Natal and neonatal factors in prematureinfant mortality: Report of a ten-year study

Abstract

Summary 1. An analysis of premature mortalityrates for a ten-year period has been presented. 2. In 20,331 live births there were1,373 living premature infants, that is, 6.8 per cent. 3. The over-all, uncorrected premature mortality rate was 22.4 per cent. If this figure is corrected by omission of premature infants under 1,000 grams, the rate drops to 15.9 per cent. 4. Breakdown into five-year groups gives mortality rates of 23.8 and 21.7 per cent, respectively, the latter figure covering the most recent period from Jan. 1, 1946, to Jan. 1, 1951. 5. There scems to be a preponderance of premature females. The female mortality rate was only 20 per cent as compared to 24.9 for males. 6. After the first forty-eight hours of life, our premature mortality was only 3.1 per cent. Expressed in another way, 86 per cent of our deaths occurred in the first forty-eight hours after birth. 7. The above factor indicates that further marked reduction in premature mortality rates will have to come from attacking the problems of this critical forty-eight-hour period of life. 8. In cases complicated by maternaland obstetric difficulties the mortality rate was 41.1 per cent as compared to 14.4 per cent in uncomplicated cases. 9. The use of episiotomy, low forceps, or both has a favorable effect on premature, mortality as shown by a death rate of 7 per cent where such procedures were employed; whereas cases not having these advantages had a higher rate of 34.1 per cent deaths. 10. In 157 cases of premature deliveries where conduction anesthesia was employed the mortality rate was 11.4 per cent. During this same period of time 593 cases receiving general or no anesthesia showed a mortality rate of 24.0 per cent.