BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

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Chapter VI. NeonatalMortality 103 TABLE 46. Neonatal Mortality&from Certain Complications of Pregnancy and Childbirth as Underlying Causes and with Immaturity as Associated Cause (Consequence) in 15 Projects. Underlying cause Associated cause Total Premature rupture of Hydramniosf~. Multiple pregnancy Other complications (6.,76..cn Immaturity as Project (709) membranes (769.1) (7.2) (769.4) (79.079.. 769.9) (7) No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate Total ......................... 1,892 399.1 550 116.0 72 15.2 815 171.9 455 96.0 1,779 375.3 ARGENTINA Chaco Province .............. 77 437.5 5 28.4 2 11.4 55 312.5 15 85.2 74 420.5 San Juan Province ............ 140 599.3 29 124.1 4 17.1 70 338.2 28 119.9 131 560.8 BOLIVIA project .............. 92 244.1 18 47.9 3 8.0 47 125.0 24 63.8 85 226.0 BRAZIL. Recife ...................... 128 421.1 10 32.9 3 9.9 85 279.6 30 98.7 123 404.6 Ribeirlio Prdto ............... 80 438.6 15 82.2 3 16.4 48 203.2 14 70.8 75 411.2 SIDoPaulo ................... 250 429.8 50 86.0 7 12.0 117 201.2 76 130.7 240 412.7 CANADA Sherbrooke .................. 44 259.3 7 41.2 1 5.9 9 53.0 27 159.1 44 259.3 CHI.E project ................ 228 523.2 108 247.8 10 22.9 08 156.0 42 96.4 221 507.1 COLOMBIA Cali ........................ 78 360.2 25 118.5 4 19.0 30 142.2 17 80.6 68 322.3 Cartagena ................... 61 340.8 14 78.2 2 11.2 26 145.3 19 106.1 57 318.4 Medellin .................... 75 386.0 25 128.9 - - 35 180.4 15 77.3 68 350.5 EL SALVADOR project ........ 117 377.2 39 125.7 1 19.3 42 135.4 30 96.7 109 351.4 JAMAICA Kingston-St. Andrew ......... 189 461.4 80 195.3 3 7.3 56 130.7 50 122.1 178 434.6 MEXICO Monterrey ................... 208 392.4 80 150.9 22 41.5 80 150.9 26 49.0 282 343.3 UNITED STATES California project ............. 127 283.9 45 100.6 2 4.5 38 84.9 42 93.9 124 277.2 a Rates per 100,009 live births. FzO. 49. Neonatal Mortality from Certain Complications of Pregnancy and Childbirth as Underlyfng Causes and with Immaturity as Associated Cause (Consequence) in 15 Projects. DEATHS PER 100,000 tLIVESITHS DEATHSPER100.000 tLIV SIETHS 0 100 200 300 400 500 600 0 100 200 300 400 Sao 600 CERTAIN COMPLICATIOINS (7691 IMMATUIlTY 17771 CIILEPROJECT IIIItOI..SI. DIII, 1ltl 11 0 ,... CNHCO PIOVIrCI 110 PAULO RICK! 110111111 T'III IL SALVAOROI 7-I1C CALI CALIFORIIA PlOJICt SOII ROWL =OPRIM UPI. mHY0WAMN0S Mut[t MOTHER MEMBIRANE$ PI9ONANC
104 Patternsof Mortality in Childhood TArn 47. Certain Complications of Pregnancy Other complications of pregnancy and and Childbirth as Underlying or Associated Causes childbirth. Three of these conditions were of Neonatal Deaths in 15 Projects Combined. frequently found as underlying or associated cause: incompetent cervix (769.0), Cause Underlying Associated antepartum or intrapartum hemorrhage unspecified and threatened abortion (769.9 for Total (709) .................... 1.802 785 Premature r.uture of ,,,ebranes both). Lack of sufficient information has not (769.1) ........................ 650 162 permitted assignment of the latter two conditions to more specific categories such as llydrannioe (709.2) .............. 72 07 Mult plo pregnancy (760.4) ........ .. 815 440 Other (rest of 760) ............... .455 107 partial premature separation of placenta, placenta previa, difficult labor due to pelvic abnormalities, etc. The conditions included under category longed (Ferguson et al., 1963). Death rates 769, described above, are closely related to from this condition ranged from 247.8 per immaturity, as can be observed in the right 100,000 live births in the Chilean project to portions of Figure 49 and Table 46. Immaturity in neonates (lying from these condi 28.4 in Chaco Province. Hydraminios is an abnormal condition tions as underlying causes was considered commonly associated with severe congenital to be a consequence in all instances, which anomalies (anencephaly, spina bifida, indicates the need for their prevention and esophageal tract, and others) atresia,as anomalies well as with of maternal urinary special management. In several instances the premature birth was precipitated by trabt, a (toemi)a, wlnltiswithpregnal problem s (toxem ia, m ultiple pregnancy, artificial "a ot v rupture "p o ue, of membranes ol w d u u through ly b diabetes, syphilis, cardiac and renal disease)by intrauterine infection) and therefore prevention of mortality under these circumstances requires measures of a different nature. and with umbilical cord obstruction and erytllroblastosis fetalis 4Murray, 1964). Hydraniios was found to be the underlying cause of few neonatal deaths (72) in 14 projects. As associated cause it was assigned in only 67 deaths. Multiple pregnancy-a common source of babies born before term and at gr.ater risk of mortality, morbidity, and complications of pregnancy-is a condition requiring spcial attention from the standpoint of early diagnosis and management (Behrman, 1965). In 815 neonatal deaths, multiple pregnancy was assigned as the underlying cause. Rates varied from 338.2 per 100,000 live births in San Juan Province to 53.0 in Sherbrooke. The close relationship between multiple pregnancy and low birth weight was previously discussed in Chapter III. The percentage distribution by birth weight of deaths from conditions included in category 769 is presented in Table 48 for the 15 projects. Between 75 and 98 per cent of all neonatal deaths from these causes occurred in babies born with weights of 2,000 grams or less. In the Sherbrooke and California projects 68.2 and 58.4 per cent weighed 1,000 grams or less at birth. Although this category includes multiple births, which have been considered the most important single cause of low birth weight, in some projects other causes of spontaneous and provoked interruption of pregnancy account for significant proportions of these neonatal deaths with very low birth weights.
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A'.1 ii,', r" lWAH', T , .NA ON i I
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PATTEiNS OF MORTALITY IN CHILnnooll
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PrincipalCollaborators Dr. Adela Le
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vi Patternsof Mortality in Childhoo
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DEDICATED TO ROBERT GOODWIN FIELD A
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CONTENTS (cont.) Page Comparisons w
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CONTENTS (cont.) Distribution of Li
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xvi Patternsof Mortality in Childho
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Chapter X Congenital Anomalies Know
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Chapter:XI Other Diseases and Exter
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APPENDICES
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APPENDIX 1 STANDARD FORM OF QUESTIO
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Appendix 1 363 Confidential INTER-A
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Appendix 1 365 INTER-AMERICAN INVES
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Appendiz 1 369 Confidential INTER-A
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APPENDIX 2 UNDERLYING AND ASSOCIATE
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Appendix 2 373 DEATH RATES Chaco Pr
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Appendix 2 375 DEATH RATES Resisten
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Appendix 8 377 DEATH RATES Rural De
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DEATH RATES San Juan Province-ARGEN
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Appendii 2 381 DEATH RATES City of
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4ppendiz2 383 DEATH RATES Suburban
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Appendiz 2 385 DEATH RATES Rural De
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ppendix 2 087 DEATH-RATES La Paz-BO
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Appendix 8 389 DEATH RATES Viacha-B
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Appendix 2 391 DEATH RATES Recife-B
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Appendix 9 393 DEATH RATES City of
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dppendix 8 395 DEATH RATES Franca,
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Appendix'$ :397 DEATH RATES Ribeiri
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Appendix B 399 Cause DEATH RATES S
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Appendix . 401 DEATH RATES Sherbroo
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Appendiz 8 403 DEATH RATES Santiago
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Appendix 9 405 nfective and parasit
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Appendiz 2 407 DEATH RATES Cali-COL
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Appendix 2 409 DEATH RATES Cartagen
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Appendiz, 411 DEATH RATES MedellIn-
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Appendix 2 413 DEATH RATES San Salv
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Appendix 2 415 DEATH RATES Rural
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Appendix 9 417 DEATH RATES Kingston
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1pPendix2 419 Cause 5 years Total D
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Appendix 8 421 DEATH RATES Rural St
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Appendirs 423 DEATH RATES Monterrey
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AppendixlB 425 DEATH RATES San Fran
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Appmdx 427 DEATH RATES Suburban Cou
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APPENDIX 4 HOME INTERVIEWS OF FAMIL
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Appenam a Sol APPENDIX 5 (cont.) NU
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-Appendix 6 433 Miguel A. Garcia Ce
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Appenae uO Denise Bernier Cleuza Ma
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REFERENCES-' American Society of Cl
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References, 439 rof,Differing Socio
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References 441 Pan American Health
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References 4 Verhoestuaete, L.J. an
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Index Accidents, 234-238 Age of mo
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447 Bolivia project, La Paz (cont.)
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Index 449 California project, Unite
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Index 451 Chaco Province project, A
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Index 453 'bile, City of Santiago (
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El Salvador project (cont.) Nutrit
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Inter American Investigation (cont.
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Index 459 Maternal infection, 99-10
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ItidI 481 Monterrey project, mexico
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irurcx 463 Recife project, Brazil (
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Index 465 Ribeirfo Pr~to, communiti
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Index 467 San Juan Provin,e project
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Index- 469 Sheehy, T. W., 149, 442
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