To examine the relative contributions of preterm delivery and congenital anomalies to neonatal mortality.
Retrospective analysis of 2009–2011 linked birth cohort-hospital discharge files for California, Missouri, Pennsylvania and South Carolina. Deaths were classified by gestational age and three definitions of congenital anomaly: any ICD-9 code for an anomaly, any anomaly with a significant mortality risk, and anomalies recorded on the death certificate.
In total, 59% of the deaths had an ICD-9 code for an anomaly, only 43% had a potentially fatal anomaly, and only 34% had a death certificate anomaly. Preterm infants (<37 weeks GA) accounted for 80% of deaths; those preterm infants without a potentially fatal anomaly diagnosis comprised 53% of all neonatal deaths. The share of preterm deaths with a potentially fatal anomaly decreases with GA.
Congenital anomalies are responsible for about 40% of neonatal deaths while preterm without anomalies are responsible for over 50%.
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Partial support by the March of Dimes Prematurity Research Center at Stanford University School of Medicine (to CSP and SKS); the Eunice Kennedy Shriver National Institute of Child Health and Human Development (RO1 HD084819 [to CSP, MP, SKS, and SAL].
The authors declare no competing interests.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Phibbs, C.S., Passarella, M., Schmitt, S.K. et al. Understanding the relative contributions of prematurity and congenital anomalies to neonatal mortality. J Perinatol 42, 569–573 (2022). https://doi.org/10.1038/s41372-021-01298-x