BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

Chapter VI. IveonaatMorca~yG
lid
OTHER DISEASES OF THE NEWBORN (774, 775, and 778)
Erythroblastosis fetalis, a common hemolytic
disorder of the fetus and the newborn,
is the result of maternal isoimnmunization to
fetal blood group antigens. The International
Classification of Diseases provides
two categories for hemolytic disease of the
newborn: 774 when complicated by kernicterus,
and 775 without mention of kernicterus.
In the 15 projects 213 neonatal deaths
were assigned to hemolytic disease as underlying
cause, and in only 45 deaths was one
of these conditions considered an associated
cause (Table 55). The rates as underlying
and associated causes combined ranged
from 119.3 and 107.0 per 100,000 live births
in the Chilean project and in San Juan
TA.LE 55. Neonatal Mortality, from Hemolytic
Disease of Newborn as Underlying or Associated
Cause in 15 Projects. Total I
Project
Tot75 Underlying Assoeiated
I _
No. Rate No. Rate No. Rate
Ta .hemorrhage
Total .............. 25 54.4 213 4. 4 9.5
ARGENTINA 68.2 - ­
12 68.2 12
Chaco Province...
San Juan Province.. 25 107.0 23 98.5 2 8.o
BOLIVIA project .... 8 21.3 7 18.0 I 2.7
BRAZIL
Recife ............. 10 32.9 10 32.0 - ­
4 21.9 4 21.9
Ribeirfo Prato ....
Slo Paulo ......... 38 65.3 25 43.0 13 22.4
CANADA
Slherbrooke ........ 14 82.5 13 76.6 I 5.9
CHILE project ..... 52 119.3 40 91.8 12 27.5
COLOMBIA
Cali ............. 11 52.1 10 47.4 1 4.7
Cartagena ......... 7 39.1 7 30.1 -
Medellin ......... 9 46.4 0 46.4 -
­
-
EL SALVADOR
project............ 16 51.0 11 35.5 5 10.1
JAMAICA
Kingston-
St. Andrew ..... 18 43.9 10 39.1 2 4.0
MEXICO
Monterrey ......... 25 47.2 21 39.6 4 7.5
UNITED STATES
California project... 9 20.1 5 11.2 4 8.9
Province to 20.1 in the California project.
These differences could be the result of
various factors, including frequency of
blood type incompatibilities in various
population groups and extent of therapeutic
management.
The condition known as postmaturity
(778.1) was found as underlying cause in
only four deaths but was an associated
cause in 80 (Table 56). Postmaturity is not
used as underlying cause whenever another
perinatal cause is diagnosed. Of the 84 neonatal
deaths froin postmaturity, 28 occurred
in Monterrey, two as underlying and 26 as
associated cause.
In subcategory 778.2, conditions characterized
by internal or external hemorrhage
are included under the heading of hemor­
rhagic disease of the newborn. In the 15
projects 181 neonatal deaths were assigned
to these conditions as underlying cause and
in 380 additional deaths they were found as
associated cause. In many instances the
had been found in autopsy, and
therefore no traumatic origin was assigned
(it being impossible to determine the real
origin). In several of these deaths, the
bleeding in an organ (lungs, adrenal, and
even digestive tract) could have been the
effect of profound metabolic changes induced
by severe asphyxia.
TABLE 56. Other Conditions of Newborn as
Underlying or A&sociated Causes of Neonatal
Deaths in 15 Projects Combined.
_
Calzse Underlying Associated
Other conditions of newborn (778). 259 1,132
Poatmaturity (778.1) .............
Hemorrhagic disease of newborn
(778.2) ........................
Other (rest of 778) ...............
4
281
74
80
380
672
Rates R per 100,000 live births.