Two geographically defined populations with different organization of medical care. Cause-specific analysis of early neonatal deaths.

In a previous study, a difference in early neonatal mortality was found between two geographically defined populations with different perinatal health services. The mortality was lower in districts served by hospitals with specialized obstetric service but lacking neonatal wards than in districts with both these facilities. This unexpected finding was not explained by population-related differences in perinatal risk factors. In the present cause-specific analysis of the early neonatal deaths, it was shown, after exclusion of lethal malformations, that the observed difference remained. It was most pronounced in full-term non-malformed infants, possibly indicating that it was more related to antenatal/obstetric care factors than to the pediatric care facilities available.