Analysis of neonatal mortality in the University Hospital La Fe Valencia. Years 1971-2009

Background and objectives: Neonatal mortality (NM) is a reliable marker of quality clinical care. The primary objective of this study was to analyse evolution of NM in the Division of Neonatology (level IIIc according to the Spanish Classification) University Hospital La Fe Valencia (HULF) from the beginning of its activity in 1971 until 2009. Secondary objectives were the evaluation of prematurity rate (PR) and low birth weight rate (LBWR). Material and methods: There was a total of 308,989 births, with 2.135 neonatal deaths (ND), during the period studied. Results: NM has shown a significant decrease (10.18% in 1971 vs. 6.24% in 2009; P<.01). This decrease was even more significant for neonates with birth weight between 500-999 g (923.1% in 1980 vs. 238.1% in 2009; P<.0001) and less for preterm with gestational age less than 28 weeks (403.8% in 1993 vs. 287.9% in 2009; P<.01). The Prematurity rate increased from 8.7% (1993) to 14% (2009) (P<.01), and LBWR increased from 5.3% (1979) to 12.8% (2009) (P<.001). Males represent 58.2% of ND, and these occurred in the first day of life in 48.2% of the cases. Respiratory conditions represent 36.3% of ND, severe congenital malformations 31.5%, neurologic conditions 14.6%, and infections 7.9%. Conclusions: In spite of the increase in LBWR and PR, a significant descent of NM has been achieved in the HULF in the last decades. (C) 2011 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L. All rights reserved.