Department of Pediatrics Division of Neonatology, Ege University School of Medicine, İzmir, Turkey.
Department of Obstetrics and Gynecology, Ege University School of Medicine, İzmir, Turkey.
Balkan Med J. 2017 Dec 1;34(6):553-558. doi: 10.4274/balkanmedj.2016.0870. Epub 2017 Aug 23.
Perinatal, foetal and neonatal mortality statistics are important to show the development of a health care system in a country. However, in our country there are very few national and regional data about the changing pattern of perinatal neonatal mortality along with the development of new technologies in this area.
Evaluation of the changes in mortality rates and the causes of perinatal and neonatal deaths within years in a perinatal reference centre which serves a high-risk population.
Cross-sectional retrospective study.
The perinatal, neonatal and foetal mortality rates in the years 1979-1980 (1 time point) and 1988-1989 (2 time point) were compared with the year 2008 (3 time point). The causes of mortality were assessed by Wigglesworth classification and death reports. The neonatal mortality in the neonatal intensive care unit was also calculated.
Foetal mortality rates were 44/1000, 31.4/1000 and 41.75/1000 births, perinatal mortality rates were 35.6/1000, 18.8/1000 and 9/1000 births, and neonatal mortality rates were 35.6/1000, 18.8/1000 and 9/1000 live births for the three study time points, respectively. The mortality rate in neonatal intensive care unit decreased consistently from 33%, to 22.6% and 10%, respectively, together with decreasing neonatal mortality rates. The causes of perinatal deaths were foetal death 85%, immaturity 4%, and lethal congenital malformations 8% according to Wigglesworth classification in 2008, showing the high impact of foetal deaths on this high perinatal mortality rate. Infectious causes of neonatal deaths decreased but congenital anomalies increased in the last decades.
Although neonatal mortality rate decreased significantly; foetal mortality rate has stayed unchanged since the late eighties. In order to decrease foetal and perinatal mortality rates more efficiently, reducing consanguineous marriages and providing better antenatal care for high risk pregnancies are needed.
围产儿、胎儿和新生儿死亡率统计数据对于展示一个国家医疗保健系统的发展情况非常重要。然而，在我国，关于围产儿-新生儿死亡率随着该领域新技术发展而变化的模式，仅有非常少的全国性和区域性数据。
评估在一个为高危人群服务的围产期参考中心，多年来围产儿-新生儿死亡率的变化情况以及导致围产儿和新生儿死亡的原因。
横断面回顾性研究。
将 1979-1980 年（1 个时间点）、1988-1989 年（2 个时间点）和 2008 年（3 个时间点）的围产儿、新生儿和胎儿死亡率进行比较。通过威格尔斯沃思分类和死亡报告评估死亡率原因。还计算了新生儿重症监护病房的新生儿死亡率。
胎儿死亡率分别为 44/1000、31.4/1000 和 41.75/1000 出生，围产儿死亡率分别为 35.6/1000、18.8/1000 和 9/1000 出生，新生儿死亡率分别为 35.6/1000、18.8/1000 和 9/1000 活产，分别为三个研究时间点。新生儿重症监护病房的死亡率从 33%持续下降到 22.6%和 10%，同时新生儿死亡率也在下降。根据威格尔斯沃思分类，2008 年围产儿死亡的原因分别为胎儿死亡 85%、不成熟 4%和致命先天性畸形 8%，这表明胎儿死亡对高围产儿死亡率的影响很大。在过去几十年中，新生儿死亡的感染原因有所减少，但先天性异常有所增加。
尽管新生儿死亡率显著下降，但自 80 年代末以来，胎儿死亡率一直保持不变。为了更有效地降低胎儿和围产儿死亡率，需要减少近亲结婚，并为高危妊娠提供更好的产前护理。
