Nationwide Birth Weight and Gestational Age-specific Neonatal Mortality Rate in Taiwan

Shuo-Tse Hsu; Chia-Jung Hsieh; Hung-Wen Chen; Suh-Fang Jeng; Hui-Chen Wu; Mei-Huei Chen; Chien-Yi Chen; Hung-Chieh Chou; Po-Nien Tsao; Pau-Chung Chen; Wu-Shiun Hsieh

doi:10.1016/j.pedneo.2014.07.006

Nationwide Birth Weight and Gestational Age-specific Neonatal Mortality Rate in Taiwan

Pediatr Neonatol. 2015 Jun;56(3):149-58. doi: 10.1016/j.pedneo.2014.07.006. Epub 2014 Oct 30.

Authors

Affiliations

¹ Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
² Department of Public Health, Tzu Chi University, Hualien, Taiwan.
³ Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
⁴ School and Graduate Institute of Physical Therapy, National Taiwan University College of Medicine, Taipei, Taiwan.
⁵ Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
⁶ Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
⁷ Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: pchen@ntu.edu.tw.
⁸ Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hsiehws@ntu.edu.tw.

PMID: 25440779
DOI: 10.1016/j.pedneo.2014.07.006

Abstract

Background: There are limited nationwide data relating to neonatal mortality rate in Taiwan. This study aims to provide updated national birth weight/gestational age-specific neonatal mortality reference rates.

Methods: We abstracted the birth registration database from the Ministry of Interior in Taiwan from 1998 to 2002 and linked the data to the death registration database from the Ministry of Health and Welfare in Taiwan between 1998 and 2003. We included 1,331,785 infants born between 20 weeks and 44 weeks of gestation and weighing within the median ± 2 interquartile ranges in their age group in this study. We calculated the birth weight/gestational age-specific neonatal mortality rates of different genders by birth weight increments of 250 g and at gestational age intervals of 1 week. A Poisson regression model was used in modeling the mortality data.

Results: A total of 4,169 deaths occurred within 28 days of life out of a total of 1,331,785 live births between 20 weeks and 44 weeks of gestation, giving a neonatal mortality rate (0-27 days) of 3.39 per 1000 live births for males and 2.80 per 1000 for females. The infant mortality rate remained higher in the male (5.91 per 1000) than the female (5.10 per 1000) population within the 1(st) year of life. Birth weight/gestational age-specific neonatal mortality rates were plotted with curves representing the 10(th) and 90(th) birth weight percentiles. The risk of an early neonatal death (0-6 days) does not exceed 50% except for female neonates < 500 g and ≤ 23 weeks, which implies that the limit of viability is now at 23 weeks for females.

Conclusion: We have provided an easy-to-use birth weight/gestational age-specific neonatal mortality rate chart as a reference document that physicians and parents can use to make decisions based on ethical considerations relating to whether to give palliative care or further invasive management. The normative data are crucial for public health policies on neonatal care in Taiwan.

Keywords: low birth weight; neonatal mortality; preterm birth.

MeSH terms

Birth Weight*
Female
Gestational Age
Humans
Infant
Infant Mortality
Infant, Newborn
Male
Risk
Taiwan / epidemiology