Why Do Babies Die? Elaine B. St. John, MD Division of Neonatology University of Alabama at Birmingham.

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Presentation transcript:

Why Do Babies Die? Elaine B. St. John, MD Division of Neonatology University of Alabama at Birmingham

Mortality by Country

Mortality by State

Mortality by Gestational Age

Causes of Death in Liveborns Extreme Prematurity RDS PDA Pulmonary hemorrhage CLD NEC MOSF IVH Termination/LAWR Asphyxia/HIE PPHN Other Anomaly/Sequence Chromosomal Abnormality CHD Other Infection Unexplained

Effect of Maternal Steroids

Effect of Consensus Statement on Prenatal Steroids 0% 20% 40% 60% 80% 100% 1991-2001 25-26wks 27-28wks Home, No O 2 at 28d Died PTD O Died <12 hrs

Alphabet Soup AOP Apnea of Prematurity, A&B BPD Bronchopulmonary Dysplasia CLD Chronic Lung Disease HIE Hypoxic Ischemic Encephalopathy IVH Intraventricular Hemorrhage NEC Necrotizing Enterocolitis PIE Pulmonary Interstitial Emphysema PPHN Persistent Pulm. Hypertension of the Newborn, PFC RDS Respiratory Distress Syndrome, HMD ROP Retinopathy of Prematurity, RLF

Alphabet Soup?

Annual Rates of Low Birth Weight, Preterm and Neonatal Mortality 1981 – 1998 Single Live Births to U.S. Resident Mothers ?

Distribution of Births Survival & Births by GA 100% 30% 90% 25% 80% 70% Survival 20% 60% Distribution of Births Distribution of Births Survival 50% 15% 40% 10% 30% 20% 5% 10% 0% 0% 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 GA (wks)

Livebirth Causes of Death