ISSN : 2146-3123
E-ISSN : 2146-3131

The Change of Perinatal Mortality in Three Decades in a Reference Center in Aegean Region: Neonatal Mortality has Decreased but Fetal Mortality Stayed Unchanged
Nilgün Kültürsay 1, Niyazi Aşkar 2, Demet Terek 1, Ahmet Özgür Yeniel 2, Özge Altun Köroğlu 1, Mehmet Yalaz 1, Ferda Özkınay 3, Mete Akisu 1
1Department of Pediatrics Division of Neonatology, Ege University School of Medicine, İzmir, Turkey
2Department of Obstetrics and Gynecology, Ege University School of Medicine, İzmir, Turkey
3Department of Pediatrics Division of Genetics, Ege University School of Medicine, İzmir, Turkey
DOI : 10.4274/balkanmedj.2016.0870

Background: Perinatal, fetal and neonatal mortality statistics are important to show the development of health care system in a country. However in our country there are very few national and regional data about the changing pattern of perinatal neonatal mortality along with the development of new technologies in this area.
Aims: The aim of the present study is to evaluate the changes in mortality rates and the causes of perinatal and neonatal deaths within years in a perinatal reference center which serves to a high risk population.
Study Design: Cross sectional retrospective study
Methods: The perinatal and neonatal, fetal mortality rates in the years 1979-1980 (1st time point) and 1988-1989 (2nd time point ) were compared with the year 2008 (3rd time point). The causes of mortality were assessed by Wigglesworth classification and the death reports. The neonatal mortality in the neonatal intensive care unit (NICU) was also calculated.
Results: The fetal mortality rates (FMRs) were 44/1000, 31.4/1000 and 41.75/1000 births, perinatal mortality rates (PMRs) were 35.6 /1000,18.8 /1000 and 9/1000 births, and neonatal mortality rates (NMRs) were 35.6 /1000, 18.8 /1000 and 9/1000 live births in three study time points, in order. The mortality rate in NICU decreased consistently as 33%, 22.6% and 10% in study time points , together with the decreasing NMRs. The causes of perinatal deaths were fetal death 85%, immaturity 4%, lethal congenital malformations 8% according to Wigglesworth classification in 2008 showing the high impact of fetal deaths on this high PMR. Infectious causes of neonatal deaths decreased but congenital anomalies increased in the last decades.
Conclusion: Although NMR decreased significantly; FMR has stayed unchanged since late eighties. In order to decrease fetal and perinatal mortality rates more efficiently, reducing the consanguineous marriages, providing better antenatal care for high risk pregnants are needed.

Keywords: Perinatal mortality, neonatal mortality, fetal mortality, premature birth

Keywords : Perinatal mortality, neonatal mortality, fetal mortality, premature birth
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