Évolution de la mortalité néonatale au CHU de Blida (Algérie) de 1999 à 2006

Abstract

Within the framework of the active information system set up by the department of epidemiology on hospital mortality at the Blida (Algeria) University Teaching Hospital (CHU), a study was carried out to assess the importance and evolution of neonatal mortality recorded at the CHU in the last eight years (1999-2006) as well as the causes of neonatal death. The International Classification of Diseases (ICD-9) was used to encode the nature of the causal disease. Using the software EpiInfo™ in its sixth version performed data entry, monitoring and analysis. On the whole, 2,167 neonatal deaths were recorded at the CHU during the study period, representing a proportional mortality of 25.4%. Early neonatal mortality (0-6 days) accounted for 83.4% of all neonatal mortality. Nearly two thirds of early neonatal deaths occurred in the first three days of life. The monthly evolution of the number of early neonatal deaths revealed a significant rising trend during the study period (P < 0.05) without identification of seasonal effect. The sex ratio was practically the same for early and late neonatal mortality, respectively 1.4 and 1.5. Prematurity accounted for 42.1% of the deaths in early neonatal deaths, followed by respiratory distress syndrome and infection, respectively 17.0 and 14.4%. Infections, with a relative frequency of 36.2%, represented the most common cause for the late neonatal mortality. The rate of early neonatal mortality during the study period, when this one took for denominator the number of newborns admitted in neonatology to express the mortality of service, was 15.6%. Throughout the study period, the rate of early neonatal mortality, without counting the deaths among transferred newborms, could be estimated at 19.2 per 1,000 live births, while the overall neonatal mortality rate could be estimated at 22.3 per 1,000 live births. No significant temporal tendency was pointed out. The CHU of Blida is not characterized by a lower risk of neonatal mortality compared to that recorded at national level. The data of the CHU will contribute to assessing the achievement of objectives set by the National programme on the perinatality.