ABSTRACT

This study aimed to determine the mortality in a Jamaican birth cohort over a 3-month period. Data on the outcome of 87.5% of all births in Jamaica between July and September 2011 were used to determine trends in and determinants of neonatal mortality. There were 9650 live births and 144 neonatal deaths yielding a Neonatal Mortality Rate of 14.9/1000 (95% CI: 12.6–17.52/1000) livebirths. One hundred and twenty-one (84%) deaths occurred within the first seven days of life giving an Early Neonatal Mortality Rate of 12.5/1000 (95%CI: 10.4–15.0/1000) livebirths and a Late Neonatal Mortality Rate of 2.38/1000 (95%CI: 1.51–3.57/1000) live births. Sixty-nine (48%) deaths occurred within the first 24 hours. Thirty-eight neonates (26%) died prior to being admitted to a neonatal unit, approximately within 2 hours of life.

Maternal age <15 years, decreasing birthweight, prematurity, male gender, multiple gestation and birth by caesarean section were associated with an increased risk of mortality p < 0.05. In order for Jamaica to experience further decline in its Neonatal Mortality Rate to meet the Sustainable Developmental Goal of at least as low as 12 per 1,000 live births by 2030 the focus must be on decreasing mortality in the very low birth weight infants who disproportionally contribute to mortality as well as continuing to implement measures to further decrease mortality in the larger infants.

摘要

本研究旨在确定牙买加出生队列 3 个月内的死亡率。2011 年 7 月至 9 月期间牙买加 87.5% 的出生结果数据用于确定新生儿死亡率的趋势和决定因素。有 9650 例活产和 144 例新生儿死亡，新生儿死亡率为 14.9/1000（95% CI：12.6-17.52/1000）活产。一百二十一 (84%) 例死亡发生在生命的前 7 天内，早期新生儿死亡率为 12.5/1000 (95%CI: 10.4–15.0/1000) 活产，晚期新生儿死亡率为 2.38/ 1000 (95% CI: 1.51–3.57/1000) 活产。前 24 小时内发生了 69 例 (48%) 死亡。38 名新生儿 (26%) 在进入新生儿病房之前死亡，大约在出生后 2 小时内死亡。

产妇年龄 <15 岁、出生体重下降、早产、男性、多胎妊娠和剖腹产分娩与死亡风险增加相关，p < 0.05。为了让牙买加的新生儿死亡率进一步下降，以实现到 2030 年至少低至每 1,000 个活产中 12 个的可持续发展目标，重点必须放在降低极低出生体重婴儿的死亡率上死亡率，并继续采取措施进一步降低较大婴儿的死亡率。