Cirugía y Cirujanos

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board

>Journals >Cirugía y Cirujanos >Year 2003, Issue 4

Velasco-Murillo V, Palomares-Trejo A, Navarrete-Hernández E
Causality and hospital perinatal mortality trend at the Mexican Institute of Social Security, 1998-2002
Cir Cir 2003; 71 (4)

Language: Español
References: 26
Page: 304-313
PDF: 84.91 Kb.

Full text


Objective: To analyze levels, trend and causes of hospital perinatal mortality at the Instituto Mexicano del Seguro Social (IMSS) during the 5 years from 1998 to 2002 to identify magnitude and related factors in our population and discuss some technical bases and epidemiologic aspects for planning strategies to contribute to its reduction. Material and methods: Descriptive study on the death certificate s of 39,994 cases of perinatal deaths distributed among 19,108 fetal deaths of 28 weeks and more of gestation and 20,886 neonatal deaths 7 to days of life that occurred in IMSS hospitals during the reference period. With this information and the data on total births, dead or live from the official information system of our Institution, we established annual rates for the entire IMSS, including administrative regions and zones of medical services. We also generated 5-year cumulated numbers for frequencies and rates of perinatal death causes in the IMSS, using the codes of Tenth Revision of the International Diseases Classification. Results: Hospital perinatal mortality at the IMSS showed a reduction from 1998 (13 per 1,000 births) to 2002 (11.4 per 1,000 births). That trend was observed in the four administrative regions and in the majority of number of medical services zones, but with many differences in levels. It was similar in proportions of fetal (47.8%) and neonatal deaths (52.2%). Two thirds of fetal mortality was linked to maternal complications during pregnancy and labor. A similar proportion of neonatal deaths was due to premature birth and its complications. During the period analysis, the tendency toward reduction was confirmed in perinatal mortality in IMSS, but it is necessary to plan new strategies to improve the quality of medical care during pregnancy and the labor and to reinforce activities to prevention and care in premature births to achieve more rapid the following years.

Key words: Perinatal mortality, causes, tendency.


  1. World Health Organization. Perinatal mortality: a listing of available information, Family and Reproductive Health. Geneva, Switzerland: Motherhood WHO, 1996.

  2. Wise PH. The anatomy of a disparity in infant mortality. Annu Rev Public Health 2003;24:341-362.

  3. Safe Motherhood World Health Organization, World Bank. Health around the world, Geneva, Switzerland: Motherhood WHO 1997.

  4. Instituto Mexicano del Seguro Social. Dirección de Prestaciones Médicas. Boletín Estadístico Anual de Mortalidad, 2002.

  5. Cardona-Pérez JA, Ruiz-Tapia RA, Avila-Palafox RE, Madrazo-Navarro M. La salud reproductiva en la Seguridad Social. México: Conferencia Interamericana de Seguridad Social;1997.

  6. Instituto Mexicano del Seguro Social. Dirección de Prestaciones Médicas. Boletín Estadístico Anual de Mortalidad, 1993-2002.

  7. McCormick MC, Wise PH. Infant mortality. Curr Opin Pediatr 1993;5(5):552-557.

  8. Moss W, Darmstadt GL, Marsh DR, Black RE, Antosham M. Research priorities for the reduction of perinatal and neonatal morbidity and mortality in developing country communities. J Perinatol 2002;22(7):513-515.

  9. Barash JH, Weinstein LC. Preconception and prenatal care. Prim Care 2002;29(3):519-542.

  10. Kurjak A, Bekavac I. Perinatal problems in developing countries: lessons learned and future challenges. J Perinat Med 2001;29(3):179-187.

  11. Prual A, De Bernis L, El Joud DO. Potencial role of prenatal care in reducing maternal and perinatal mortality in sub-Saharan Africa. J Gynecol Obstet Biol Reprod (Paris) 2002;31(1):90-99.

  12. García Carrapato MR. The offspring of gestational diabetes. J Perinat Med 2003;31(1):5-11.

  13. American Academy of Pediatrics. The American College of Obstetricians and Gynecologists. Guidelines for perinatal care, Washington, D.C., USA: ACOG;1997.

  14. Organización Mundial de la Salud. Organización Panamericana de la Salud. Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud. 10th rev. OMS;1995.

  15. World Health Organization. Centro Latinoamericano de Perinatología y Desarrollo Humano. Mortalidad materna, perinatal, infantil en América Latina y el Caribe. WHO;2002.

  16. Joensen F, Olsen SF, Holm T, Joensen HD. Perinatal deaths in the Faroe Islands during 1986-95. Acta Obstet Gynecol Scand 2000;79:834-838.

  17. Kramer MS, Liu S, Luo Z, Yuan H, Platt RW, Joseph KS. Analysis of perinatal mortality and its components: time for a change. Am J Epidemiol 2002;156(6):493-497.

  18. Vintzileos AM, Ananth CV, Smulian JC, Scorza WE, Knuppel RA. The impact of prenatal care on neonatal deaths in the presence and absence of antenatal high-risk conditions. Am J Obstet Gynecol 2002;186(5):1011-1016.

  19. Goffinet F, Breart G. Per-partum anoxia and handicaps: epidemiological aspects. J Gynecol Obstet Biol Reprod (Paris) 2003;32(1 Suppl):S111-S113.

  20. Kramer MS, Platt RW, Yang H, Haglund B, Cnattingius S, Bergsjo P. Registration artifacts in international comparisons of infant mortality. Paediatric Perinatol Epidemiol 2002;16(1):16-22.

  21. Velasco-Murillo V. Prevención y tratamiento del parto pretérmino: lo nuevo acerca del viejo problema. Rev Med IMSS 2001;39(5):417-427.

  22. Martínez de Villarreal L, Pérez JZ, Vázquez PA, Herrera RH, Campos M del R, López RA, et al. Decline of neural tube defects cases alter a folic acid campaign in Nuevo León, Mexico. Teratology 2002;66(5):249-256.

  23. Velasco-Murillo V, Navarrete-Hernández E, Pozos-Cavanzo JL, Ojeda-Mijares RI, Cárdenas-Lara C, Cardona-Pérez JA. Indicaciones y justificación de las cesáreas en el Instituto Mexicano del Seguro Social. Gac Med Mex 2000;136(5):421-431.

  24. Lessaris KJ, Annibale DJ, Southgate M, Hulsey TC, Ohning BL. Effects of changing health care financial policy on very low birthweight neonatal outcomes. South Med J 2002;95(4):426-430.

  25. Penchaszadeh VB. Preventing congenital anomalies in developing countries. Community Genetics 2002;5(1):61-69.

  26. Lumley J, Watson L, Watson M, Bower C. Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects. Cochrane Rev Abstract 2003. www.Medscape.com

>Journals >Cirugía y Cirujanos >Year 2003, Issue 4

· Journal Index 
· Links 

Copyright 2019