The aim of the Fourth Millennium Developmental Goal is to reduce mortality among children less than 5 years by two thirds between 1990 and 2015. Efforts are more focus on improving children’s health. The aim of this study was to describe the trend of stillbirth and neonatal deaths in University Kebangsaan Malaysia Medical Centre from 2004 to 2010. A retrospective cross-sectional study was conducted using hospital data on perinatal mortality and monthly census delivery statistics. There were 45,277 deliveries with 526 stillbirths and neonatal deaths. More than half of the stillborn cases were classified as normally formed macerated stillbirth and prematurity was common in neonatal deaths. The trend of SB and NND was found fluctuating in this study. However, by using proportionate test comparing rate, there was a transient significant decline of stillbirth but not neonatal deaths rates between 2004 and 2006. On the other hand, the neonatal deaths rate showed significant increment from 2006 to 2008. When both mortality rates were compared using proportionate test, from the start of the study, year 2004 with end of the study, year 2010, there was no significant decline noted. Trends of stillbirth and neonatal death rates in University Kebangsaan Malaysia Medical Centre within 7 years study period did not show the expected outcome as in Millennium Developmental Goal of two thirds reduction.
Stillbirth ; Infant Mortality

Haemolytic disease of the foetus and newborn (HDFN) is caused by maternal red blood cells (RBC) alloimmunisation resulted from incompatibility of maternal and foetal RBCs. However, only a few HDFN attributed to anti-M were reported, varying from asymptomatic to severe anaemia with hydrops foetalis and even intrauterine death. A case of severe HDFN due to anti-M alloantibody from an alloimmunized grandmultiparous Malay woman with recurrent pregnancy loss is reported here. The newborn was delivered with severe and prolonged anaemia which required frequent RBC transfusions, intensive phototherapy and intravenous immunoglobulin administration. Although anti-M is rarely known to cause severe HDFN, a careful serological work-up and close assessment of foetal well-being is important, similar to the management of RhD HDFN. Alloimmunisation with anti-M type can lead to severe HDFN and even foetal loss.