BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

Chapter VI. Neonatal Mortality
107
Fia. 50. Neonatal Mortality from Conditions of Placenta as Underlying Causes and with Immaturity
as Associated Cause (Consequence) in 15 Projects.
CALIOISIAPROJICI
CARTIAGNA
NO11II|1Y
DEATHS PEt 100.000 LIVE lIRTHS
DEATHS PER 100,000 LIVE BIRTHS
0 o too ISO 200 250 0 30 100 iSo 200
CONDITIONS OF PLACENTA 1770O1IMWNT 77
CHILE PROilCI
SiOPAULO
CAl
SAl JUAN PROVINCE
SHtlAnOOKt
Imuiiio pniTO
CHACOPROVINCE
IL SALVADOR PROJECT
IIOLIVIA PROJECT
KINGSTON.ST. A1DOIW
MPLACENTA PREVIA r7-IPREMATURE SEPARATIONCOTHER
Other abnormalities of the placenta and
membranes (rest of 770) had low rates and
were not diagnosed in six of the 15 projects;
the highest rate was in San Juan Province,
17.1 per 100,000 live births.
The conditions of placenta (placenta
previa, premature s2paration, and other abnormalities)
are important causes of low
birth weight because of premature birth,
intrauterine malnutrition, or both. Whenever
one of these conditions was underlying
cause of a neonatal death and immaturity
was associated, the latter w:as considered
to be a consequence.
However, when immaturity was found as
an associated cause in those neonatal deaths
due to conditions of the umbilical cord as
underlying causes, it was considered to be
a contributory condition and not a consequence.
Figure 50 shows in the left portion
the rates for placental conditions as
underlying causes, and in the right portion
for those same causes the rates for immaturity
as a consequence. The pattern of the
total rates in the two portions is strikingly
similar. In fact, of 590 deaths from these
conditions, 513 or 86.9 per cent occurred in
immature neonates. It was evident, moreover,
that almost all deaths from these
causes occurred in the first week of life
(Table 40).
When neonatal deaths from conditions of
placenta and cord as underlying causes and
with birth weight stated were distributed by
birth weight, only the projects in California
and Sherbrooke showed percentages above
40 in the group of 1,000 grams or less. The
total numbers of deaths from these causes
were small in most projects and in a few
(as in Recife and Monterrey) a sizable
portion did not have weights recorded and
thus data were not incorporated in this
report.
Conditionsof Umbilical Cord (771)
These conditions include compression,
prolapse, and other accidents and abnormalities
of the umbilical cord (knots, entanglement,
varices, etc.) and were considered
to be the underlying causes of death of
small numbers of neonates in all projects.