Mortality Rates

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Mortality Rates

  1. 1. Mortality Rates Definitions and Measurement Ayman Abou Mehrem, MD, CABP Neonatology Academic Day March 24, 2010
  2. 2. Objectives <ul><li>Definitions </li></ul><ul><li>Perinatal mortality </li></ul><ul><li>Neonatal mortality </li></ul><ul><li>Infant mortality </li></ul><ul><li>Child mortality </li></ul>
  3. 3. Definitions, Live Birth <ul><li>Complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy , which, after such separation, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered liveborn . </li></ul>
  4. 4. Definitions, Fetal Death, Stillbirth <ul><li>Death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles. </li></ul>
  5. 5. Definitions, Perinatal period <ul><li>The perinatal period commences at 22 completed weeks (154 days) of gestation (the time when birth weight is normally 500 g), and ends seven completed days after birth. (1) </li></ul>
  6. 6. Definitions, Neonatal period <ul><li>The neonatal period commences at birth and ends 28 completed days after birth </li></ul><ul><li>Early Neonatal Period: first seven days </li></ul><ul><li>Late Neonatal Period: 7-27days of life </li></ul>
  7. 7. Reporting criteria <ul><li>WHO Criteria: (2) </li></ul><ul><ul><li>Birth weight: at least 500 g </li></ul></ul><ul><ul><li>Gestational age: 22 completed weeks </li></ul></ul><ul><ul><li>Crown-heel length: 25 cm </li></ul></ul><ul><li>Canada: (3) </li></ul><ul><ul><li>Birth weight: at least 500 g </li></ul></ul><ul><ul><li>Duration of pregnancy: 20 weeks or longer </li></ul></ul>
  8. 8. Statistics for international comparison 2 <ul><li>Birth weight: at least 1000 g </li></ul><ul><li>Gestational age: 28 completed weeks </li></ul><ul><li>Crown-heel length: 35 cm </li></ul><ul><li>NB: the number of deaths due to malformations should whenever possible be identified for live births and fetal deaths </li></ul>
  9. 9. Perinatal Mortality <ul><li>An important indicator of: </li></ul><ul><ul><li>Maternal care </li></ul></ul><ul><ul><li>Maternal health and nutrition </li></ul></ul><ul><ul><li>Quality of obstetric and paediatric care </li></ul></ul>
  10. 10. Perinatal Mortality <ul><li>Perinatal Mortality Rate: </li></ul><ul><ul><li>The number of deaths of fetuses (according to the reporting criteria) plus the number of early neonatal deaths, per 1000 total births </li></ul></ul><ul><ul><li>x 1000 </li></ul></ul><ul><ul><li>Canada 2007: 6.4 per 1000 total births. (3) </li></ul></ul><ul><ul><li>Fetal and Early Neonatal Deaths </li></ul></ul><ul><ul><li>___________________________ </li></ul></ul><ul><ul><li>Total Births </li></ul></ul>
  11. 11. Perinatal Mortality <ul><li>Perinatal Mortality Ratio: </li></ul><ul><li>x 1000 </li></ul><ul><ul><li>Fetal and Early Neonatal Deaths </li></ul></ul><ul><ul><li>___________________________ </li></ul></ul><ul><ul><li>Live Births </li></ul></ul>
  12. 12. Neonatal Mortality <ul><li>Neonatal Mortality Rate: </li></ul><ul><ul><li>The number of deaths of infants during the neonatal period, per 1000 live births </li></ul></ul><ul><ul><li>x 1000 </li></ul></ul><ul><ul><li>Canada 2007: 3.8 per 1000 live births. (3) </li></ul></ul><ul><ul><li>Neonatal Deaths </li></ul></ul><ul><ul><li>_______________ </li></ul></ul><ul><ul><li>Live Births </li></ul></ul>
  13. 13. Neonatal Mortality <ul><li>Early Neonatal Mortality Rate: </li></ul><ul><ul><li>The number of early neonatal deaths during a given year per 1,000 live births in the same year. </li></ul></ul><ul><ul><li>x 1000 </li></ul></ul><ul><ul><li>Canada 2007: 1193, no rate calculated. (3) </li></ul></ul><ul><ul><li>Early Neonatal Deaths </li></ul></ul><ul><ul><li>____________________ </li></ul></ul><ul><ul><li>Live Births </li></ul></ul>
  14. 14. Post-Neonatal Mortality <ul><li>Post-Neonatal Mortality Rate: </li></ul><ul><ul><li>The number of deaths of infants aged 28 to 364 days, per 1000 live births </li></ul></ul><ul><ul><li>x 1000 </li></ul></ul><ul><ul><li>Canada 2007: 1.3 per 1000 live births. (3) </li></ul></ul><ul><ul><li>Post-Neonatal Deaths </li></ul></ul><ul><ul><li>___________________ </li></ul></ul><ul><ul><li>Live Births </li></ul></ul>
  15. 15. Infant Mortality <ul><li>Infant Mortality Rate: </li></ul><ul><ul><li>The number of deaths of infants aged less than one year, per 1000 live births </li></ul></ul><ul><ul><li>x 1000 </li></ul></ul><ul><ul><li>Canada 2007: 5.1 per 1000 live births. (3) </li></ul></ul><ul><ul><li>Deaths under 1 yr of age </li></ul></ul><ul><ul><li>_____________________ </li></ul></ul><ul><ul><li>Live Births </li></ul></ul>
  16. 16. Child Mortality <ul><li>The most important </li></ul><ul><li>is </li></ul><ul><li>Under-5 Mortality Rate </li></ul>
  17. 17. Under-5 Mortality Rate * <ul><li>A leading indicator of the level of child health and overall development in countries. </li></ul><ul><li>The fourth indicator of 8 MDGs (Millennium Development Goals) </li></ul><ul><ul><li>* WHO website: http://www.who.int/healthinfo/statistics/indunder5mortality/en/ </li></ul></ul>
  18. 18. Under-5 Mortality Rate * <ul><li>Probability of a child born in a specific year or period dying before reaching the age of five, if subject to age-specific mortality rates of that period </li></ul><ul><li>Strictly speaking , not a rate (i.e. the number of deaths divided by the number of population at risk during a certain period of time) </li></ul><ul><li>A probability of death derived from a life table and expressed as rate per 1,000 live births </li></ul><ul><ul><li>* WHO website: http://www.who.int/healthinfo/statistics/indunder5mortality/en/ </li></ul></ul>
  19. 19. Under-5 Mortality Rate
  20. 20. References <ul><li>International statistical classification of diseases and related health problems, 10th revision (ICD-10) </li></ul><ul><li>Neonatal and Perinatal Mortality; World Health Organization 2006 </li></ul><ul><li>Deaths 2007, Statistics Canada, Health Statistics Division, Catalogue no. 84F0211X, March 2010 </li></ul>

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