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.