The National Neonatology Forum (NNF) has done a laudable job to collect National Database on Neonatal Morbidity and Mortal- ity(l,2)..The 1995 data was published in July, 1997 in Bulletin in NNF(2); and now again in February, 1999 in Indian Pediatrics(l). It means that the data collected during year 1995 took nearly eighteen months to be processed/ analyzed and thereafter published in Bulletin NNF(2). It took another twenty months for the same data to appear in Indian Pediatrics( 1). In the present era of hightech information technology the above time lag is rather unfortunate. By now, expectation was for the data for years 1996 and 1997.

Two participating centers did not send full year reports to the nodal center for data collection. The participants inability to stick to the time schedule shows their lack of interest in the project. Two important institutions (with over] 0,000 deliveries per year - Pediatrics Department, Safdarjang Hospital, New Delhi, and Nowrosjee Wadia Maternity Hospital, Mumbai) need to be involved as participating centers to enhance the representative national character of the data.

The data base pertains only to intramural births at the participating centers. These centers do receive a significant number of babies born outside (extramural births) who are referred to neonatal intensive care units. There is need to include this group as well in the data collection because their morbidity/ mortality pattern might be different vis-a-vis intramural birth cohort.

Still births contributed to nearly sixty per cent of perinatal mortality rate and no definite cause could be established in a large number (40%) of them. The autopsy of all still births should be made mandatory to arrive at the primary cause of fetal death. This will help in planning of preventive/interventional strategies to reduce the high fetal wastage. It will be interesting to know about the autopsy rate at the participating centers.

Perinatal mortality has significant relation to educational status of woman, and to the number of antenatal visits before delivery(3). The data pertaining to this needs mentioning in the report.

Surgery was done in ] 51 (0.4%) neonates. The details regarding indication of surgery will be of interest to the readers.

An expert commentary along with more detailed presentation of data base will go a long way in reducing the high perinata/ neonatal mortality in our country. The pediatrician will be grateful if the National Neo- natal Perintal data base is made an annual feature of Indian Pediatrics (say in every March issue of the Journal).
 

Jai Kishan,
Jackson Hospital,
Mianwali Colony,
Gurgaon,
Haryana. India.