most common cause of neonatal deaths. A high proportion followed LST being withheld, most likely a reflection of the low rates of medical termination in Ireland. Modes of dying in the neonatal period vary between maternity centres with culturally different backgrounds.
新生儿死亡模式在各国国内及不同国家间的产科中心存在差异。关于爱尔兰等堕胎率较低国家的死亡模式报告较少。我们对爱尔兰一家产科中心2010年1月至2013年1月期间所有新生儿死亡病例进行了回顾性病历审查。死亡模式分为以下几种：（1）停止维持生命治疗（LST）；（2）对濒死婴儿撤除LST；（3）因生活质量原因撤除LST；（4）尽管接受了最大程度的重症监护治疗仍死亡。研究期间共有64例死亡病例。先天性异常占死亡病例的47%，早产占41%。停止LST是最常见的死亡模式，占所有死亡病例的38%。尽管接受了最大程度的重症监护治疗，仍有12%的新生儿死亡。
先天性异常是新生儿死亡的最常见原因。很大一部分是在停止LST后发生的，这很可能反映了爱尔兰较低的人工流产率。新生儿期的死亡模式在文化背景不同的产科中心之间存在差异。
