PURPOSE: In the past 15 years in Korea, there have been findings reporting a remarkable improvement in reduction of neonatal, infant, and perinatal mortality rates. Consequently, this study was conducted to examine the trends of maternal mortality ratio and observe if it has also improved over time. METHODS: The trends of maternal deaths from 1995 to 2010 in Korea were analyzed based on the following materials: 1) surveys of maternal death rate conducted by the Korea Institute for Health and Social Affairs (1995-2008), 2) statistical report of causes of death in Korea by Statistics Korea (2007-2010). RESULTS: The number of maternal deaths and the maternal mortality ratio declined steadily from 1995 to 2010 in Korea; however, they have increased slightly since 2008. The direct maternal mortality ratio was reduced when comparing the direct proposition maternal death ratio of 16:4 in 1995 and of 9.1:5 in 2010. The maternal mortality ratio tended to be higher in women from 35-39 years old age group, 40 years or older. Gangwon province had the highest maternal mortality ratio of all provinces in Korea. In 2009, the average maternal mortality ratio for the OECD nations was 10.1 while it was 10.8 for Korea, a little higher than the OECD average. CONCLUSION: Although the maternal mortality ratio improved by a significant reduction between 1995 and 2010 in Korea, the level is still about average for the OECD countries. It appears that even more efforts should be made to improve maternal mortality ratio compared to the progression in the areas of neonatal and infant mortality rates.
Cause of Death ; Female ; Humans ; Infant ; Infant Mortality ; Korea ; Maternal Death ; Maternal Mortality ; Perinatal Mortality

OBJECTIVETo investigate the main causes of deaths and the influencing factors in children with malignant tumors in the hospital, explore the possible way to improve the treatment.

METHODSClinical data of 84 patients with malignant tumors who died during hospitalization in the Department of Hematology/Oncology from June 1999 to December 2008 were collected and retrospectively analyzed. Major causes of deaths and their influencing factors were analyzed.

RESULTS(1) Treatment related complications which occurred in 73 cases (86.9%) were the leading cause of death, including infection-related death which was the most common cause of 51 cases (60.7%), hemorrhage-related death occurred in up to 28 cases (33.3%), and acute tumor lysis syndrome (ATLS) related death occurred in 2 cases (2.4%), graft versus host disease (GVHD) related death after allogeneic hematopoietic stem cell transplantation occurred in 4 cases (4.8%). Moreover, primary diseases related death occurred in 30 cases (35.7%). (2) In this group, there were no significant differences in treatment phases when the death occurred among patients with leukemia (56 cases), lymphoma (9 cases) and other non-hematopoietic and lymphoid tissue tumors (7 cases, chi(2) = 4.784, P = 0.310). (3) The infection related death increased significantly when WBC count was lower than 1.0 x 10(9)/L, which is totally different from those whose WBC was higher than or equal to 1.0 x 10(9)/L (chi(2) = 25.486, P < 0.001). (4) Twenty-six cases were detected to be infected with definite pathogens; different pathogens were identified 36 times in the 26 patients. Gram-negative bacteria (15/36, 41.7%) were the most common pathogens, followed by fungal organisms (14/36, 38.9%) and gram-positive bacteria (7/36, 19.4%).

CONCLUSIONMore attention should be paid to the prevention and treatment of cancer therapy related complications in children with malignant tumors. Infection was the leading cause of death, gram-negative bacteria and fungi were predominating pathogens. Application of effective antibiotics and combined antifungal drugs timely, especially in the remission induction or first chemotherapy period as well as in the period of neutropenia, may reduce mortality of children with malignant tumors significantly.

Adolescent ; Cause of Death ; Child ; Child, Preschool ; Female ; Hospital Mortality ; Hospitalization ; Humans ; Infant ; Male ; Neoplasms ; complications ; mortality ; Neoplasms, Second Primary ; mortality

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.

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

This study aimed to analyze infant, maternal, perinatal, and fetal mortality statistics in the Republic of Korea (Korea), 2014. It was based on the open-access data available from the Statistics Korea website (http://kostat.go.kr/portal/eng/index.action). Recent trends in these vital statistics were also examined. The results of this study constitute a descriptive presentation and analysis of the national data. The number of infant deaths was 1,305 out of 435,435 live births in 2014, and the infant mortality rate was 3.0. The number of maternal deaths was 48. The maternal mortality ratio per 100,000 live births was 11.0. The maternal mortality ratio per 100,000 women of child-bearing age (15 to 49 years old) was 0.37. The number of perinatal deaths was 1,365, and the perinatal mortality rate was 3.1. The number of fetal deaths was 5,317. The fetal mortality rate was 12.1. The trends in those vital statistics in recent years were consistent except for a few findings, including a decrease in the maternal mortality ratio of pregnant women 40 years old and older and a change in the proportions of the causes of infant death, with a decrease in mortality due to neonatal respiratory distress and an increase in mortality due to bacterial sepsis. Although these vital statistics were generally consistent, some aspects varied by year. Pregnant women less than 20 years old should be monitored more intensively for their babies' health. Our findings can serve as basic data supporting the establishment of health policies by the Korean government.
Cause of Death ; Female ; Fetal Death ; Fetal Mortality ; Health Policy ; Humans ; Infant Death ; Infant Mortality ; Infant* ; Korea ; Live Birth ; Maternal Death ; Maternal Mortality ; Mortality ; Perinatal Death ; Perinatal Mortality* ; Pregnant Women ; Republic of Korea* ; Sepsis ; Vital Statistics

OBJECTIVE: The aim of this study was to analyze the perinatal mortality rate (PMR) and to evaluate the risk factors of perinatal deaths such as birth weight, gestational age, maternal age, fetal sex, number of antenatal visits, and cause of deaths. METHODS: Review of electronic medical records of 4,910 cases of singleton deliveries from 1998 to 2003 at Yongdong Severance Hospital was done. The perinatal period was defined according to the WHO definition and the cause of mortality was determined according to Aberdeen Classification. RESULTS: Crude (corrected) PMR was 22.8 (13.4). Among 4862 deliveries excluding termination of pregnancy and severe congenital anomalies, (1) stillbirths accounted for 78% (51/65) of perinatal deaths. (2) Distribution of neonatal birth weights less than 1,000 g, 1,000~1,499 g, 1,500 g~2,499 g were 0.3%, 0.7%, 5.6% with survival rates of 73.7%, 86.1%, and 99.6% respectively. (3) Deaths of preterm births accounted for 86% (12/14) of total neonatal deaths. (4) PMR of 494 cases of advanced maternal age was higher (20.2) than those of other age groups without statistical significance (p=0.273). (5) PMR of male-to-female ratio was 173:100 with statistical significance (p= 0.031). (6) PMR of infants with less than 2 antenatal visits was 152.0, in comparison with the rate (7.3) of infants with more than 2 antenatal visits (p<0.001). Among 112 cases of crude perinatal deaths, the leading causes were congenital anomalies (31.3%), prematurity cause unknown (28.6%), and maternal disease (10.7%). CONCLUSIONS: The number of births is decreasing, but no significant decrease of PMR was observed. Therefore, intensive care of preterm infants and congenital anomalous babies should be improved.
Birth Weight ; Cause of Death ; Electronic Health Records ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Critical Care ; Maternal Age ; Parturition ; Perinatal Mortality ; Pregnancy ; Premature Birth ; Risk Factors ; Stillbirth ; Survival Rate

PURPOSE: The neonatal mortality rate in Japan has currently been at the lowest level in the world. However, it is unclear whether there are still some potentially preventable neonatal deaths. We, therefore, aimed to examine the backgrounds of neonatal death and the possibilities of prevention in a region of Japan. MATERIALS AND METHODS: This is a population-based study of neonatal death in Shiga Prefecture of Japan. RESULTS: The 103 neonatal deaths in our prefecture between 2007 and 2011 were included. After reviewing by a peer-review team, we classified the backgrounds of these neonatal deaths and analyzed end-of-life care approaches associated with prenatal diagnosis. Furthermore, we evaluated the possibilities of preventable neonatal death, suggesting specific recommendations for its prevention. We analyzed 102 (99%) of the neonatal deaths. Congenital malformations and extreme prematurity were the first and the second most common causes of death, respectively. More than half of the congenital abnormalities (59%) including malformations and chromosome abnormality had been diagnosed before births. We had 22 neonates with non-intensive care including eighteen cases with congenital abnormality and four with extreme prematurity. Twenty three cases were judged to have had some possibility of prevention with one having had a strong possibility of prevention. Among specific recommendations of preventable neonatal death, more than half of them were for obstetricians. CONCLUSION: There is room to reduce neonatal deaths in Japan. Prevention of neonatal death requires grater prenatal care by obstetricians before birth rather than improved neonatal care by neonatologists after birth.
Cause of Death ; Female ; Humans ; Infant ; *Infant Mortality ; Infant, Newborn ; Infant, Premature ; Japan/epidemiology ; Male ; *Perinatal Death ; Perinatal Mortality ; Pregnancy ; Pregnancy Complications/epidemiology/*etiology

A review of all 919 perinatal deaths occurring in II Sin Christian Hospital From 1985 to 1989 was carried out. The results of clinical analysis were as follows: 1) The overall perinatal mortality rate was 26.30 per 1,000 birth. 2) The perinatal mortality rate was lowest in the gestation group between 37~41 week and in the weight group between 2,501~4,000 gm. 3) The perinatal mortality rate was high in the age group under 20 and 40 and more. 4) The perinatal mortality rate was increased with an increasing number of parity. 5) The majority of neonatal deaths occurred within 24 hours of life, and the most common cause of death was prematurity. 6) The most common congesital anomaly was multiple anomaly, and the most common single anomaly was anencephaly. 7) In pregnancy, the most common maternal complication was anemia.
Anemia ; Anencephaly ; Cause of Death ; Female ; Humans ; Infant ; Infant Mortality* ; Parity ; Parturition ; Perinatal Mortality ; Pregnancy

PURPOSE: This study was conducted to analyze recent trends and causes of maternal mortality in Korea between 2009 and 2014. METHODS: We investigated trends and causes of maternal death using the data from Complementary Investigations on the Infant, Maternal, and Perinatal Mortality carried out by Statistics Korea between 2009 and 2014. Maternal age, administrative district, causes of death and gestational age at the time of death were collected from data. Statistics including maternal mortality ratio (MMR) and maternal mortality rate were calculated. We also analyzed MMR according to the age, and administrative districts. The causes of maternal death were sorted and classified using International Classification of Diseases and World Health Organization recommendations. RESULTS: The average MMR during 6 years was 13.16 and maternal mortality rate was 0.45. MMR was highest in 2011 (17.2) and lowest in 2012 (9.9). The average MMR of the administrative districts varied greatly from 7.51 (Gwangju) to 26.84 (Jeju). The average MMR during the study period was lowest in maternal age of 20-24 (6.9), and highest in 45-49 (143.7). On average, direct and indirect maternal deaths accounted for 66.2% and 29.9% of total maternal death, respectively. The three most common causes of maternal deaths were obstetrical embolism (24.4%), postpartum hemorrhage (18.3%), and hypertensive disease of pregnancy (5.5%) in decreasing order of frequency. CONCLUSION: Although MMR is decreasing during the study period, it fluctuates widely according to maternal age, districts, and constant effort for improvements is necessary. To reduce maternal deaths, solution to control preventable causes of maternal deaths, careful management of pregnancies with advanced maternal age, and policy to solve the discrepancy in the medical services among diverse regions in the country are needed.
Cause of Death ; Embolism ; Gestational Age ; Humans ; Infant ; International Classification of Diseases ; Korea* ; Maternal Age ; Maternal Death ; Maternal Mortality* ; Perinatal Mortality ; Postpartum Hemorrhage ; Pregnancy ; World Health Organization

Cause of Death ; Child Mortality ; trends ; Female ; Hospital Mortality ; trends ; Humans ; Male

OBJECTIVETo study the under-five mortality rate and the causes of death in Zhejiang Province between 2000 and 2009 in order to provide a basis for reducing the mortality rate in the region.

METHODSBy stratified random cluster sampling, all the children under 5 years old from 30 sampling areas of Zhejiang Province between 2000 and 2009 were enrolled. The under-five mortality rate and the leading causes of death were investigated by descriptive analysis and Chi-square test.

RESULTSThe under-five mortality rate demonstrated a decreased trend in Zhejiang Province between 2000 and 2009, with the under-five mortality rate of 14.83‰ in 2000 compared to 9.49‰ in 2009. In 2009, the under-five mortality rate in rural regions was significantly higher than that in urban regions (9.14‰ vs 6.50‰; P<0.01). Compared with the resident population, there were an increased under-five mortality rate in floating population (12.12‰ vs 6.42‰; P<0.01). Preterm delivery/low birth weight was the top death cause in children under 5 years old. The top three causes of death in infants less than 1 year old were preterm delivery/low birth weight, congenital heart disease and birth asphyxia compared to drowning, traffic accident and falling in children aged 1-4 years.

CONCLUSIONSThere are differences in the under-five mortality rate between rural and urban children as well as between the floating and resident population in 2009. The leading causes of death in different age groups are different. It is essential to reduce the mortality rate by preventing preterm delivery, low birth weight and congenital malformations to infants and preventing accidental injuries to children aged 1-4 years.

Cause of Death ; Child Mortality ; Child, Preschool ; China ; epidemiology ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Time Factors