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Changes in cause of neonatal death over a decade.

AIMS
To classify neonatal deaths at Wellington Hospital (Wellington, New Zealand) over a 10-year period and assess changes in cause of death over time.


METHODS
Retrospective audit from 1995-2004 of live-born infants > or = 20 weeks gestation dying before 28 days of age. Deaths were classified according to the PSANZ-NDC Classification guideline. The years 1995-1999 and 2000-2004 were compared to analyse for changes in cause of death.


RESULTS
There were 219 neonatal deaths: 67(31%) of these were term infants and 154 preterm; 109 infants from 1995-1999 and 110 from 2000-2004. The autopsy rate was 62% and highest in term infants (76%). Deaths due to congenital anomaly and extreme prematurity decreased over time and deaths due to infection increased.


CONCLUSIONS
Use of the PSANZ-NDC death classification system enables an accurate cause of death to be established for most neonatal deaths and allows monitoring of mortality rates over time.