Causes of neonatal death: results from NeoKIP community-based trial in Quang Ninh province, Vietnam.

AIM: To ascertain the causes of neonatal death in a province in northern Vietnam and analyse their distribution over age at death, birth weight and place of delivery. METHODS: Verbal autopsy interviews using a questionnaire derived from WHO standard and adapted to Vietnamese conditions was performed on all neonatal deaths occurring in Quang Ninh province from July 2008 to June 2010. Three experienced paediatricians independently reviewed all verbal autopsy records (233) and assigned a main cause of death. In case of disagreement in the allocation of cause of death, a consensus process was initiated to decide on a final cause. RESULTS: Neonatal mortality rate within the study area was 16/1000 (238 neonatal deaths and 14,453 live births) over the study period. Prematurity/low birth-weight (37.8%), intrapartum-related neonatal deaths (birth asphyxia, 33.2%), infections (13.0%) and congenital malformation (6.7%) were the four leading causes of death. Four cases of neonatal tetanus were found. Intrapartum-related deaths dominated in the home delivery group, whereas prematurity was the most prominent cause of death at all facility levels. Most neonatal deaths occurred within the first 24 h after delivery (58.6%). CONCLUSION: A high proportion of deaths due to prematurity and intrapartum-related causes, calls for improvements of delivery care and resuscitation practices at health facilities.