Neonatal mortality determinants in Jamaica - abstract

ABSTRACT

The Perinatal Survey included among its objectives the quantification of the island's neonatal mortality rate, the identification of the causes of these deaths and the determination of characteristics of both mother and infant that are associated with an increased risk of death, so that intervention and reduction would be possible. Data were collected on babies born between September 1986 and August 1987 and who died in the first 28 days of life, anywhere in Jamaica. Postmortems were performed where feasible. A death questionnaire provided information on date, place and time of death, age of mother and classification of death by the Wigglesworth method. Additional social, environmental, medical, obstetric and neonatal data were included on a main questionnaire. Data from the death questionnaire were analyzed, using SPSS. There were 950 neonatal deaths identified over the 12-month period of study. The neonatal mortality was 17.9 per 1,000 live births, with the early and late neonatal mortality rates being 16.0 and 1.9 per 1,000 respectively. The major contributors to neonatal death were prematurity and perinatal asphyxia (73.5 percent). The majority of deaths (56.2 percent) occurred in the first day of life. Twins had a sevenfold greater risk of dying than singletons, with 58.6 per cent of deaths among second twins. One-third of neonatal deaths were to teenage mothers although they accounted for 26 percent of total births. Babies born to mothers under 15 years of age were four times more likely to die than infants of mothers 25 - 29 years of age. The neonatal death rate in Jamaica is high with room for improvement, particularly in the prevention of perinatal asphyxia and the early identification and management of mothers whose infants are at high risk of neonatal death (AU)