Underregistration of neonatal deaths: an empirical study of the accuracy of infantile vital statistics in Taiwan

Study objective-The accuracy of the official statistic on infant deaths in Taiwan has been questioned. This study aimed to survey infant deaths nationwide, to measure associated vital statistics, and compare them with the official statistics to assess accuracy. Design and participants-A nationwide survey of all gestational outcomes occurring at greater than or equal to 20 weeks' gestation over a three day study period (15-17 May 1989) was conducted to collect data from 23 counties and cities nationwide using a two stage data collection procedure. Main results-The survey derived infant death rate was 9.72 per 1000 Live births, which was higher than the reported official statistic of 5.71 per 1000 live births. A more detailed examination of data on infant deaths showed that the estimated neonatal death rate of 6.68 per 1000 live births (95% confidence intervals: 3.33, 11.96 per 1000 live births) was significantly higher than the published official statistic of 1.94 per 1000 live births, while the postneonatal mortality of 3.04 per 1000 live births was comparable to the reported statistic of 3.37 per 1000 live births. Conclusions-This study empirically documented the underregistration of infant deaths in Taiwan, particularly those occurring during the first 27 days of life.