Identification and characterization of areas of extended perinatal mortality rates associated with congenital anomalies, Colombia 1999-2008
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Objectives: Determine the characteristics of fetal, perinatal, and extended perinatal mortality caused by congenital anomalies between 1999 and 2008 using vital statistics; Detect areas with high mortality rates and mortality concentration of congenital anomalies.
Methodology: Descriptive Study Mortality vital statistic registries
Discussion: The geographical distribution of the extended perinatal mortality by central nervous system anomalies remains despite a folic acid supplementation program (2002). Mortality by chromosomal anomalies showed an increasing trend since 2003. Cardiovascular system anomalies show an increasing trend during the all period. Geographical mortality areas: Show a belt pattern of municipalities between departments: Andina and Orinoquia regions (eastern plains); Areas with important agricultural production; Areas are related to geographical location of river sources, Cauca, Magdalena and Guaviare river.
Conclusions: Perinatal mortality analysis based on vital statistics helps us to understand the characteristics of mortality associated with congenital anomalies. Geographical areas could identify specific for implementation or strengthen of public actions, in order to reduce its occurrence. Geographical analysis of municipalities by anomalies group invite to more specific factorial analysis studies and propose more precise intervention.
Recommendations: Improve the registry of fetal and neonatal deaths around the country in urban and rural zones. Design specific prevention strategies for birth defects. For example, enforcement of folic acid supplementation initiatives in areas with the highest number of cases of neural tube defects. Investment in high mortality areas in order to find related environmental factors and developing intervention plans in all levels. Cardiovascular system anomalies findings supports antenatal screening and multidisciplinary care to improve survival in preventable cases.