Mortinatalité et mortalité néonatale

In France in 2000 the stillbirth rate was 4.6 per 1 000 births and the neonatal death rate was 3.0 per 1 000. France has an average position among European countries for neonatal mortality. The lowest level of mortality is observed in Finland and Sweden. According the International Classification of Diseases (ICD 9), the main causes of neonatal death in 1995 were congenital anomalies (27 % of deaths), and perinatal conditions (54 %), especially intrauterine hypoxia and birth asphyxia (10 %), respiratory distress syndrome (8 %), and fetal and neonatal haemorrhage (6 %). Mortality can be used to assess medical care during the perinatal period if the risk factors of mortality are collected and taken into account in the analysis. The main factors are : gestational age, birth weight, and the number of newborns (singletons, twins, triplets, …).The trend towards a more active approach of care during pregnancy, delivery and the first days of life has various consequences on mortality. Consequently it is necessary to follow some recommendations in medical assessment. Definitions of births and deaths should include very preterm births (≥ 22 weeks) and very small fetus or infants (≥ 500 grams), and rates of mortality should be measured for extended perinatal mortality or fetal and infant mortality, after excluding deaths attributed to congenital anomalies.