Hsu Shuo-Tse, Hsieh Chia-Jung, Chen Hung-Wen, Jeng Suh-Fang, Wu Hui-Chen, Chen Mei-Huei, Chen Chien-Yi, Chou Hung-Chieh, Tsao Po-Nien, Chen Pau-Chung, Hsieh Wu-Shiun
Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
Department of Public Health, Tzu Chi University, Hualien, Taiwan.
Pediatr Neonatol. 2015 Jun;56(3):149-58. doi: 10.1016/j.pedneo.2014.07.006. Epub 2014 Oct 30.
There are limited nationwide data relating to neonatal mortality rate in Taiwan. This study aims to provide updated national birth weight/gestational age-specific neonatal mortality reference rates.
We abstracted the birth registration database from the Ministry of Interior in Taiwan from 1998 to 2002 and linked the data to the death registration database from the Ministry of Health and Welfare in Taiwan between 1998 and 2003. We included 1,331,785 infants born between 20 weeks and 44 weeks of gestation and weighing within the median ± 2 interquartile ranges in their age group in this study. We calculated the birth weight/gestational age-specific neonatal mortality rates of different genders by birth weight increments of 250 g and at gestational age intervals of 1 week. A Poisson regression model was used in modeling the mortality data.
A total of 4,169 deaths occurred within 28 days of life out of a total of 1,331,785 live births between 20 weeks and 44 weeks of gestation, giving a neonatal mortality rate (0-27 days) of 3.39 per 1000 live births for males and 2.80 per 1000 for females. The infant mortality rate remained higher in the male (5.91 per 1000) than the female (5.10 per 1000) population within the 1(st) year of life. Birth weight/gestational age-specific neonatal mortality rates were plotted with curves representing the 10(th) and 90(th) birth weight percentiles. The risk of an early neonatal death (0-6 days) does not exceed 50% except for female neonates < 500 g and ≤ 23 weeks, which implies that the limit of viability is now at 23 weeks for females.
We have provided an easy-to-use birth weight/gestational age-specific neonatal mortality rate chart as a reference document that physicians and parents can use to make decisions based on ethical considerations relating to whether to give palliative care or further invasive management. The normative data are crucial for public health policies on neonatal care in Taiwan.
台湾地区全国性的新生儿死亡率数据有限。本研究旨在提供最新的按出生体重/胎龄划分的新生儿死亡率参考率。
我们提取了台湾地区内政部1998年至2002年的出生登记数据库，并将这些数据与台湾地区卫生福利部1998年至2003年的死亡登记数据库相链接。本研究纳入了1331785名妊娠20周零天至44周零六天出生、体重在其年龄组中位数±2个四分位间距范围内的婴儿。我们按250克的出生体重增量和1周的胎龄间隔计算了不同性别的按出生体重/胎龄划分的新生儿死亡率。使用泊松回归模型对死亡率数据进行建模。
在1331785例妊娠20周零天至44周零六天的活产婴儿中，共有4169例在出生后28天内死亡，男性新生儿死亡率（0 - 27天）为每1000例活产3.39例，女性为每1000例2.80例。在生命的第1年，男性婴儿死亡率（每1000例5.91例）仍高于女性（每1000例5.10例）。按出生体重/胎龄划分的新生儿死亡率用代表第10和第90百分位出生体重的曲线绘制。除体重<500克且胎龄≤23周的女性新生儿外，早期新生儿死亡（0 - 6天）风险不超过50%，这意味着女性的存活极限现在为23周。
我们提供了一个易于使用的按出生体重/胎龄划分的新生儿死亡率图表，作为医生和家长可用于基于伦理考虑决定是否给予姑息治疗或进一步侵入性治疗的参考文件。这些规范数据对台湾地区新生儿护理的公共卫生政策至关重要。
