Description of perinatal mortality data in a tertiary care hospital: are there any trends?

Description of perinatal mortality data in a tertiary care hospital: are there any trends?

Batllori Badia E, Villar Ruiz OP, González Villalaín C, Forcén Acebal L, Barbero Casado P, García Alcázar D.

Gynecology and Obstetrics Service, Hospital Universitario “12 de Octubre”, Madrid, Spain

ebatllori@gmail.com.

Background:
To analyse perinatal deaths (PD) in our hospital and to study if there are any trends in our data.

Methods:
Neonatal mortality (NM) can be classified into early (ENM) if it occurs 22 weeks of gestation) from 1985. The FD rate in our hospital since 2008, oscillates between 3,5 and 6,5 ‰, comparable to other developed countries.

Results:
Antepartum mortality (APM) and ENM have decreased until 2000 and have remained stable since then. This decline is probably due to health care improvements. From a neonatal point of view, the use of antenatal corticosteroids for fetal maturation. From an obstetrics point of view, detection of placental related diseases like fetal growth restriction and prevention of prematurity. The increasing complexity of the patient (mother, fetus and newborn) might have been a counterbalance accounting for the stability in the last 18 years. Intrapartum mortality (IPM) and LNM have remained stable since 1985. IPM in our setting is usually due to cervical insufficiency, which is often seen in nulliparous women who are not high-risk population a priori, therefore barely preventable. LNM has been growing in comparison to ENM. The reason could be that some infant deaths that previously occurred before first week of life, have now been delayed. Finally, FD account for around 60% of all PD. We must focus on the importance of FD and the prevention of known risk factors (maternal pathology, placental related disorders and prematurity).

Conclusions:
APM and ENM have experienced a reduction until 2000 and remained stable since then. IPM have remained stable since 1985. The proportion of LNM may be increasing in comparison to ENM. The proportion of FD is clearly higher than ND, so we must encourage practices focused on its prevention.

Keywords: Perinatal death, neonatal mortality, fetal mortality, trends

Ethics statement:
Patient data has been collected from database used during patient consultations of our perinatal mortality outpatient clinic. This data is stored and only the main authors have the right to access to personal data to ensure subject safety. No personal data has been used to write this retrospective descriptive study, therefore no ethical approval (further than Heads of Service) has been required. The authors declare no conflict of interest

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