BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

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.