Post on 31-Dec-2015
description
Why Do Babies Die?Why Do Babies Die?Why Do Babies Die?Why Do Babies Die?
Elaine B. St. John, MDElaine B. St. John, MDDivision of NeonatologyDivision of NeonatologyUniversity of Alabama at University of Alabama at
BirminghamBirmingham
Mortality by CountryMortality by CountryMortality by CountryMortality by Country
Mortality by StateMortality by StateMortality by StateMortality by State
Mortality by Gestational Mortality by Gestational AgeAge
Mortality by Gestational Mortality by Gestational AgeAge
Causes of Death in Causes of Death in LivebornsLiveborns
Causes of Death in Causes of Death in LivebornsLiveborns
OtherInfection
Unexplained
Asphyxia/HIE
PPHN
Other Anomaly/Sequence
ChromosomalAbnormality
CHD
Extreme Prematurity
RDS
PDA
Pulmonary hemorrhage
CLD
NEC
MOSF
IVH
Termination/LAWR
Effect of Maternal Effect of Maternal SteroidsSteroids
Effect of Maternal Effect of Maternal SteroidsSteroids
0%0%
20%20%
40%40%
60%60%
80%80%
100%100%
1991-20011991-2001
25-26wks25-26wks1991-20011991-2001
27-28wks27-28wks
Home, No OHome, No O22 at 28d at 28d
Died PTDDied PTDOO22
Died <12 hrsDied <12 hrs
Effect of Consensus Statement on Prenatal Steroids
Alphabet Alphabet SoupSoup
Alphabet Alphabet SoupSoup
AOP AOP Apnea of Prematurity, A&BApnea of Prematurity, A&BBPD BPD Bronchopulmonary DysplasiaBronchopulmonary DysplasiaCLD CLD Chronic Lung DiseaseChronic Lung DiseaseHIEHIE Hypoxic Ischemic EncephalopathyHypoxic Ischemic EncephalopathyIVHIVH Intraventricular HemorrhageIntraventricular HemorrhageNECNEC Necrotizing EnterocolitisNecrotizing EnterocolitisPIEPIE Pulmonary Interstitial EmphysemaPulmonary Interstitial EmphysemaPPHNPPHN Persistent Pulm. Hypertension of the Persistent Pulm. Hypertension of the
Newborn, PFCNewborn, PFCRDSRDS Respiratory Distress Syndrome, HMDRespiratory Distress Syndrome, HMDROPROP Retinopathy of Prematurity, RLFRetinopathy of Prematurity, RLF
Alphabet Soup?Alphabet Soup?Alphabet Soup?Alphabet Soup?
Annual Rates of Low Birth Weight, Annual Rates of Low Birth Weight, Preterm and Neonatal Mortality Preterm and Neonatal Mortality
1981 – 19981981 – 1998Single Live Births to U.S. Resident Single Live Births to U.S. Resident
MothersMothers
Annual Rates of Low Birth Weight, Annual Rates of Low Birth Weight, Preterm and Neonatal Mortality Preterm and Neonatal Mortality
1981 – 19981981 – 1998Single Live Births to U.S. Resident Single Live Births to U.S. Resident
MothersMothers
0
2
4
6
8
10
12
81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98
Neonatal Mort. Rate LBW Preterm
?
Survival & Births by Survival & Births by GAGA
Survival & Births by Survival & Births by GAGA
0%0%
10%10%
20%20%
30%30%
40%40%
50%50%
60%60%
70%70%
80%80%
90%90%
100%100%
2424 2525 2626 2727 2828 2929 3030 3131 3232 3333 3434 3535 3636 3737 3838 3939 4040 4141 4242
GA (wks)GA (wks)
SurvivalSurvival
0%
5%
10%
15%
20%
25%
30%
Distribution of Births
Distribution of Births
SurvivalSurvival
Distribution of BirthsDistribution of Births
Livebirth Causes of DeathLivebirth Causes of DeathLivebirth Causes of DeathLivebirth Causes of Death
Termination
Extrem. Prem.
IVH
CLD
OtherSepsis
CHD
Anomalies
PPHN
AsphyxiaUnknown
Pulm. Hemorr.
HMD
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42
GA (wks)
Su
rviv
al
0%
5%
10%
15%
20%
25%
30%
Dis
trib
uti
on o
f B
irth
s
Survival
Distribution of Births