scholarly journals Are infant mortality rates increasing in England? The effect of extreme prematurity and early neonatal deaths

2020 ◽  
Author(s):  
Selina Nath ◽  
Pia Hardelid ◽  
Ania Zylbersztejn
Keyword(s):  
Infant Mortality ◽  
Gestational Age ◽  
Mortality Rates ◽  
Infant Survival ◽  
Extreme Prematurity ◽  
Neonatal Deaths ◽  
Infant Deaths ◽  
Live Births ◽  
National Statistics ◽  
Early Neonatal Deaths

Abstract Background Infant mortality has been rising in England since 2014. We examined potential drivers of these trends. Methods We used aggregate data on all live births, stillbirths and linked infant deaths in England in 2006–2016 from the Office for National Statistics. We compared trends in infant mortality rates overall, excluding births at <24 weeks of gestation, by quintile of SES and gestational age. Results Infant mortality decreased from 4.78 deaths/1000 live births in 2006 to 3.54/1000 in 2014 (annual decrease of 0.15/1000) and increased to 3.67/1000 in 2016 (annual increase of 0.07/1000). This rise was driven by increases in deaths at 0–6 days of life. After excluding infants born at <24 weeks of gestation, infant mortality continued to decrease after 2014. The risk of infant death was 94% higher in the most versus least deprived SES quintile, which reduced to a 55% higher risk after adjusting for gestational age. Conclusions The observed increase in infant mortality rates since 2014 is wholly explained by an increasing number of deaths at 0–6 days of age among babies born at <24 weeks of gestation. Policies focused on improving maternal health to reduce preterm birth could substantially reduce the socio-economic gap in infant survival.

Infant Mortality Among Singletons and Twins in Japan During 1999–2008 on the Basis of Risk Factors

2013 ◽  
Vol 16 (2) ◽  
pp. 639-644 ◽  
Author(s):  
Yoko Imaizumi ◽  
Kazuo Hayakawa
Keyword(s):  
Infant Mortality ◽  
Maternal Age ◽  
Survival Rates ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Infant Mortality Rate ◽  
Age Group ◽  
Neonatal Deaths ◽  
Infant Deaths ◽  
Live Births

The infant mortality rate (IMR) among single and twin births from 1999 to 2008 was analyzed using Japanese Vital Statistics. The IMR was 5.3-fold higher in twins than in singletons in 1999 and decreased to 3.9-fold in 2008. The reduced risk of infant mortality in twins relative to singletons may be related, partially, to survival rates, which improved after fetoscopic laser photocoagulation for twin — twin transfusion syndrome. The proportion of neonatal deaths among total infant deaths was 54% for singletons and 74% for twins. Thus, intensive care of single and twin births may be very important during the first month of life to reduce the IMR. The IMR decreased as gestational age (GA) rose in singletons, whereas the IMR in twins decreased as GA rose until 37 weeks and increased thereafter. The IMR was significantly higher in twins than in singletons from the shortest GA (<24 weeks) to 28 weeks as well as ≥38 weeks, whereas the IMR was significantly higher in singletons than in twins from 30 to 36 weeks. As for maternal age, the early neonatal and neonatal mortality rates as well as the IMR in singletons were significantly higher in the youngest maternal age group than in the oldest one, whereas the opposite result was obtained in twins. The lowest IMR in singletons was 1.1 per 1,000 live births for ≥38 weeks of gestation and heaviest birth weight (≥2,000 g), while the lowest IMR in twins was 1.8 at 37 weeks and ≥2,000 g.

Risk of Neonatal and Infant Mortality in Twins and Singletons by Gestational Age

2018 ◽  
Vol 36 (08) ◽  
pp. 798-805 ◽  
Author(s):  
Han-Yang Chen ◽  
Suneet P. Chauhan
Keyword(s):  
Infant Mortality ◽  
Gestational Age ◽  
Regression Models ◽  
Causes Of Death ◽  
Error Variance ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Adjusted Risk ◽  
Live Births ◽  
Risk Ratios

Objective To compare neonatal and infant mortality rates stratified by gestational age (GA) between singletons and twins and examine the three leading causes of death among them. Study Design This was a retrospective cohort study using the U.S. vital statistics datasets. The study was restricted to nonanomalous live births at 24 to 40 weeks delivered in 2005 to 2014. We used multivariable Poisson regression models with robust error variance to examine the association between birth plurality (singleton vs. twin) and mortality outcomes within each GA, while adjusting for confounders. The results were presented as adjusted risk ratios (aRRs) with 95% confidence intervals (CIs). Results Of 26,292,747 live births, 96.6% were singletons and 3.4% were twins. At 29 to 36 weeks of GA, compared with singletons, twins had a lower risk of neonatal mortality (aRR: 0.37–0.78) and infant mortality (aRR: 0.54–0.86). When examined by GA, the three leading causes of neonatal and infant mortality varied between singletons and twins. Conclusion When stratified by GA, the risk of neonatal and infant mortality was lower at 29 to 36 weeks in twins than in singletons, though the cause of death varied.

Regional Contribution of Previable Infant Deaths to Infant Mortality Rates in the United States

2019 ◽  
Author(s):  
MacKenzie Lee ◽  
Eric S. Hall ◽  
Meredith Taylor ◽  
Emily A. DeFranco
Keyword(s):  
United States ◽  
Infant Mortality ◽  
Infant Death ◽  
The United States ◽  
Mortality Rates ◽  
Population Based ◽  
Infant Mortality Rate ◽  
Infant Deaths ◽  
Live Births ◽  
Healthy People 2020

Objective Lack of standardization of infant mortality rate (IMR) calculation between regions in the United States makes comparisons potentially biased. This study aimed to quantify differences in the contribution of early previable live births (<20 weeks) to U.S. regional IMR. Study Design Population-based cohort study of all U.S. live births and infant deaths recorded between 2007 and 2014 using Centers for Disease Control and Prevention's (CDC's) WONDER database linked birth/infant death records (births from 17–47 weeks). Proportion of infant deaths attributable to births <20 vs. 20 to 47 weeks, and difference (ΔIMR) between reported and modified (births ≥20 weeks) IMRs were compared across four U.S. census regions (North, South, Midwest, and West). Results Percentages of infant deaths attributable to birth <20 weeks were 6.3, 6.3, 5.3, and 4.1% of total deaths for Northeast, Midwest, South, and West, respectively, p < 0.001. Contribution of < 20-week deaths to each region's IMR was 0.34, 0.42, 0.37, and 0.2 per 1,000 live births. Modified IMR yielded less regional variation with IMRs of 5.1, 6.2, 6.6, and 4.9 per 1,000 live births. Conclusion Live births at <20 weeks contribute significantly to IMR as all result in infant death. Standardization of gestational age cut-off results in more consistent IMRs among U.S. regions and would result in U.S. IMR rates exceeding the healthy people 2020 goal of 6.0 per 1,000 live births.

scholarly journals A Study of Early Neonatal Deaths at Kathmandu Medical College Teaching Hospital

1970 ◽  
Vol 27 (2) ◽  
pp. 79-82
Author(s):  
M Shrestha ◽  
BL Bajracharya ◽  
DS Manandhar
Keyword(s):  
Birth Weight ◽  
Neonatal Mortality ◽  
Death Rate ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
Early Neonatal Death ◽  
Extreme Prematurity ◽  
Neonatal Deaths ◽  
Live Births ◽  
Early Neonatal Deaths

Over 9 million deaths occur each year in the perinatal and neonatal periods globally. 98% of these deaths take place in the developing world. Nepal has a high neonatal mortality rate (NMR) of 38.6 per 1000 live births (2001). Two thirds of the newborn deaths usually occur in the first week of life (early neonatal death). Newborn survival has become an important issue to improve the overall health status and for achieving the millennium developmental goals of a developing country like Nepal. Aims and Objectives: This study was carried out to determine the causes of early neonatal deaths (ENND) at KMCTH in the two-year period from November 2003 to October2005 (Kartik 2060 B.S. to Ashoj 2062). Methodology: This is a prospective study of all the early neonatal deaths in KMCTH during the two-year study period. Details of each early neonatal death were filled in the standard perinatal death audit forms of the Department. Results: Out of the 1517 total births in the two-year period, there were 10 early neonatal deaths (ENND). Early neonatal death rate during the study period was 6.7 per 1000 live births and early neonatal death rate (excluding less than 1 kg) was 6.1 per 1000 live births The important causes of early neonatal deaths were extreme prematurity, birth asphyxia, congenital anomalies and septicaemia. During the study period, there was no survival of babies with a birth weight of less than 1 kg. Among the maternal characteristics, 80% of the mothers of early neonatal deaths were aged between 20-35 years. 50% of the mothers were primigravida. 50% of the mothers of ENNDs had delivered their babies by caesarean section.Discussion: Most of the early neonatal deaths were due to extreme prematurity. Birth asphyxia was the second most important cause of early neonatal deaths. 70% of ENNDs were among LBW babies. Prevention of premature delivery, proper management of very low birth weight babies and early detection and appropriate management of perinatal hypoxia have become important interventional strategies in reducing early neonatal deaths in KMCTH.Conclusion: Early neonatal mortality at KMCTH is fairly low. Good care during pregnancy, labour and after the birth of the baby has helped to achieve these results. Low cost locally made equipments were used to manage the sick newborns. Reduction of early neonatal deaths require more intensive care including use of ventilators, surfactant and parenteral nutrition and prevention of preterm births Key words: Early neonatal death (ENND), neonatal mortality   doi:10.3126/jnps.v27i2.1584 J. Nepal Paediatr. Soc. Vol 27(2), p.79-82

Trends in and determinants of neonatal and infant mortality in Nigeria based on Demographic and Health Survey data

2020 ◽  
pp. 1-11
Author(s):  
Kamalesh Kumar Patel ◽  
Jang Bahadur Prasad ◽  
Rajeshwari A. Biradar
Keyword(s):  
Infant Mortality ◽  
Health Survey ◽  
Mortality Rates ◽  
Demographic And Health Survey ◽  
Infant Mortality Rate ◽  
North West ◽  
Infant Deaths ◽  
Live Births ◽  
The North ◽  
West Region

Abstract This study aimed to assess the changes in neonatal and infant mortality rates in Nigeria over the period 1990 to 2018 using Nigerian Demographic and Health Survey (NDHS) data, and assess their socio-demographic determinants using data from the most recent survey conducted in 2018. The infant mortality rate was 87 per 1000 live births in 1990, and this increased to 100 per 1000 live births in 2003 – an increase of around 15% over 13 years. Neonatal and infant mortality rates started to decline steadily thereafter and continued to do so until 2013. After 2013, neonatal morality rose slightly by the year 2018. Information for 27,465 infants under 1 year of age from the NDHS-2018 was analysed using bivariate and multivariate analysis and the Cox proportional hazard technique. In 2018, infant deaths decreased as wealth increased, and the incidence of infant deaths was greater among those of Islam religion than among those of other religions. A negative association was found between infant deaths and the size of a child at birth. Infant mortality was higher in rural than in urban areas, and was higher among male than female children. Both neonatal and infant death rates varied by region and were found to be highest in the North West region and lowest in the South region. An increasing trend was observed in neonatal mortality in the 5-year period from 2013 to 2018. Policy interventions should be focused on the poor classes, women with a birth interval of less than 2 years and those living in the North West region of the country.

scholarly journals Health capabilities and the determinants of infant mortality in Brazil, 2004–2015: an innovative methodological framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alexandre Bugelli ◽  
Roxane Borgès Da Silva ◽  
Ladislau Dowbor ◽  
Claude Sicotte
Keyword(s):  
Infant Mortality ◽  
Educational Attainment ◽  
Health Professionals ◽  
Capita Income ◽  
Mortality Rates ◽  
Fertility Rate ◽  
Employment Rate ◽  
Infant Deaths ◽  
Bolsa Familia ◽  
Per Capita

Abstract Background Despite the implementation of a set of social and health policies, Brazil has experienced a slowdown in the decline of infant mortality, regional disparities and persistent high death levels, raising questions about the determinants of infant mortality after the implementation of these policies. The objective of this article is to propose a methodological approach aiming at identifying the determinants of infant mortality in Brazil after the implementation of those policies. Method A series of multilevel panel data with fixed effect nested within-clusters were conducted supported by the concept of health capabilities based on data from 26 Brazilian states between 2004 and 2015. The dependent variables were the neonatal, the infant and the under-five mortality rates. The independent variables were the employment rate, per capita income, Bolsa Família Program coverage, the fertility rate, educational attainment, the number of live births by prenatal visits, the number of health professionals per thousand inhabitants, and the access to water supply and sewage services. We also used different time lags of employment rate to identify the impact of employment on the infant mortality rates over time, and household income stratified by minimum wages to analyze their effects on these rates. Results The results showed that in addition to variables associated with infant mortality in previous studies, such as Bolsa Família Program, per capita income and fertility rate, other factors affect child mortality. Educational attainment, quality of prenatal care and access to health professionals are also elements impacting infant deaths. The results also identified an association between employment rate and different infant mortality rates, with employment impacting neonatal mortality up to 3 years and that a family income below 2 minimum wages increases the odds of infant deaths. Conclusion The results proved that the methodology proposed allowed the use of variables based on aggregated data that could hardly be used by other methodologies.

Low Birth Weight, Vital Records, and Infant Mortality

PEDIATRICS ◽  
1986 ◽  
Vol 78 (6) ◽  
pp. 1143-1145
Author(s):  
MYRON E. WEGMAN
Keyword(s):  
Birth Weight ◽  
Infant Mortality ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
The United States ◽  
Low Birth Weight Infants ◽  
Neonatal Deaths ◽  
Live Births ◽  
Order Of Magnitude ◽  
Almost All

About one tenth of all infant deaths occur in babies weighing less than 500 g at birth, almost all of whom die very shortly thereafter. In 1983, when the United States reported 3,638,933 live births, 4,368 of them were less than 500 g; that year there were 26,507 neonatal deaths. This means that slightly more than 0.1% of all live births contributed to 17% of neonatal mortality. Given this order of magnitude, any change in the numbers relating to these tiny babies can have a disproportionate influence on reported infant mortality and on interstate comparisons. Two questions promptly arise. How accurate and meaningful are the data regarding babies born weighing less than 500 g? What can be done to decrease the deaths in this category? Wilson et al1 call attention to how the number of very low birth weight infants reported by a state may be affected by the state's definition of a live birth.

IMPROVED INFANT MORTALITY RATES IN A POPULATION SERVED BY A COMPREHENSIVE NEIGHBORHOOD HEALTH PROGRAM

PEDIATRICS ◽  
1971 ◽  
Vol 47 (6) ◽  
pp. 989-994 ◽  
Author(s):  
André Chabot
Keyword(s):  
Infant Mortality ◽  
Low Income ◽  
Health Program ◽  
Mortality Rates ◽  
Federal Grants ◽  
Census Tracts ◽  
Live Births ◽  
Department Of Health ◽  
Community Health Program ◽  
The Impact

The Denver Department of Health and Hospitals developed from multiple federal grants (M and I, C and Y, OEO, PHS, and Family Planning) a comprehensive community health program for the low income population of Denver. To measure the impact of this program, infant mortality rates were reviewed in the low income and nonwhite populations. Infant mortality in 25 selected low income census tracts in Denver was 34.2 per thousand live births in 1964. This decreased to 24.5 by 1968. Infant mortality of nonwhites in Denver was 41.9 in 1964 and decreased to 25.2 by 1968. This decrease in infant mortality rates in both of these populations compares very favorably with such data from other cities.

Retrospective analysis of neonatal deaths secondary to infections in England and Wales, 2013–2015

2020 ◽  
pp. fetalneonatal-2020-319093
Author(s):  
Godwin Oligbu ◽  
Leila Ahmed ◽  
Laura Ferraras-Antolin ◽  
Shamez Ladhani
Keyword(s):  
Mortality Rate ◽  
Retrospective Analysis ◽  
Neonatal Mortality ◽  
Mortality Rates ◽  
Neonatal Mortality Rate ◽  
England And Wales ◽  
Neonatal Deaths ◽  
Live Births ◽  
Extremely Preterm ◽  
Related Mortality

ObjectiveTo estimate the overall and infection-related neonatal mortality rate and the pathogens responsible using electronic death registrations.DesignRetrospective analysis of national electronic death registrations data.SettingEngland and Wales.PatientsNeonates aged <28 days.Main outcome measuresOverall and infection-related mortality rate per 1000 live births in term, preterm (28–36 weeks) and extremely preterm (<28 weeks) neonates; the contribution of infections and specific pathogens; comparison with mortality rates in 2003–2005.ResultsThe neonatal mortality rate during 2013–2015 (2.4/1000 live births; 5095 deaths) was 31% lower than in 2003–2005 (3.5/1000; 6700 deaths). Infection-related neonatal mortality rate in 2013–2015 (0.32/1000; n=669) was 20% lower compared with 2003–2015 (0.40/1000; n=768), respectively. Infections were responsible for 13.1% (669/5095) of neonatal deaths during 2013–2015 and 11.5% (768/6700) during 2003–2005. Of the infection-related deaths, 44.2% (296/669) were in term, 19.9% (133/669) preterm and 35.9% (240/669) extremely preterm neonates. Compared with term infants (0.15/1000 live births), infection-related mortality rate was 5.9-fold (95% CI 4.7 to 7.2) higher in preterm (0.90/1000) and 188-fold (95% CI 157 to 223) higher in extremely preterm infants (28.7/1000) during 2013–2015. A pathogen was recorded in 448 (67%) registrations: 400 (89.3%) were bacterial, 37 (8.3%) viral and 11 (2.4%) fungal. Group B streptococcus (GBS) was reported in 30.4% (49/161) of records that specified a bacterial infection and 7.3% (49/669) of infection-related deaths.ConclusionsOverall and infection-related neonatal mortality rates have declined, but the contribution of infection and of specific pathogens has not changed. Further preventive measures, including antenatal GBS vaccine may be required to prevent the single most common cause of infection-related deaths in neonates.

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