Original scientific paper
PATTERNS OF NEWBORNS’ DEATHS TO DISCHARGE FROM HOSPITAL IN CROATIA IN THE YEAR 2009
Boris Filipović-Grčić
; Zavod za neonatologiju i intenzivno liječenje Klinike za pedijatriju KBC Zagreb, Kišpatićeva 12, 10000 Zagreb
Hrvoje Kniewald
; Zavod za neonatologiju i intenzivno liječenje Klinike za pedijatriju KBC Zagreb, Kišpatićeva 12, 10000 Zagreb
Urelija Rodin
; Hrvatski zavod za javno zdravstvo
Dorotea Bartoniček
; Zavod za neonatologiju i intenzivno liječenje Klinike za pedijatriju KBC Zagreb, Kišpatićeva 12, 10000 Zagreb
Ruža Grizelj
; Zavod za neonatologiju i intenzivno liječenje Klinike za pedijatriju KBC Zagreb, Kišpatićeva 12, 10000 Zagreb
Jasminka Stipanović-Kastelić
; Zavod za neonatologiju i intenzivno liječenje Klinike za pedijatriju KBC Zagreb, Kišpatićeva 12, 10000 Zagreb
Emilja Juretić
; Klinika za ženske bolesti i porode KBC-a u Zagrebu
Snježana Gverić-Ahmetašević
; Klinika za ženske bolesti i porode KBC-a u Zagrebu
Milan Stanojević
; Odjel za intenzivno liječenje novorođenčadi Klinike za ginekologiju i porodništvo KB »Sveti Duh« u Zagrebu
Ivanka Antončić Furlan
; Klinika za ženske bolesti i porode KBC-a Split
Igor Prpić
; Klinika za ženske bolesti i porode KBC-a Rijeka
Branimir Peter
; Klinika za ženske bolesti i porode KBC-a Rijeka
Jadranka Blašković Kokeza
; Klinike za pedijatriju KBC Osijek
Jesenka Borošak
; Odjel za intenzivnu njegu novorođenčadi Klinike za ženske bolesti i porode KB »Sestre Milosrdnice« Zagreb
Vesna Benjak
; Zavod za neonatologiju i intenzivno liječenje Klinike za pedijatriju KBC Zagreb, Kišpatićeva 12, 10000 Zagreb
Linda Pavić
; Klinika za ženske bolesti i porode Opće bolnice Zadar
Karmen Magaš
; Klinika za pedijatriju OB Varaždin
Ivan Krajinović
; Klinika za pedijatriju OB Slavonski Brod
Mirna Milevoj-Ražem
; Klinika za pedijatriju OB Pula
Gorana Juka-Kožul
; Klinika za ženske bolesti i porode Kliničke bolnice »Merkur«
Dorotea Ninković
; Zavod za neonatologiju i intenzivno liječenje Klinike za pedijatriju KBC Zagreb, Kišpatićeva 12, 10000 Zagreb
Abstract
Early neonatal mortality (ENM) is one of components of perinatal mortality. In recent years ENM is smaller than the fetal one. ENM was in 2009 in Croatia for newborns of all birth-weights (BW), including those of BW <500 g 3,3‰, higher than in 2008 when it was 2,7‰. Neonatal mortality (NM) was increased from 3,1‰ in 2008 to 4,0‰. Mortality to discharge from hospital (MDH) was increased from 3,5‰ in 2008 to 4,2‰. The largest part of these deaths can be attributed to increase of mortality of infants of BW <2500 g. Infant mortality rate is also increased from 4,5‰ in 2008 to 5,3‰. Excess of infant mortality occurred in the first day and in the period 2–7th day of life. As much as 88,9% of infant deaths are caused by perinatal conditions, congenital anomalies and chromosomal abnormalities. ENM for all infants did 79,8% of MDH (150/188), and farther 38 infants (20,2%) died after the first week of life. Therefore, ENM was not underestimated instead of possible higher late neonatal mortality, pediatric-neonatal services didn’t reduce ENM on expenses of higher late neonatal mortality or MDH. In the years 2003–2006 three fourths of newborns of BW 500–1499 g were born in maternities of IIIrd level. In the year 2009 four fifths of these newborns were born in maternities of IIIrd level. Through the years the proportion of these infants born in maternities of IIIrd level is increasing, but that proportion should be even larger by encouraging prenatal screening. Comparisons of ENM and NM with some European countries show the possibility of further improvement in perinatal markers. With aim of the proper analysis of newborns’ outcome data, creation of new certificates of vital events is planned with details of postnatal transport and place of treatment of newborn. It is necessary to continue to follow survival or mortality of all newborns to discharge from hospital. These data will give us benchmark for planning of neonatal resources, development of recommendations in perinatology-neonatology for prenatal and postnatal transfer, and for more exact prognoses to parents of the smallest newborns.
Keywords
: early neonatal mortality; neonatal mortality to discharge from hospital; regional organization of perinatal care; VLBW and ELBW infants
Hrčak ID:
69958
URI
Publication date:
1.12.2010.
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