Dangers of death on the first day of life by the minute.

OBJECTIVE

To evaluate mortality on the first day of life by minute and hour, and examine changes in major causes of death in the past three decades.

STUDY

DESIGN

We evaluated mortality on the first day of life by the hour (0, 1, …, 23 h), and in the first hour by 5-min block (0-4, 5-9, …, 55-59 min) using data on cause of death for 15,690 infants in Canada from 1981 to 2012.

RESULTS

Infant mortality on the first day declined from 2.60 per 1000 in the 1980s to 1.26 in the 2000s. The decline was greater at 6-23 h than at 0-5 h of life, and among infants with congenital anomalies compared with prematurity and birth asphyxia.

CONCLUSION

Infant mortality is highest on the first day of life. More focus on prematurity and birth asphyxia in the first 5 h of life is needed to improve infant mortality.