Studies of birthweight-specific neonatal mortality rates have
indicated that rates below 750 per 1,000 live births in the 1,000 g
or
less birthweight range (1) suggest underreporting of neonatal
deaths.
In a current study, the degree of underreporting of neonatal deaths
and the neonatal birthweight-specific mortality rates for the 1981
Kentucky birth cohort were estimated for low birthweight (LBW)
(2,500
g, or less) infants.*
Kentucky recorded 57,294 resident in-state live births in 1981,
as
determined by a review of the 1981 and 1982 computer birth files.
Of
these, 4,057 (7.1%) were 2,500 g or less. Among the 4,057 LBW
births,
332 neonatal deaths were identified through a computer system for
linking infant death and birth files. Subsequently, all LBW birth
cohort members not known to have died were grouped by hospital of
birth, and a request was mailed to each hospital for classification
of
births by discharge status (dead, alive to home, or alive to
another
hospital). Similar requests were sent to hospitals receiving
transfers during the neonatal period. Infants classified as
discharged dead during the neonatal period and for whom no death
certificate could be located were classified as reporting failures.
Fifteen unreported neonatal deaths were identified by 11
different
hospitals, one of which had three unreported deaths (Table 2). No
significant trend in underreporting by birthweight was found. An
additional 18 neonatal deaths could not be classified by
birthweight
because of lack of information.
Reported by CW Spurlock, Div of Epidemiology, MW Hinds, MD, State
Epidemiologist, Kentucky Dept of Health Svcs; GH Bergeisen, Indian
Health Svc, Bemidji, Minnesota; Program Evaluation Br, Pregnancy
Epidemiology Br, Div of Reproductive Health, Center for Health
Promotion and Education, CDC.
Editorial Note
Editorial Note: The birthweight-specific mortality rates observed
in
Kentucky are roughly comparable to rates reported during similar
periods in other southern states that link birth and infant death
certificates (2-4).
These findings indicate that current neonatal mortality rates
below 750 per 1,000 live births in the 1,000 g or less weight range
do
not necessarily indicate underreporting and may reflect continuing
advances in perinatal care for very small infants.
References
McCarthy BJ, Terry J, Rochat RW, Quave S, Tyler CW Jr. The
underregistration of neonatal deaths: Georgia 1974-1977. Am J
Public Health 1980;70:977-82.
Goldenberg RL, Humphrey JL, Hale CB, Boyd BW, Wayne JB.
Neonatal
deaths in Alabama, 1970-1980: an analysis of birth weight- and
race-specific neonatal mortality rates. Am J Obstet Gynecol
1983;145:545-52.
Georgia Council on Maternal and Infant Health, Office of Health
Planning and Statistics. The perinatal data book, trends and
measures, 1972-1981. Atlanta, Georgia: Department of Human
Resources, 1983.
Buescher PA. The impact of low birth weight on North Carolina
neonatal mortality. State Center for Health Statistics (special
series no. 30). Raleigh: North Carolina Department of Human
Resources, 1983.
*In 1979, the National Center for Health Statistics recommended
that
the definition of low birthweight be changed from 2,500 g or less
to
less than 2,500 g to comply with the International Classification
of
Diseases, 9th Revision. National vital statistics are reported
using
the less than 2,500 g definition; however, the 2,500 g or less
definition has been recently used by the Institute of Medicine for
comparison with previous years.
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