Analysis Of Single-center Death Cases In Neonatal Department From 2009 To 2018

ObjectivesIn this study,we collected the clinical data of the neonatal department in the First Affiliated Hospital of Xiamen University from January 1,2009 to December 31,2018,and analyzed the mortality rate,the main causes of death and their changing trends in 10 years,in order to reduce the neonatal mortality rate and improve the level of infant health care.Materials and MethodsThis is a single-center retrospective study.In this study,we collected all neonates admitted to the neonatal department of the First Affiliated Hospital of Xiamen University who were dead during hospitalization from January 1,2009 to December 31,2018,and analyzed the death statistical contents,The cause of death shall prevail on the basis of the first cause of death,and the combined cause of death shall not be taken into account.The statistical contents are as following:(1)the death number and mortality rate of death cases,gender,age composition,gestational age and birth weight,cause of death composition,and sequence change of main causes of death.(2)diurnal age was divided into three groups: early neonate(0~7 days),late neonate(8~28 days),and infants over 28 days of age(>28 days).Gestational age was divided into three groups: premature infants(<37 weeks),full-term infants(37~42 weeks),and expired infants(>42 weeks).Birth weight was divided into three groups: low birth weight(<2500g),normal weight(2500~4000g),and macrosomia(>4000g).The statistical software was SPSS 21.0.The count data was expressed in N,%,and the comparison of the rates was performed using Chi-square test and P<0.05 was considered to be statistically significant.Results1.During the 10 years,a total of 24,167 newborn were admitted to the neonatal department of our hospital,of which 427 cases were dead.The mortality rate of hospitalized neonates was 1.77 %,which showed a downtrend over time(P< 0.05);The mortality rate was significantly higher for males than females,with a ratio of 1.36:1;Among the 427 death cases,there were 260 cases of early neonates,accounting for 60.9% of the total number of deaths,and 109 cases of late neonates,accounting for 25.5%,58 cases of infants over 28 days,accounting for 13.6%.2.There were 266 premature infant deaths,accounting for 62.3% of the total number of deaths,and the composition ratio showed an increasing trend(P < 0.05).There were 273 cases with low birth weight,accounting for 63.9% of the total number of deaths,and the overall trend was on the rise(P < 0.05).3.Respiratory failure(39.8%),infectious diseases(17.6%),neonatal asphyxia(11.7%),birth defects(11.5%)and congenital heart disease(6.6%)were the top five causes of death among hospitalized patients in the 10 years.4.Respiratory failure had always been the leading cause of death among hospitalized infants all the time,and there was no statistically significant difference in the composition of causes of death between the infant’s sex,mother’s birth age,education,and delivery method(P > 0.05).The ratio of cause of death between fetal age,birth weight,maternal pregnancy complications and death age was statistically significant(P< 0.05).Conclusions1.From 2009 to 2018,the number of inpatients in neonatal department of our hospital was on the rise,the number of deaths showed a downward trend,and the mortality rate of inpatients was on the decline;There were significantly more male than female deaths;The younger the age,the higher the mortality;The younger the gestational age,the higher the mortality;The lower the birth weight,the higher the mortality;2.The proportion of premature infants and low-birth-weight infants in the death of hospitalized children presented an increasing trend;3.The top five death causes in the neonatal department of our hospital were respiratory failure,infectious disease,neonatal asphyxia,birth defects and congenital heart disease;4.Respiratory failure was the first death cause in hospitalized infant.The main causes of death and orders of infants were different in different gestational ages,different birth weights,different death ages and whether their mothers had pregnancy complications.