Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China: A Multicenter Retrospective Study.

Chen-hong Wang; Li-zhong DU; Xiao-lu MA; Li-ping Shi; Xiao-mei Tong; Hong Liu; Guo-fang Ding; Bin YI; Xin-nian Pan; Dan-ni Zhong; Ling Liu; Mei LI; Cui-qing Liu; Shi-wen Xia; Hong-yun Wang; Ling HE; Kun Liang; Xiao-yu Zhou; Shu-ping Han; Qin Lyu; Yin-ping Qiu; Ruo-bing Shan; De-zhi MU; Xiao-hong Liu; Si-qi Zhuang; Jing Guo; Li Liu; Jia-jun Zhu; Hong Xiong

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Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China: A Multicenter Retrospective Study.

Author: Chen-Hong WANG ¹ ; Li-Zhong DU ¹ ; Xiao-Lu MA ¹ ; Li-Ping SHI ¹ ; Xiao-Mei TONG ² ; Hong LIU ³ ; Guo-Fang DING ⁴ ; Bin YI ⁵ ; Xin-Nian PAN ⁶ ; Dan-Ni ZHONG ⁷ ; Ling LIU ⁸ ; Mei LI ⁹ ; Cui-Qing LIU ¹⁰ ; Shi-Wen XIA ¹¹ ; Hong-Yun WANG ¹² ; Ling HE ¹³ ; Kun LIANG ¹⁴ ; Xiao-Yu ZHOU ¹⁵ ; Shu-Ping HAN ¹⁶ ; Qin LYU ¹⁷ ; Yin-Ping QIU ¹⁸ ; Ruo-Bing SHAN ¹⁹ ; De-Zhi MU ²⁰ ; Xiao-Hong LIU ²¹ ; Si-Qi ZHUANG ²² ; Jing GUO ²³ ; Li LIU ²⁴ ; Jia-Jun ZHU ²⁵ ; Hong XIONG ²⁶
Author Information

1. Department of Neonatal Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310051, China.
2. Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China.
3. Department of Neonatology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
4. Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
5. Department of Neonatology, Gansu Provincial Maternity and Children-care Hospital, Lanzhou, Gansu 730050, China.
6. Department of Neonatology, Guangxi Maternal and Child Health Hospital, Nanning, Guangxi 530003, China.
7. Department of Neonatology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China.
8. Department of Neonatology, Guiyang Maternal and Child Health Care Hospital, Guiyang, Guizhou 550003, China.
9. Department of Neonatology, Harbin Children's Hospital, Harbin, Heilongjiang 150010, China.
10. Department of Neonatology, Children's Hospital of Hebei Province, Shijiazhuang, Hebei 050031, China.
11. Department of Neonatology, Hubei Maternity and Child Heath Hospital, Wuhan, Hubei 430070, China.
12. Department of Neonatal Intensive Care Unit, Inner Mongolia Maternal and Child Health Hospital, Huhhot, Inner Mongolia 010030, China.
13. Department of Neonatology, Jiangxi Provincial Children's Hospital, Nanchang, Jiangxi 330006, China.
14. Department of Pediatric, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
15. Department of Neonatology, Nanjing Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 320100, China.
16. Department of Neonatology, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210004, China.
17. Department of Neonatal Intensive Care Unit, Ningbo Women and Children's Hospital, Ningbo, Zhejiang 315012, China.
18. Department of Neonatology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, China.
19. Department of Neonatology, Qingdao Women and Children's Hospital, Qingdao, Shandong 266000, China.
20. Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
21. Department of Neonatology, Shenzhen Children's Hospital, Shenzhen, Guangdong 518026, China.
22. Department of Neonatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
23. Department of Neonatology, Tianjin Children's Hospital, Tianjin 300074, China.
24. Department of Neonatology, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
25. Department of Neonatology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China.
26. Department of Neonatology, Zhengzhou Children's Hospital, Zhengzhou, Henan 450007, China.
Publication Type:Journal Article
MeSH: Cause of Death; China; Female; Hospital Mortality; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; mortality; Intensive Care Units, Neonatal; statistics & numerical data; Male; Perinatal Death; Retrospective Studies
From: Chinese Medical Journal 2016;129(22):2652-2658
CountryChina
Language:English
Abstract:
BACKGROUNDGlobally, the proportion of child deaths that occur in the neonatal period remains a high level of 37-41%. Differences of cause in neonate death exist in different regions as well as in different economic development countries. The specific aim of this study was to investigate the causes, characteristics, and differences of death in neonates during hospitalization in the tertiary Neonatal Intensive Care Unit (NICU) of China.
METHODSAll the dead neonates admitted to 26 NICUs were included between January l, 2011, and December 31, 2011. All the data were collected retrospectively from clinical records by a designed questionnaire. Data collected from each NICU were delivered to the leading institution where the results were analyzed.
RESULTSA total of 744 newborns died during the 1-year survey, accounting for 1.2% of all the neonates admitted to 26 NICUs and 37.6% of all the deaths in children under 5 years of age in these hospitals. Preterm neonate death accounted for 59.3% of all the death. The leading causes of death in preterm and term infants were pulmonary disease and infection, respectively. In early neonate period, pulmonary diseases (56.5%) occupied the largest proportion of preterm deaths while infection (27%) and neurologic diseases (22%) were the two main causes of term deaths. In late neonate period, infection was the leading cause of both preterm and term neonate deaths. About two-thirds of neonate death occurred after medical care withdrawal. Of the cases who might survive if receiving continuing treatment, parents' concern about the long-term outcomes was the main reason of medical care withdrawal.
CONCLUSIONSNeonate death still accounts for a high proportion of all the deaths in children under 5 years of age. Our study showed the majority of neonate death occurred in preterm infants. Cause of death varied with the age of death and gestational age. Accurate and prompt evaluation of the long-term outcomes should be carried out to guide the critical decision.