An Epidemiological Approach to the Problem of Rising Neonatal Mortality in Baltimore

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Abstract
The rise in neonatal mortality rates in Baltimore in 1958 to 22 per 1000 live births was investigated epidemiologically. In several Baltimore hospitals certain conditions worth more intensive consideration were revealed. At Hospital A, direct relationships between the rise in neonatal mortality and the following factors were thought possible: (1) a rise in proportion of patients failing to seek prenatal care (2) an increase in incidence of puerperal morbidity (3) a change in age distribution of neonatal deaths with an increase in proportion of infants becoming ill and subsequently dying after the first 48 hours of life (4) an excess dosage of chloram-phenicol in the newborn, particularly premature infants. In contrast, these factors played no significant role in the increase in neonatal mortality at Hospital B, where a rise in the number of immature deliveries alone was sufficient to account for their slightly elevated neonatal mortality rate.

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