Characteristics of fetal and neonatal deaths registered in San Martín, Peru, 2011–2025
DOI:
https://doi.org/10.59594/iicqp.2026.v4n2.180Keywords:
Fetal Death, Perinatal Death, Infant MortalityAbstract
Objective: To describe the clinical and epidemiological characteristics of fetal and neonatal deaths registered in San Martín, Peru, from 2011 to 2025 and to evaluate the association between neonatal death characteristics and timing of death.
Methods: This observational analytical study was based on publicly available regional data. Clinical, obstetric, geographic, and temporal variables were summarized using frequencies, percentages, medians, and interquartile ranges. Among neonatal deaths with classifiable timing of death, characteristics were compared according to timing of death: less than 24 hours, 1–6 days, and 7–27 days. Adjusted prevalence ratios (aPRs) were estimated using Poisson regression with robust variance.
Results: A total of 3,084 deaths were analyzed: 1,423 (46.1%) fetal and 1,661 (53.9%) neonatal. Among neonatal deaths, 1,130 (68.0%) occurred in preterm newborns and 1,127 (67.9%) in newborns with low birth weight. The most frequent causes of neonatal death were other causes (28.0%), prematurity-immaturity (27.7%), and infections (24.6%). Among the 1,637 neonatal deaths with classifiable timing of death, 572 occurred within the first 24 hours, 715 at 1–6 days, and 350 at 7–27 days. Among neonatal deaths, the proportion occurring within the first 24 hours was higher in records with a gestational age of less than 28 weeks (aPR = 1.88; 95% CI: 1.55–2.28), asphyxia and related causes (aPR = 3.25; 95% CI: 2.58–4.11), congenital malformations or lethal congenital malformation (aPR = 2.74; 95% CI: 2.11–3.56), and prematurity-immaturity (aPR = 1.76; 95% CI: 1.37–2.26).
Conclusions: Neonatal deaths were concentrated among preterm and low-birth-weight newborns. Deaths occurring within the first 24 hours showed a profile characterized by extreme prematurity, asphyxia and related causes, and congenital or lethal malformations. These findings describe differences in the timing of death and do not estimate mortality risk among live-born infants.
Downloads
References
1. Gonzalez RM, Gilleskie D. Infant mortality rate as a measure of a country’s health: a robust method to improve reliability and comparability. Demography. 2017;54(2):701-20. doi: 10.1007/s13524-017-0553-7
2. Hessami K, Homayoon N, Hashemi A, Vafaei H, Kasraeian M, Asadi N. COVID-19 and maternal, fetal and neonatal mortality: a systematic review. J Matern Fetal Neonatal Med. 2022;35(15):2936-41. doi: 10.1080/14767058.2020.1806817
3. Sharrow D, Hug L, Liu Y, Fell GW, You D. Global, regional, and national levels and trends in under 5, infant, and neonatal mortality during 1990-2024 with scenario based projections to 2030: modelling study. BMJ. 2026;393:e088684. doi: 10.1136/bmj-2025-088684
4. Ávila Vargas-Machuca JG. Desigualdad en la mortalidad neonatal del Perú generada por la pobreza y educación, 2011-2019. Rev Peru Med Exp Salud Publica. 2022;39(2):178-84. doi: 10.17843/rpmesp.2022.392.10629
5. Lucas R, Thames T, Chestnut JF, DeMaria AL, Stoneburner A. Maternity care access and infant mortality. JAMA Netw Open. 2025;8(11):e2542831. doi: 10.1001/jamanetworkopen.2025.42831
6. Pathirana J, Muñoz FM, Abbing-Karahagopian V, Bhat N, Harris T, Kapoor A, et al. Neonatal death: case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine. 2016;34(49):6027-37. doi: 10.1016/j.vaccine.2016.03.040
7. Tamir TT. Neonatal mortality rate and determinants among births of mothers at extreme ages of reproductive life in low and middle income countries. Sci Rep. 2024;14(1):12596. doi: 10.1038/s41598-024-61867-w
8. Erchick DJ, Lackner JB, Mullany LC, Bhandari NN, Shedain PR, Khanal S, et al. Causes and age of neonatal death and associations with maternal and newborn care characteristics in Nepal: a verbal autopsy study. Arch Public Health. 2022;80(1):26. doi: 10.1186/s13690-021-00771-5
9. Boerma T, Campbell OMR, Amouzou A, Blumenberg C, Blencowe H, Moran A, et al. Maternal mortality, stillbirths, and neonatal mortality: a transition model based on analyses of 151 countries. Lancet Glob Health. 2023;11(7):e1024-31. doi: 10.1016/S2214-109X(23)00195-X
10. Avila J, Vásquez-Mejía A, Soto-Cabezas G, Reyes-Vega MF, Olivares N, Talavera-Romero L, et al. Neonatal mortality inequalities in Peru, 2007–2021: an ecological joinpoint trends analysis. Int J Equity Health. 2026;25(1):11. doi: 10.1186/s12939-025-02731-9
11. Copaja-Corzo C, Gomez-Colque S, Vilchez-Cornejo J, Hueda-Zavaleta M, Taype-Rondan A. Fetal death and its association with indicators of social inequality: 20-year analysis in Tacna, Peru. PLoS One. 2023;18(10):e0292183. doi: 10.1371/journal.pone.0292183
12. Avila Vargas-Machuca JG, Tavera Salazar MR, Miranda Monzon JA. Mortalidad neonatal en Perú al 2030. Proyecciones departamentales con enfoque de equidad. Rev Cuerpo Med HNAAA. 2023;16 Suppl 1:e1957. doi: 10.35434/rcmhnaaa.2023.16Supl.1.1957
13. Dol J, Hughes B, Bonet M, Dorey R, Dorling J, Grant A, et al. Timing of neonatal mortality and severe morbidity during the postnatal period: a systematic review. JBI Evid Synth. 2023;21(1):98-199. doi: 10.11124/JBIES-21-00479
14. Ávila J, Tavera M, Carrasco M. Características epidemiológicas de la mortalidad neonatal en el Perú, 2011-2012. Rev Peru Med Exp Salud Publica. 2015;32(3):423-30. doi: 10.17843/rpmesp.2015.323.1670
15. Shamba D, Day LT, Zaman SB, Sunny AK, Tarimo MN, Peven K, et al. Barriers and enablers to routine register data collection for newborns and mothers: EN-BIRTH multi-country validation study. BMC Pregnancy Childbirth. 2021;21 Suppl 1:233. doi: 10.1186/s12884-020-03517-3
16. Gupta A, Paria A. Transition from fetus to neonate. Surgery (Oxf). 2022;40(11):685-90. doi: 10.1016/j.mpsur.2022.10.001
17. Bell EF, Hintz SR, Hansen NI, Bann CM, Wyckoff MH, DeMauro SB, et al. Mortality, in-hospital morbidity, care practices, and 2-year outcomes for extremely preterm infants in the US, 2013-2018. JAMA. 2022;327(3):248-63. doi: 10.1001/jama.2021.23580
18. Haro-Norabuena RS, Gonzales-Carrillo JJ, Arce-Huamani MA. Neonatal factors associated with mortality among preterm infants admitted to neonatal intensive care in a Peruvian national hospital. Healthcare (Basel). 2025;13(19):2420. doi: 10.3390/healthcare13192420
19. Bekele GG, Roga EY, Gonfa DN, Geda GM. Incidence and predictors of mortality among neonates admitted with birth asphyxia to neonatal intensive care unit of West Shewa Zone Public Hospitals, Central Ethiopia. BMJ Paediatr Open. 2024;8(1):e002403. doi: 10.1136/bmjpo-2023-002403
20. Kawakami MD, Sanudo A, Teixeira MLP, Andreoni S, de Castro JQX, Waldvogel B, et al. Neonatal mortality associated with perinatal asphyxia: a population-based study in a middle-income country. BMC Pregnancy Childbirth. 2021;21(1):169. doi: 10.1186/s12884-021-03652-5
21. Coggins SA, Glaser K. Updates in late-onset sepsis: risk assessment, therapy, and outcomes. Neoreviews. 2022;23(11):738-55. doi: 10.1542/neo.23-10-e738
22. Care of Preterm or Low Birthweight Infants Group. New World Health Organization recommendations for care of preterm or low birth weight infants: health policy. EClinicalMedicine. 2023;63:102155. doi: 10.1016/j.eclinm.2023.102155
23. Hoeijmakers F, Beck N, Wouters MWJM, Prins HA, Steup WH. National quality registries: how to improve the quality of data? J Thorac Dis. 2018;10 Suppl 29:S3490-9. doi: 10.21037/jtd.2018.04.146
24. Stirling RG, Ahern S, Millar J, Evans S, Dawkins P, Zalcberg J. Clinical quality registries: establishing the socio-technical infrastructure for learning health systems. Learn Health Syst. 2025;9(4):e70036. doi: 10.1002/lrh2.70036
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Investigación e Innovación Clínica y Quirúrgica Pediátrica
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
This website is published under the 
