Department of Neonatology, Children's Hospital of Fudan University, 399 Wanyuan Street, Minhang District, Shanghai, China.
Department of Neonatology, Guangdong General Hospital, Guangzhou, China.
World J Pediatr. 2018 Feb;14(1):44-51. doi: 10.1007/s12519-017-0101-y. Epub 2018 Jan 30.
To determine the trend and causes of neonatal mortality in a large level III neonatal intensive care unit in Shanghai during a 15-year period.
This is a retrospective, single-centered study. All neonates who died during the period from January 1, 1999 to December 31, 2013 at Children's Hospital of Fudan University were included. We extracted relevant clinical information from their medical records, analyzed neonatal mortality rate and the characteristics of these patients, and compared neonatal deaths between different periods and populations.
Among a total of 50,957 admissions during the study period, there were 929 neonatal deaths. The neonatal mortality rate was 1.82%. Trends in neonatal mortality rate showed an increase in the period from 1.0% in 2003 to 2.2% in 2013. The main causes of neonatal mortality were complications of preterm birth (33.6%), congenital anomalies (21.3%), infections (12.6%), and birth asphyxia (9.1%). The proportions of complications of preterm birth (P < 0.001) and congenital anomalies (P = 0.018) increased yearly, while the proportions of birth asphyxia (P < 0.001) and infections (P < 0.001) decreased. Proportions of deaths caused by birth asphyxia (P = 0.005) and infections (P < 0.001) were both higher in the migrating population than in the permanent residents.
Neonatal mortality rate increased from 2003 to 2013 in our study. The proportion of preterm infants in neonatal deaths also increased within the same period. Complications of preterm birth were the main cause of neonatal mortality and the percentage increased year by year. Neonates in the migrating population appeared to be at a higher risk of death during the neonatal period compared to those in the permanent residents, and efforts should be made towards improving perinatal care to prevent infections and birth asphyxia in this vulnerable population.
旨在确定在上海一家大型三级新生儿重症监护病房 15 年间新生儿死亡率的趋势和原因。
这是一项回顾性、单中心研究。纳入 1999 年 1 月 1 日至 2013 年 12 月 31 日期间复旦大学附属儿科医院所有死亡的新生儿。我们从病历中提取相关临床信息，分析新生儿死亡率及这些患者的特征，并比较不同时期和人群的新生儿死亡情况。
研究期间共有 50957 例住院患儿，其中 929 例新生儿死亡，新生儿死亡率为 1.82%。新生儿死亡率呈上升趋势，从 2003 年的 1.0%上升至 2013 年的 2.2%。新生儿死亡的主要原因是早产并发症（33.6%）、先天畸形（21.3%）、感染（12.6%）和出生窒息（9.1%）。早产并发症（P<0.001）和先天畸形（P=0.018）的比例逐年增加，而出生窒息（P<0.001）和感染（P<0.001）的比例逐年下降。出生窒息（P=0.005）和感染（P<0.001）导致的死亡比例在流动人口中均高于常住居民。
本研究中，2003 年至 2013 年新生儿死亡率呈上升趋势，同期新生儿死亡中早产儿比例也有所增加。早产并发症是新生儿死亡的主要原因，且比例逐年上升。流动人口中的新生儿在新生儿期死亡的风险似乎高于常住居民，应努力改善围产期保健，以预防该脆弱人群的感染和出生窒息。
