Hospital mortality rates of infants with birth weight less than or equal to 1,500 g in the northeast of Brazil.

OBJECTIVE To obtain information on the hospital mortality of infants born in Fortaleza with birth weights less than or equal to 1,500 g, and to compare it with data from the Vermont Oxford Network, a center of excellence for neonatal care. METHODS Prospective cohort study, enrolling all infants with birth weight less than or equal to 1,500 g born in Fortaleza between March 1, 2002 and February 28, 2003 from all the hospitals and maternity units with neonatal intensive care units. Infants were followed from birth until hospital discharge or hospital death, using the Vermont Oxford Network questionnaire. RESULTS A total of 774 newborn infants were analyzed. The neonatal mortality coefficient was 477 per thousand, and the postneonatal mortality coefficient was 35 per thousand, taking the hospital mortality coefficient to 512 per thousand. The coefficient of early neonatal mortality was 335 per thousand, and the coefficient of late neonatal mortality was 142 per thousand. Mortality coefficients were higher in Fortaleza for all weight ranges than on the Vermont Oxford Network and were also, with the exception of the less than or equal to 600 g weight range, higher than in Montevideo. CONCLUSIONS The results demonstrate high rates of hospital mortality among very low birth weight infants, with a greater concentration during the first week of life, suggesting that not only the care provided at the neonatal intensive care units is deficient, but also that prenatal and delivery-room care is inadequate.