BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

Chapter VI. NeotatalMortality
93
TALE 38. Number of Neonatal Deaths with
Autopsy in 15 Projects.
Fio. 43. Percentage of Neonatal Deaths with
Autopsy in 15 Projects.
with autopsy 0 20 40 60 ao
Project Deaths CALIFORNIA POJ.
No. % SHtnCOOKE
- SANJUANPlOV.
11116IO.Sl.AKII
Total ..................... 12.674 2,354 18.6 CAIA61iI
11C111
ARGENTINA
CHILI
Chaco Province .......... 508 75 13.2 [L SALVAOR PRO).
San Juan Province ....... o00 294 32.5 CALI
BOLIVIA project .......... 1,091 46 4.2 CHICO PROVIICI
BRAZIL
0 PAULO
ll111110P1110
Recife ................... 1.073 203 18.9 IOUVIA PROJiC
Ribeirflo Prato ........... . 515 56 10.9 HIPEILIN
SAo Paulo...............91,058 251 12.8 HONlTIERET
CANADA
Sherbrooke .............. 229 124 54.1
CHILlE project ............
COLOMBIA
1,160 213 18.4
Cali .................... . 536 78 14.6
PI
CENT
Monterrey) less than 5 per cent of neonatal
Cartagena ............... 401 08 24.4 deaths had autopsies. The implications of
Medellin ................ 383 13 34 this deficit in number of autopsies (not
EL SALVADOR project ....
JAMAICA
017 156 17.0
Kingston-St. Andrew ..... 000 265
taking into account their wide variety in
MEXICO 268
quality) are obvious, particularly when
Monterrey ............... 1.377 40 2.9 mortality from certain causes such as
UNITED STATES
California project ......... .570 442 77.5 trauna, infection, and congenital anomalies
affecting internal organs is to be measured.
IAGNITUDE OF NEONATAL MORTALITY AND ROLE OF IMMATURITY
Mortality in the neonatal period varied the Sherbrooke and California projects to
greatly. The rates per 1,000 live births 14.1 and 13.3 in San Juan Province and Sao
ranged from 12.7 and 13.5 in the California Paulo. In this age group, which is subject
and Sherbrooke projects to 38.8 and 35.3 to increasing effects of the environment, the
in San Juan Province and Recife (Table 39 rates could be reduced to a small fraction of
and Figure 44). These figures make it those currently found in certain projects in
clear that even in this age period great im- Latin America. Actions leading to reducprovements
can be attained. Even in the tion of mortality in these crucial age periods
group under 7 days of age-the one most would have a great impact on tile future
affected by underregistration and corn- health of infants surviving the first four
monly considered the least susceptible to weeks of life. In this chapter, which will
reduction of mortality-death rates could deal with the causes of neonatal deaths,
be lowered by about half in several projects. first attention will be given to the "certain
In the last three weeks of the neonatal causes of perinatal morbidity and morperiod
(7-27 days) the variations in rates tality," because of their prominent role and
were proportionally greater, the range being chronological significance.
from 1.2 and 1.7 per 1,000 live births in The study of underlying causes in the