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\expndtw0\charscalex100 \ul0\nosupersub\cf5\f6\fs17 Ir J Med Sci (2010) 179:313-314
\line \up0 \expndtw-3\charscalex100 DOI 10.1007/s11845-009-0395-4 \par\pard\ql
\li1133\sb0\sl-218\slmult0 \par\pard\ql\li1133\sb1\sl-218\slmult0 \up0
\expndtw0\charscalex112 \ul0\nosupersub\cf1\f2\fs19 LETTER TO THE EDITOR
\par\pard\ql \li1020\sb0\sl-368\slmult0 \par\pard\ql\li1020\sb191\sl-368\slmult0
\up0 \expndtw0\charscalex106 \ul0\nosupersub\cf2\f3\fs32 Irish neonatal
mortality \par\pard\ql \li1020\sb0\sl-230\slmult0 \par\pard\ql\li1020\sb116\sl-
230\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf3\f4\fs20 B.
McCoy\ul0\nosupersub\cf4\f5\fs20 \ul0\nosupersub\cf3\f4\fs20 S.
Gormally\par\pard\sect\sectd\sbknone\cols2\colno1\colw6102\colsr20\colno2\colw5638\
colsr160\ql \li1020\sb0\sl-195\slmult0 \par\pard\ql \li1020\sb0\sl-195\slmult0
\par\pard\ql \li1020\sb0\sl-195\slmult0 \par\pard\ql \li1020\sb0\sl-195\slmult0
\par\pard\ql \li1020\sb0\sl-195\slmult0 \par\pard\ql \li1020\sb0\sl-195\slmult0
\par\pard\ql \li1020\sb0\sl-195\slmult0 \par\pard\ql \li1020\sb0\sl-195\slmult0
\par\pard\ql \li1020\sb0\sl-195\slmult0 \par\pard\ql \li1020\sb104\sl-
195\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf5\f6\fs17 Received: 15
February 2009 / Accepted: 24 June 2009 / Published online:\par\pard\ql
\li1210\sb4\sl-195\slmult0 \up0 \expndtw0\charscalex100 Royal Academy of Medicine
in Ireland 2009\par\pard\ql \li1020\sb0\sl-230\slmult0 \par\pard\ql
\li1020\sb135\sl-230\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf3\f4\fs20 Dear Editor,\par\pard\qj \li1020\ri130\sb118\sl-
249\slmult0 \up0 \expndtw-2\charscalex100 The neonatal mortality figures for
Ireland are collected \up0 \expndtw0\charscalex104 annually from Paediatric and
Maternity Units in Ireland \up0 \expndtw-1\charscalex100 using a questionnaire,
through the Faculty of Paediatrics in \up0 \expndtw-1\charscalex100 the College
of Physicians, Ireland \up0 \expndtw0\charscalex101 [\ul0\nosupersub\cf6\f7\fs20
1\ul0\nosupersub\cf3\f4\fs20 -\ul0\nosupersub\cf6\f7\fs20
3\ul0\nosupersub\cf3\f4\fs20 ]. The neonatal\par\pard\qj \li1020\ri132\sb1\sl-
249\slmult0 \up0 \expndtw-2\charscalex100 mortality rate (NMR) is the number
of neonatal deaths \up0 \expndtw-3\charscalex100 within the first \up0
\expndtw-2\charscalex100 28 days per 1,000 live births and
early\par\pard\qj \li1020\ri131\sb2\sl-248\slmult0 \up0 \expndtw-1\charscalex100
neonatal mortality is the number of deaths occurring in the \up0 \expndtw-
6\charscalex100 first \up0 \expndtw0\charscalex105 7 days. The corrected neonatal
mortality rate is the\par\pard\qj \li1020\ri131\sb1\sl-248\slmult0 \up0
\expndtw0\charscalex100 neonatal mortality rate excluding deaths due to
congenital \up0 \expndtw-1\charscalex100 malformations. Deaths are categorised
by the Wiggles-\line \up0 \expndtw0\charscalex100 worth classification \up0
\expndtw0\charscalex101 (lethal malformation, prematurity,\par\pard\ql
\li1020\sb17\sl-230\slmult0 \up0 \expndtw-2\charscalex100 asphyxia and
\u8216?\u8216?specific\u8217?\u8217?) [\ul0\nosupersub\cf6\f7\fs20
4\ul0\nosupersub\cf3\f4\fs20 ].\par\pard\qj \li1020\ri131\sb4\sl-
249\slmult0\fi226 \up0 \expndtw-2\charscalex100 In 2006, the response rate to the
questionnaire was 98%. \up0 \expndtw-1\charscalex100 The total number of neonatal
deaths reported for 2006 was \up0 \expndtw0\charscalex105 128. The number of live
births greater than 500 g birth \up0 \expndtw0\charscalex101 weight was 64,237 for
the same period [\ul0\nosupersub\cf6\f7\fs20
5\ul0\nosupersub\cf3\f4\fs20 ].\par\pard\qj \li1020\ri131\sb1\sl-
249\slmult0\fi226 \up0 \expndtw-1\charscalex100 The NMR for 2006 was 2.0 per
1,000. The corrected \line \up0 \expndtw0\charscalex104 NMR was 1.3. The principle
causes of death were con-\line \up0 \expndtw-1\charscalex100 genital malformations
\up0 \expndtw0\charscalex103 34% (n = 43), prematurity \up0 \expndtw-
2\charscalex100 49%\par\pard\qj \li1020\ri130\sb1\sl-249\slmult0 \up0
\expndtw0\charscalex105 (n = 63) and asphyxia 11% (n = 14). Of the 43 neonatal
\line \up0 \expndtw-1\charscalex100 deaths due to congenital malformations, the
most common \line \up0 \expndtw-3\charscalex100 diagnoses were Trisomy 18 (7
cases), Trisomy 13 (5 cases), \line \up0 \expndtw-2\charscalex100 Potters sequence
\up0 \expndtw-2\charscalex100 (6 \up0 \expndtw-2\charscalex100 cases), Anencephaly
\up0 \expndtw-2\charscalex100 (5 \up0 \expndtw-1\charscalex100 cases)
and\par\pard\ql \li1020\sb16\sl-230\slmult0 \up0 \expndtw0\charscalex100 congenital
cardiac malformations (4 cases).\par\pard\qj \li1020\ri130\sb6\sl-248\slmult0\fi226
\up0 \expndtw-1\charscalex100 The mode of death was reported in 76 cases (59%). The
\up0 \expndtw0\charscalex100 reported mode of death was withdrawal of
ventilatory \up0 \expndtw-1\charscalex100 support in \up0 \expndtw-1\charscalex100
58% of cases, withholding cardiopulmonary\par\pard\ql \li1020\sb16\sl-
230\slmult0 \up0 \expndtw0\charscalex101 resuscitation at delivery in \up0
\expndtw0\charscalex102 16% of cases and further\par\pard\ql \li1020\sb0\sl-
195\slmult0 \par\pard\ql \li1020\sb0\sl-195\slmult0 \par\pard\ql \li1020\sb0\sl-
195\slmult0 \par\pard\ql \li1020\sb2\sl-195\slmult0 \up0 \expndtw0\charscalex105
\ul0\nosupersub\cf5\f6\fs17 B. McCoy (\ul0\nosupersub\cf7\f8\fs17
&\ul0\nosupersub\cf5\f6\fs17 ) S. Gormally\par\pard\qj \li1020\ri707\sb2\sl-
199\slmult0 \up0 \expndtw0\charscalex100 Department of Neonatology, Our Lady of
Lourdes Hospital, \up0 \expndtw-1\charscalex100 Drogheda, Louth,
Ireland\par\pard\ql \li1020\sb5\sl-195\slmult0 \up0 \expndtw-1\charscalex100 e-
mail: blathmccoy@yahoo.co.uk\par\pard\column \ql \li6131\sb0\sl-195\slmult0
\par\pard\ql \li6131\sb0\sl-195\slmult0 \par\pard\ql \li6131\sb0\sl-195\slmult0
\par\pard\ql \li6131\sb0\sl-195\slmult0 \par\pard\ql \li6131\sb0\sl-195\slmult0
\par\pard\ql \li6131\sb0\sl-195\slmult0 \par\pard\ql \li6131\sb0\sl-195\slmult0
\par\pard\ql \li6131\sb0\sl-195\slmult0 \par\pard\ql \li6131\sb0\sl-195\slmult0
\par\pard\ql \li29\sb104\sl-195\slmult0 \up0 \expndtw0\charscalex100 18 July
2009\par\pard\qj \li6122\sb0\sl-249\slmult0 \par\pard\qj \li6122\sb0\sl-249\slmult0
\par\pard\qj \li20\ri817\sb49\sl-249\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf3\f4\fs20 cardiopulmonary resuscitation was withheld
following \up0 \expndtw-2\charscalex100 initial resuscitation (non-escalation) in
13% of cases. There \up0 \expndtw0\charscalex100 was no response to resuscitation
attempts in the remaining \up0 \expndtw0\charscalex103 13% of cases. The reporting
of mode of death is compa-\line \up0 \expndtw0\charscalex103 rable with figures for
previous years. In the survey, only \up0 \expndtw0\charscalex103 1.5% fail to
report the diagnosis at death, yet 41% fail to \up0 \expndtw-2\charscalex100 report
the mode of death. Does this reflect an unwillingness \up0 \expndtw-1\charscalex100
to report on actions taken around the issues of withdrawal, \up0
\expndtw0\charscalex103 withholding or non-escalation of therapy for neonates in
\up0 \expndtw0\charscalex100 our NICUs around the country?\par\pard\qj
\li20\ri816\sb1\sl-249\slmult0\fi226 \up0 \expndtw0\charscalex101 The lower NMR for
2006 is the lowest on record since \up0 \expndtw0\charscalex101 the survey began in
1987 (Tables\ul0\nosupersub\cf6\f7\fs20 1\ul0\nosupersub\cf3\f4\fs20
,\ul0\nosupersub\cf6\f7\fs20 2\ul0\nosupersub\cf3\f4\fs20 ). Prematurity is the
\up0 \expndtw0\charscalex100 leading cause of death. Asphyxia still accounts for
11% of \up0 \expndtw-1\charscalex100 mortality and is a key target for the future.
Our inability to \up0 \expndtw0\charscalex101 reduce this figure over the years is
disappointing. A more \up0 \expndtw0\charscalex100 detailed examination of
antenatal details for these cases is \up0 \expndtw0\charscalex101 essential to
attempt to identify at risk infants.\par\pard\ql \li20\ri816\sb0\sl-
249\slmult0\fi226\tx257 \up0 \expndtw0\charscalex100 Postmortem rates have not
improved in the past 6 years \line \up0 \expndtw0\charscalex103
(Table\ul0\nosupersub\cf6\f7\fs20 3\ul0\nosupersub\cf3\f4\fs20 ). Previous
studies have suggested that post-\line \up0 \expndtw-1\charscalex100 mortem in
the neonatal population can provide a diagnosis \line \up0 \expndtw-1\charscalex100
in 36% of cases and can change recurrence risks in 11% of \line \up0
\expndtw0\charscalex103 cases [\ul0\nosupersub\cf6\f7\fs20
6\ul0\nosupersub\cf3\f4\fs20 ]. The public perception of pathological investi-\line
\up0 \expndtw0\charscalex108 gations and the media focus in recent times
have \line \up0 \expndtw0\charscalex102 undoubtedly had a role to play in this. As
neonatologists, \line \up0 \expndtw-2\charscalex100 however, we should be aware
that consent from parents can \line \up0 \expndtw0\charscalex101 be influenced by
the manner in which the consent is \line \up0 \expndtw0\charscalex100
obtained, by whom and the timing of discussions [\ul0\nosupersub\cf6\f7\fs20
7\ul0\nosupersub\cf3\f4\fs20 ]. \line\tab \up0 \expndtw0\charscalex100 The lower
NMR for 2006 may reflect a significant \line \up0 \expndtw-1\charscalex100
improvement in neonatal outcome as a result of improving \line \up0
\expndtw0\charscalex100 levels of care, availability of a national transport team
and \line \up0 \expndtw-1\charscalex100 the ever improving standard of living in
Ireland. However, \line \up0 \expndtw0\charscalex104 it may also be due to the fact
that more babies are dying \line \up0 \expndtw0\charscalex104 outside the 28-day
period. Also, in the absence of man-\line \up0 \expndtw0\charscalex102
datory reporting of neonatal deaths in Ireland, this figure \line \up0 \expndtw-
2\charscalex100 may represent underreporting of deaths by some units.
This\par\pard\ql \li3990\sb306\sl-345\slmult0 \up0 \expndtw0\charscalex157
\ul0\nosupersub\cf8\f9\fs30 123

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\ul0\nosupersub\cf5\f6\fs17
314\par\pard\sect\sectd\sbknone\cols2\colno1\colw5962\colsr160\colno2\colw5638\cols
r160\ql \li1020\sb0\sl-195\slmult0 \par\pard\ql \li1020\sb159\sl-195\slmult0
\up0 \expndtw0\charscalex101 Table 1 Cause of death (%) compared with previous
years\par\pard\ql \li2301\sb134\sl-
195\slmult0\tx2819\tx3343\tx3867\tx4390\tx4914\tx5438 \up0 \expndtw-2\charscalex100
1987\tab \up0 \expndtw-2\charscalex100 1999\tab \up0 \expndtw-2\charscalex100
2001\tab \up0 \expndtw-2\charscalex100 2002\tab \up0 \expndtw-2\charscalex100
2004\tab \up0 \expndtw-2\charscalex100 2005\tab \up0 \expndtw-2\charscalex100
2006\par\pard\ql \li1020\sb181\sl-
195\slmult0\tx2296\tx2819\tx3343\tx3867\tx4390\tx4914\tx5438 \up0 \expndtw-
2\charscalex100 Congenital\tab \up0 \expndtw-2\charscalex100 39\tab \up0 \expndtw-
2\charscalex100 39\tab \up0 \expndtw-2\charscalex100 39\tab \up0 \expndtw-
2\charscalex100 44.5\tab \up0 \expndtw-2\charscalex100 30\tab \up0 \expndtw-
2\charscalex100 41\tab \up0 \expndtw-2\charscalex100 34\par\pard\ql \li1189\sb6\sl-
195\slmult0 \up0 \expndtw-2\charscalex100 malformation\par\pard\ql \li1020\sb61\sl-
195\slmult0\tx2296\tx2819\tx3343\tx3867\tx4390\tx4914\tx5438 \up0 \expndtw-
2\charscalex100 Prematurity\tab \up0 \expndtw-2\charscalex100 35\tab \up0 \expndtw-
2\charscalex100 37\tab \up0 \expndtw-2\charscalex100 30\tab \up0 \expndtw-
2\charscalex100 36\tab \up0 \expndtw-2\charscalex100 48\tab \up0 \expndtw-
2\charscalex100 43\tab \up0 \expndtw-2\charscalex100 49\par\pard\ql
\li1020\sb61\sl-195\slmult0\tx2380\tx2904\tx3343\tx3952\tx4476\tx4914\tx5438
\up0 \expndtw-2\charscalex100 Asphyxia\tab \up0 \expndtw-2\charscalex100 8\tab \up0
\expndtw-2\charscalex100 3\tab \up0 \expndtw-2\charscalex100 12\tab \up0 \expndtw-
2\charscalex100 7.5\tab \up0 \expndtw-2\charscalex100 9\tab \up0 \expndtw-
2\charscalex100 11\tab \up0 \expndtw-2\charscalex100 11\par\pard\ql \li1009\sb0\sl-
195\slmult0 \par\pard\ql \li1009\sb0\sl-195\slmult0 \par\pard\ql \li1009\sb62\sl-
195\slmult0 \up0 \expndtw0\charscalex101 Table 2 Neonatal mortality rate (NMR)
over the past 10 years\par\pard\column \ql \li6122\sb0\sl-230\slmult0
\par\pard\ql \li20\sb74\sl-230\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf3\f4\fs20 issues of inaccurate figures and incomplete
reports, but\par\pard\qj \li20\ri817\sb5\sl-248\slmult0 \up0
\expndtw0\charscalex101 caution is advised. If established, it must be acceptable
to \line \up0 \expndtw0\charscalex100 the neonatal units involved. Mandatory
reporting can lead \line \up0 \expndtw-1\charscalex100 to false expectations that
mortality rates will automatically \line \up0 \expndtw0\charscalex103 be reduced if
established, this is not the case. Mandatory \line \up0 \expndtw0\charscalex100
reporting is an acknowledgement of the importance of the \line \up0
\expndtw0\charscalex106 mortality figures. It would serve as a tool to encourage
\line \up0 \expndtw-1\charscalex100 discussion of the details around the
deaths and it also \line \up0 \expndtw0\charscalex100 allows for more certainty
of the reported figures. \par\pard\sect\sectd\sbknone \li1009\sb119\sl-
184\slmult0\fi0\tx1534\tx1970\tx2407\tx2843\tx3280\tx3717\tx4154\tx4591\tx5027\tx54
65 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf10\f11\fs16 Year:\tab \up0
\expndtw-2\charscalex100 1997\tab \up0 \expndtw-2\charscalex100 1998\tab \up0
\expndtw-2\charscalex100 1999\tab \up0 \expndtw-2\charscalex100 2000\tab \up0
\expndtw-2\charscalex100 2001\tab \up0 \expndtw-2\charscalex100 2002\tab \up0
\expndtw-2\charscalex100 2003\tab \up0 \expndtw-2\charscalex100 2004\tab \up0
\expndtw-2\charscalex100 2005\tab \up0 \expndtw-2\charscalex100
2006\par\pard\sect\sectd\sbknone\cols2\colno1\colw5962\colsr160\colno2\colw5638\col
sr160\ql \li1009\sb171\sl-
184\slmult0\tx1965\tx2402\tx2838\tx3275\tx3712\tx4149\tx4586\tx5022\tx5460 \up0
\expndtw0\charscalex103 NMR: 3.8\tab \up0 \expndtw-2\charscalex100 4.0\tab \up0
\expndtw-2\charscalex100 3.48\tab \up0 \expndtw-2\charscalex100 4.0\tab \up0
\expndtw-2\charscalex100 3.9\tab \up0 \expndtw-2\charscalex100 3.1\tab \up0
\expndtw-2\charscalex100 3.0\tab \up0 \expndtw-2\charscalex100 2.8\tab \up0
\expndtw-2\charscalex100 3.1\tab \up0 \expndtw-2\charscalex100 2.0\par\pard\ql
\li1020\sb0\sl-195\slmult0 \par\pard\ql \li1020\sb0\sl-195\slmult0 \par\pard\ql
\li1020\sb0\sl-195\slmult0 \par\pard\ql \li1020\sb3\sl-195\slmult0 \up0
\expndtw0\charscalex102 \ul0\nosupersub\cf5\f6\fs17 Table 3 The postmortem rate
over the last 6 years\par\pard\ql \li1020\sb134\sl-
195\slmult0\tx2412\tx3017\tx3623\tx4228\tx4833\tx5438 \up0 \expndtw-2\charscalex100
Year\tab \up0 \expndtw-2\charscalex100 2001\tab \up0 \expndtw-2\charscalex100
2002\tab \up0 \expndtw-2\charscalex100 2003\tab \up0 \expndtw-2\charscalex100
2004\tab \up0 \expndtw-2\charscalex100 2005\tab \up0 \expndtw-2\charscalex100
2006\par\pard\column \ql \li6122\sb0\sl-230\slmult0 \par\pard\ql \li20\sb88\sl-
230\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf3\f4\fs20
References\par\pard\qj \li6122\sb0\sl-198\slmult0 \par\pard\qj \li20\ri817\sb48\sl-
198\slmult0\tx237 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf5\f6\fs17 1. Foran
A, Dempsey E, Watters A, Gormally SM (2002) Irish \line\tab \up0
\expndtw0\charscalex101 neonatal mortality\u8212?12 years on. Ir Med J 95:267-
269\par\pard\qj \li20\ri817\sb2\sl-199\slmult0\tx237 \up0 \expndtw0\charscalex101
2. Waters A, Gormally SM (2003) Irish neonatal mortality statistics \line\tab
\up0 \expndtw0\charscalex100 2000. Ir J Med Sci 172(3):154. doi:{\field{\*\fldinst
{HYPERLINK http://dx.doi.org/10.1007/BF02914506 }}{\fldrslt
{\ul0\nosupersub\cf9\f10\fs17
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195\slmult0\tx2412\tx3017\tx3623\tx4228\tx4833\tx5438 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf5\f6\fs17 Postmortem (%)\tab \up0 \expndtw-2\charscalex100 29\tab
\up0 \expndtw-2\charscalex100 32\tab \up0 \expndtw-2\charscalex100 31\tab \up0
\expndtw-2\charscalex100 38\tab \up0 \expndtw-2\charscalex100 19\tab \up0 \expndtw-
2\charscalex100 21\par\pard\qj \li1020\sb0\sl-249\slmult0 \par\pard\qj
\li1020\ri130\sb172\sl-249\slmult0 \up0 \expndtw0\charscalex102
\ul0\nosupersub\cf3\f4\fs20 potentially confounding factor will be addressed to
some \line \up0 \expndtw0\charscalex100 degree in the future by the ever-
increasing number of \line \up0 \expndtw0\charscalex106 neonatal units signing
up to the Vermont database. \line \up0 \expndtw0\charscalex104 Unfortunately,
the majority of units are registering only \line \up0 \expndtw0\charscalex103
infants born under 1,500 g. While the establishment of a \line \up0
\expndtw0\charscalex100 National Perinatal Unit is an exciting development, such
a \line \up0 \expndtw0\charscalex102 database will capture only early neonatal
deaths. Manda-\line \up0 \expndtw0\charscalex107 tory reporting would seem to be
the key to address the\par\pard\ql \li1048\sb0\sl-345\slmult0 \par\pard\ql
\li1048\sb0\sl-345\slmult0 \par\pard\ql \li1048\sb0\sl-345\slmult0 \par\pard\ql
\li1048\sb0\sl-345\slmult0 \par\pard\ql \li1048\sb0\sl-345\slmult0 \par\pard\ql
\li1048\sb0\sl-345\slmult0 \par\pard\ql \li1048\sb0\sl-345\slmult0 \par\pard\ql
\li1048\sb0\sl-345\slmult0 \par\pard\ql \li1048\sb0\sl-345\slmult0 \par\pard\ql
\li1048\sb0\sl-345\slmult0 \par\pard\ql \li1048\sb0\sl-345\slmult0 \par\pard\ql
\li1048\sb0\sl-345\slmult0 \par\pard\ql \li1048\sb0\sl-345\slmult0 \par\pard\ql
\li1048\sb0\sl-345\slmult0 \par\pard\ql \li1048\sb0\sl-345\slmult0 \par\pard\ql
\li1048\sb0\sl-345\slmult0 \par\pard\ql \li1048\sb0\sl-345\slmult0 \par\pard\ql
\li1048\sb0\sl-345\slmult0 \par\pard\ql \li1048\sb0\sl-345\slmult0 \par\pard\ql
\li1048\sb62\sl-345\slmult0 \up0 \expndtw0\charscalex157
\ul0\nosupersub\cf8\f9\fs30 123\par\pard\column \ql \li20\sb3\sl-195\slmult0
\up0 \expndtw0\charscalex103 \ul0\nosupersub\cf5\f6\fs17 3. Finan E, Gormally SM
(2005) Irish neonatal mortality statistics\par\pard\ql \li227\sb5\sl-195\slmult0
\up0 \expndtw0\charscalex101 2002. Irish J Med Sci 174(4):65-66\par\pard\ql
\li20\ri816\sb3\sl-198\slmult0\tx237\tx237 \up0 \expndtw0\charscalex101 4.
Wigglesworth JS (1980) Monitoring perinatal mortality\u8212?a path-\line \tab
\up0 \expndtw0\charscalex101 ophysiological approach. Lancet ii:684-686. doi:
{\field{\*\fldinst {HYPERLINK http://dx.doi.org/10.1016/S0140-6736(80)92717-8 }}
{\fldrslt {\ul0\nosupersub\cf9\f10\fs17 10.1016/S0140-}}}\line \tab \up0 \expndtw-
2\charscalex100 {\field{\*\fldinst {HYPERLINK http://dx.doi.org/10.1016/S0140-
6736(80)92717-8 }}{\fldrslt {\ul0\nosupersub\cf9\f10\fs17
6736}}}\ul0\nosupersub\cf9\f10\fs17 (80)92717-8\par\pard\ql \li20\ri816\sb2\sl-
199\slmult0\tx237\tx237 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf5\f6\fs17 5.
Irish births and deaths register 2006. Irish Central Statistics Office. \line
\up0 \expndtw-2\charscalex100 6. Kileen OG, Burke C, Devaney D, Clarke TA, Gillan
JE (2004) The \line\tab \up0 \expndtw0\charscalex102 value of the perinatal and
neonatal autopsy. Ir J Med 97(8):241-\line \tab \up0 \expndtw-2\charscalex100
244\par\pard\qj \li20\ri817\sb1\sl-199\slmult0\tx237 \up0 \expndtw0\charscalex103
7. Laing IA (2004) Clinical aspects of neonatal death and autopsy. \line\tab
\up0 \expndtw-1\charscalex100 Semin Neonatol 9(4):247-254. doi:{\field{\*\fldinst
{HYPERLINK http://dx.doi.org/10.1016/j.siny.2003.11.004 }}{\fldrslt
{\ul0\nosupersub\cf9\f10\fs17 10.1016/j.siny.2003.11.004}}}

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