Infant, neonatal and perinatal mortality rates in Singapore

Abstract

Infant, neonatal and perinatal mortality rates are reliable indices of the health status and delivery of health care in a country. These rates have been declining in Singapore since World War II, and presently have become comparable to those of many developing countries. The pattern has also changed; postneonatal mortality has fallen markedly, resulting in neonatal mortality accounting for 75% of infant mortality, and first week mortality for 85% of neonatal mortality. Perinatal mortality rates have also declined over the years, due mainly to a decline in the first week mortality rates though a slight fall in stillbirth rates has also occurred. Further improvements can be expected in the perinatal and neonatal mortality rates. As neonatal intensive care improves, the prognosis of the very small and feeble infants will be brighter even though the efforts required might be very much greater. Such a challenge will prove to be very exciting and stimulating, and be an impetus to the raising of neonatal intensive care to a much higher level.

PIP: An analysis of the mortality statistics of Singapore reveals the progress that has been made since the end of World War 2. A rapid decline in these rates has since been observed, particularly in the infant mortality rate and the postneonatal mortality rate. The neonatal mortality rate also declined but at a much slower rate. The neonatal mortality rate also declined but at a much slower rate. By 1980, the postneonatal mortality rate had fallen below the neonatal mortality rate, an indication of the improvement of health and health care of infants beyond the neonatal period. The major causes of infant morbidity and mortality were infections and malnutrition. Currently, accidents and malignant conditions have become important causes of morbidity and mortality. With the rapid decline in the infant and postneonatal mortality rates, along with a slower improvement in the neonatal mortality rate since the War, deaths in the neonatal period account for the major proportion of infant deaths. At this time, about 75% of infant deaths occur in the neonatal period, i.e., the neonatal mortality rate is 75% of the infant mortality rate. This becomes more marked when the 1st week mortality rate is considered. 1st week deaths account for about 85% of all neonatal deaths. An improvement in the perinatal mortality rate has occurred because of a decline in the incidence of stillbirths and even more in 1st week deaths since World War 2. Though a decline in stillbirth rate has occurred, the major cause of decline in the perinatal mortality rate has been the marked decline in the 1st week mortality rate. Over the last 8 years, there has been little decline in the stillbirth rate while the 1st week mortality rate has declined markedly. The perinatal mortality rate in Indians and Malays is much higher than in the Chinese, but a general decline was observed in all 3 ethnic groups over the years. The incidence of low birth weight infants has not declined from 1974 to 1982. Respiratory conditions still account for the major proportion of deaths. Hyaline membrane disease is still the most important condition, but the incidence of deaths has decreased. Congenital malformations have gradually increased in importance in the causation of deaths. As neonatal intensive care improves, the prognosis of the very small and feeble infants will improve even though the efforts needed might be considerably greater.