Congenital malformations as a cause of neonatal and postnatal death in Massachusetts (1970-1980).

Massachusetts birth and death certificate tapes for the years 1970-1980 were linked and analyzed to determine causes of death in the neonatal and postneonatal periods and to identify any related sociodemographic factors. Our analysis suggests that, although the neonatal mortality rate declined by about 43 percent, the postneonatal mortality rate remained relatively unchanged. Perinatal problems remained the principal cause of death during the neonatal period, throughout the decade. In the postneonatal period, congenital malformations became a leading cause of death toward the end of the decade because of a reduction in mortality from infectious diseases and perinatal problems. Infants born to mothers under 18 and over 34 years of age had the highest death rates from congenital birth defects. Higher mortality rates caused by congenital malformations were found in the more industrialized areas of Massachusetts. Further declines in infant mortality rates in Massachusetts will depend on preventive measures to reduce the incidence of congenital malformations.