Causes of early neonatal mortality

The early neonatal period extends up to the 7th day of the infants life. 75% of infant deaths occur within the first 28 days of life and most of them occur within the first 7 days. In a retrospective study undertaken from June 1 1987 to May 31 1990 data was obtained from the Neonatal Care Section of Krishna Hospital Karad District Satara in south western Maharashtra. Most of the villagers wee of low socioeconomic status and the women had poor educational level. Most of the deliveries in this area are conducted by untrained dais under unhygienic conditions. The early neonatal mortality rate (ENMR) was defined as neonatal death of babies weighing over 1000 g during the first 7 days per 1000 live births. A total of 1013 live births with weight more than 1000 g were included in the study: 533 wee males and 480 females. The incidence of low-birth-weight (=or- 2.5 kg) babies was 77.1% and that of prematurity (gestational age < 37 weeks) was 58.9%. There were 37 neonatal deaths with an ENMR of 36.6. The chief causes of ENMR were perinatal asphyxia (40.5%) prematurity (29.7%) bacterial infections (27.0%) and congenital malformations (2.8%). The mortality was higher in low-birth-weight as compared to the normal-birth-weight babies. A total of 59% of all births were preterms who contributed to 29.7% of deaths. The high incidence of low-birth-weight babies was attributable to the fact that this hospital received 79.4% of total admissions for delivery of complicated pregnancy referrals from the peripheries. The difference between mortality of babies with birth weight of less than and more than 2.5 kg was statistically significant (p<0.05). Regular antenatal checkups health education of pregnant and lactating mothers professional child delivery and timely referral of pregnancy complications to well-equipped hospitals may cut down on early neonatal mortality.