Evaluation of the cause and predisposing factors in neonatal mortality by using international coding diseases version 10 in Valiasr Hospital

Background: According to the fact that the reduction of Neonatal Mortality Rate is correspondent to improvements in health and hygienic status of the society, understanding the major neonatal mortality causes will help the society to plan better prenatal and neonatal care systems.
Methods: On this retrospective study, the major causes of the mortality of the dead neonates were extracted from files of Vali-Asr hospital according to the International Coding of Disease Ver 10 (ICD10). Data were analyzed in proportion to gestational age , birth weight , gender and neonatal age.
Findings: Mortality rate was higher during the first week of life (78%). Generally five main causes of death were; prematurity, respiratory distress syndrome, intra cerebral hemorrhage, multiple congenital anomalies and air leak syndromes. It was also revealed that the causes of death of low birth weight neonates were similar to those of premature neonates (respiratory distress syndrome, prematurity, intra cerebral hemorrhage, septicemia and air leak syndromes). Similarly there was no difference between the causes the of death in mature neonates and appropriate for growth age neonates. The main causes of death in these two groups were; congenital disease, infections (septicemia and Pneumonia), asphyxia, diffuse intra vascular coagulation, intra cerebral hemorrhage, meconium aspiration and complications of pregnancy. Data analysis indicated significant relationships between death and gestational age, neonatal age and birth weight (P=0.001) but it was not related to gender.
Conclusions: With due attention to the easy application of ICD 10 for determining the major and underlying causes of death of neonates and the fact that autopsy is not routinely applicable in neonatology wards, routine using of ICD 10 for classifying the causes of death in death certificates is highly recommended.