Article Text
Abstract
Trends in the patterns of mortality on neonatal units have been changed the last two decades, particularly in the case of fatal infection. The aims of this study were to examine patterns of neonatal mortality during a twenty-one year time span (1993 to 2013) at St George’s Hospital, London. We compared the following three time periods; 1993–1999, 2000–2006 and 2007–2013. The neonatal unit at St George’s is a regional centre that providing medical and surgical intensive care for south west London. Data was collected retrospectively using logs of patients that were admitted to the ward and the corresponding discharge summaries. Over the three epochs, the number of deaths halved (301–159–152), and this trend was seen whether inborn (173–108–80) or outborn (128–51–72). The biggest improvement in mortality was seen in the inborn preterm babies <30w (92–63–38), and the outborn term babies (44–16–19). The median age at death increased for babies <30 w (4days–9.5days–12.5days) The relative frequency of both necrotising enterocolitis (9%–13%–26%) and septicaemia (18%–20%–40%) as a cause of death increased. On closer examination, the numbers of NEC have increased (25–20–40), while sepsis has not altered significantly (47–32–55); of note, consent for post mortem also declined between each period from 32% to 25% to 21%. Our data are consistent with similar papers. It is likely that the increase in NEC reflects later mortality in preterm babies surviving longer.
References
-
St George’s Healthcare, newborn services, neonatal unit, viewed 20 November 2013, https://www.stgeorges.nhs.uk/service/childrens-services-2/neonatal/
-
Williams EJ, Embleton ND, Bythell M, Ward Platt M P. The changing profile of infant mortality from bacterial, viral and fungal infection over two decades. Acta Paediatrica 2013;102:999–1004
-
Lahmiti S, Aboussad A. Neonatal necrotizing enterocolitis. The Scientific World Journal 2011;11:655–656
-
Depani S, Ladhani S, Heath P, Lamagni T. The contribution of infections to neonatal deaths in England and Wales. The Pediatric Infectious Disease Journal 2011;30(4):345–347
-
Hickey L, Murphy A, Devaney D, Gillan J. The value of neonatal autopsy. Neonatology 2011;101(1):68–73
-
Balsara S, Faerber J, Spinner N, Feudtner C. Pediatric mortality in males versus females in the United States, 1999–2008. Pediatrics 2013;132(4):631–638