scholarly journals Disparities of infant and neonatal mortality trends in Greece during the years of economic crisis by ethnicity, place of residence and human development index: a nationwide population study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025287 ◽  
Author(s):  
Tania Siahanidou ◽  
Nick Dessypris ◽  
Antonis Analitis ◽  
Constantinos Mihas ◽  
Evangelos Evangelou ◽  
...  

ObjectiveTo study trends of infant mortality rate (IMR) and neonatal mortality rate in Greece during the period 2004–2016 and explore the role of sociodemographic factors in the years of crisis.DesignNationwide individual data for live births and infant (0–11 months) deaths provided by the Hellenic Statistical Authority were examined using Poisson, joinpoint regression and interrupted time series (ITS) analyses.SettingGreece.ParticipantsAll infant deaths (n=4862) over the 13-year period, of which 87.2% were born to Greek mothers, and respective live births.Main outcome measuresEvolution of IMR (0–364 days), early (<7 days) neonatal mortality rate (ENMR), late (7–27 days) neonatal mortality rate (LNMR) and post neonatal (28–364 days) mortality rate (PNMR) trends, by maternal nationality, place of residence and Human Development Index (HDI).ResultsBy Poisson regression, overall, during the study period, among infants of Greek mothers, IMR and PNMR declined significantly (−0.9%; 95% CI −1.7% to −0.1% and −1.6%; −3.0% to −0.2% annually, respectively), although differentially by place of residence (IMRurban: −2.1%; −2.9% to −1.3%, IMRrural: +10.6%; 7.6% to 13.6%). By contrast, among infants of non-Greek mothers, the low starting IMR/ENMR/LNMR/PNMR increased significantly (max ENMR:+12.5%; 8.6% to 16.5%) leading to a non-significant time–trend pattern overall in Greece. The inverse associations of HDI with IMR, ENMR and PNMR were restricted to Greek mothers’ infants. Joinpoint regression analyses among Greek mothers’ infants indicated non-significant increasing trends of IMR and ENMR following the crisis (+9.3%, 2012–2016, p=0.07 and +10.2%, 2011–2016, p=0.06, respectively). By contrast, the high (+17.1%; 8.1% to 26.9%, p=0.002) IMR increases among non-Greek infants were restricted to 2004–2011 and equalised to those of Greek mothers’ infants thereafter. ITS analyses in preset years (2008, 2010, 2012) identified significantly increasing trends in IMR, LNMR and PNMR after 2012, and in ENMR after 2010, among Greek mothers’ infants.ConclusionsHDI and rural residence were significantly associated with IMR. The strongly decreasing IMR trends among Greek-mothers’ infants were stagnated after a lag time of ~4 years of crisis approximating the previously sharply increasing trends among non-Greeks.

2021 ◽  
Author(s):  
Santiago García-Tizón Larroca ◽  
Juan Arevalo Serrano ◽  
Maria Ruiz Minaya ◽  
Pilar Paya Martinez ◽  
Ricardo Perez Fernandez Pacheco ◽  
...  

Abstract Backround: The available literature indicates that there are significant differences in maternal mortality according to maternal origin in high income countries. The aim of this study was to examine the trend in the maternal mortality rate and its most common causes in Spain in recent years and to analyse its relationship with maternal origin.Methods: This was a cross-sectional study of all live births as well as those resulting in maternal death in Spain during the period between 2000 and 2018. A descriptive analysis of the maternal mortality rate by cause, region of birth, maternal age, marital status, human development index and continent of maternal origin was performed. The risk of maternal death was calculated using univariate and multivariate logistic regression analyses, with adjustment for certain variables included in the descriptive analysis.Results: There was a total of 293 maternal deaths and 8,439,324 live births during the study period. The most common cause of maternal death was hypertensive disorders of pregnancy. The average maternal death rate was 3.47 per 100,000 live births. The risk of suffering from this complication was higher for immigrant women from less developed countries; therefore, a decrease of 0.01 in the maternal human development index score significantly increased the risk of this complication by 2.4%.Conclusions: The results of this study indicate that there are inequalities in maternal mortality according to maternal origin in Spain. The human development index of the country of maternal origin could be a useful tool when estimating the risk of this complication, taking into account the origin of the pregnant woman.


2004 ◽  
Vol 38 (6) ◽  
pp. 773-779 ◽  
Author(s):  
Valdinar S Ribeiro ◽  
Antônio A M Silva ◽  
Marco A Barbieri ◽  
Heloisa Bettiol ◽  
Vânia M F Aragão ◽  
...  

OBJECTIVE: To obtain population estimates and profile risk factors for infant mortality in two birth cohorts and compare them among cities of different regions in Brazil. METHODS: In Ribeirão Preto, southeast Brazil, infant mortality was determined in a third of hospital live births (2,846 singleton deliveries) in 1994. In São Luís, northeast Brazil, data were obtained using systematic sampling of births stratified by maternity unit (2,443 singleton deliveries) in 1997-1998. Mothers answered standardized questionnaires shortly after delivery and information on infant deaths was retrieved from hospitals, registries and the States Health Secretarys' Office. The relative risk (RR) was estimated by Poisson regression. RESULTS: In São Luís, the infant mortality rate was 26.6/1,000 live births, the neonatal mortality rate was 18.4/1,000 and the post-neonatal mortality rate was 8.2/1,000, all higher than those observed in Ribeirão Preto (16.9, 10.9 and 6.0 per 1,000, respectively). Adjusted analysis revealed that previous stillbirths (RR=3.67 vs 4.13) and maternal age <18 years (RR=2.62 vs 2.59) were risk factors for infant mortality in the two cities. Inadequate prenatal care (RR=2.00) and male sex (RR=1.79) were risk factors in São Luís only, and a dwelling with 5 or more residents was a protective factor (RR=0.53). In Ribeirão Preto, maternal smoking was associated with infant mortality (RR=2.64). CONCLUSIONS: In addition to socioeconomic inequalities, differences in access to and quality of medical care between cities had an impact on infant mortality rates.


Author(s):  
Godwin Oligbu ◽  
Leila Ahmed ◽  
Laura Ferraras-Antolin ◽  
Shamez Ladhani

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.


Author(s):  
I. Bielova ◽  
I. D’yakonova ◽  
L. Taraniuk ◽  
O. Demikhov

Of great importance in today's conditions is the assessment of destructive factors influencing the mortality rate of patients with COVID-19, because this analysis may be necessary to form a roadmap for governments, which aims to prevent and reduce the spread of COVID-19. The aim of the research is to analyze the factors influencing mortality caused by COVID-19, based on data from countries around the world and at the national level. Among such factors, the influence of the environmental component is highlighted. Methodology and scientific approaches: comparative analysis - in establishing the average level of indicators for groups of countries depending on the human development index HDI, as well as for key indicators to characterize the level of environmental "load" at the level of regions of Ukraine, synthesis method - economically justified analysis results average level of indicators for groups of countries depending on the human development index HDI, the method of generalization - in forming the general conclusions of the study, statistical methods (correlations and the method of averages) - in assessing the impact of factors on mortality from COVID-19. The results of the study: the article conducted a study on the analysis of factors influencing mortality caused by COVID-19. Indicators that participate in the analysis of factors influencing mortality from COVID-19 are identified. The main indicators of the standard of living and health of the population used in the world are marked. The average levels of indicators for groups of countries depending on the human development index HDI are calculated and the dependences of these indicators and their impact on the mortality rate on COVID-19 are economically substantiated. In terms of regions of Ukraine, an analysis of the impact of indicators that affect the mortality rate from COVID-19, using some components of the environmental "load". The analysis of the main indicators for the assessment of the consequences of the spread of COVID-19 is carried out and their significance at the regional level is analyzed. The possibility of using the results in further research may relate to the formation of an economic model of factors influencing mortality caused by COVID-19, which will predict different scenarios of destructive factors on mortality from COVID-19 depending on the implementation of measures to combat the spread of the disease among governments countries. The practical significance of the study is that based on the analysis of the results of the study there is the possibility of forming effective management decisions by governments to counter the spread of COVID-19 at the international and national levels. The social consequences include the social effects that result from the results of this analysis through effective health care decision-making by national governments, that may reduce the mortality rate among the population from COVID-19.


Author(s):  
Ambren Chauhan ◽  
M. Salman Shah ◽  
Najam Khalique ◽  
Uzma Eram

Background:Neonatal mortality rate is regarded as an important and sensitive indicator of the health status of a community. Children face the highest risk of dying in their first month of life. The present study was aimed to 1) determine the prevalence of neonatal mortality rate 2) identify socio-biological factors in relation to neonatal mortality.3) determine the causes of neonatal mortality. Methods:A community based cross sectional study was conducted in the field practice areas of Department of Community Medicine, AMU, Aligarh. All the live births and all neonatal deaths were taken for one year from June 2016 to May 2017. A standard Verbal autopsy questionnaire (WHO 2012) was used as a study tool. Results:The prevalence of neonatal mortality rate was38.2/1000 live births. The early neonatal mortality rate was 28.3/1000 live births and late neonatal mortality rate was 9.9/1000 live births. The associated socio –biological factors were gender [OR-2.381, 95% CI-1.037-5.468], birth order [OR-4.090, 95% CI-1.119-14.946] and gestational age [OR-12.62, 95% CI-3.26-48.82]. The leading causes of deaths among newborns were preterm births (22.2%), birth asphyxia (22.2%), other causes (19%), ARI (14.3%), congenital anomalies (14.3%) and diarrhoeaandneonatal sepsis accounted for (4.8%) each. Conclusions: The neonatal mortality rate assessed by verbal autopsy is higher than nationally reported. Most of the deaths were in early neonatal period. There is a need for programs encouraging the use of antenatal care, encouraging institutional deliveries and care of LBW neonates; as well as implementation of community-based newborn survival strategies.


Author(s):  
Krishan Kumar ◽  
Rajiv Srivastava ◽  
S. K. Mishra

Background: One of the most important indicator or index of socio-economic development of a country or region is infant mortality rate. The present study was undertaken to assess the quantum of childhood mortality and to find out the social factors associated with these deaths by verbal autopsies. Methods: This one year cross-sectional study was undertaken in a purposively selected community Development Block Sainyan, district Agra among children aged between 0-5 years using multistage random sampling technique. Suitable statistical methods were applied. Results: Out of total 8355 families surveyed, a total of 185 deaths were reported among children. Number of deaths was higher among those belonging to nuclear family and lower socioeconomic status. The neonatal mortality rate was estimated to be 33.55/1000 live births. The post neonatal mortality rate was found to be 40.78/1000 live births and infant mortality rate was 74.33/1000 live births. Mortality rate in 1-5 year age group children was 10.6/1000 same age group children, while 0-5 yrs. mortality was estimated to be 22.39/1000 children of same age group. Out of 185 children who died, 52.7% were unimmunized and another 35.67% were partially immunized. Conclusions: Female education and socioeconomic well-being should be strengthened. 


2020 ◽  
Vol 47 (4) ◽  
pp. 353-357
Author(s):  
M.O. Ochoga ◽  
R.O. Abah ◽  
A. Michael ◽  
L.E. Yaguo Ide ◽  
R. Onalo ◽  
...  

Background: Newborn morbidity and mortality have remained unacceptably high in developing countries despite consistent efforts at controlling  the scourge. Unlike in developed countries where neonatal mortality rate ranges between 1 and 5 per 1000 live births, average neonatal mortality rate in Nigeria is 36 per 1000 live births. The majority of the causes of death are largely preventable with timely low cost interventions. This study was structured to determine the pattern of morbidity and mortality amongst babies admitted in the Special Care Baby Unit of Madonna hospital Makurdi, Nigeria.Methods: The records of neonates admitted into the Special Care Baby Unit (SCBU) over a tenyear period (2005-2015) were retrospectively reviewed. Information obtained included the sex, age at admission, gestational age, birth weight, reasons for admission and outcome of treatment.Results: A total of 1,121 babies were admitted during the period under review. The male female ratio was 1.2:1.The majority of the babies were aged between 2-7 days with a mean 6.17.+ 7.01 The mean weight on admission was 2807+907g. Neonatal sepsis, jaundice, low birth weight and birthasphyxia were the most common morbidities. The overall mortalityrate was 14.1%; however, proportionate mortality due to low birth weight was highest (26.4%), followed by tetanus (23.5%), asphyxia (20.8%), Respiratory tract infection (13.8%), meningitis (13.3%), sepsis (10.3%), jaundice (9.6%), and diarhoea (4.0%)Conclusion: Neonatal mortality rate in the study was high. The major causes of admission are preventable. Strengthening perinatal care, emergency obstetric care services and neonatal resuscitation skills are necessary to reduce the neonatal mortality. Key words: Neonate, Morbidity, Mortality, Nigeria 


2017 ◽  
Vol 4 (02) ◽  
pp. 1147 ◽  
Author(s):  
Amir Tiyuri ◽  
Abdollah Mohammadian-Hafshejani ◽  
Elham Iziy ◽  
Hamidreza Sadeghi Gandomani ◽  
Hamid Salehiniya

Introduction: Lip and oral cavity cancer is one of the most prevalent cancers in Asia and considered to be a major public health problem due to the low survival rate. Because of the importance of access to information about this cancer (including incidence, mortality rate and relation to socioeconomic indicators), this study aims at investigating the incidence and mortality of lip and oral cavity cancer and its relationship with the Human Development Index (HDI) of Asia (from 2012). Method: This study was an ecological study in Asia for assessment of the correlation between age-specific incidence rate (ASIR) and age-specific mortality rate (ASMR) with the HDI and its components which include: life expectancy at birth, mean years of schooling and gross national income (GNI) per capita. Data on the standardized incidence ratio (SIR) and the standardized mortality ratio (SMR) for every Asian country for the year 2012 were obtained from the global cancer project and data on the HDI and its components were extracted from the World bank site.  We used a bivariate method for assessment of the correlation between the SIR and SMR with the HDI and its individual components. Statistical significance was assumed if P<0.05. All reported P-values were two-sided. Statistical analyses were performed using SPSS (Version 15.0, SPSS Inc.). Results: A total incidence of 162,506 cases and 95,005 deaths were recorded in Asian countries in 2012. Countries with the highest SIR (per 100,000) were the following: Maldives (11), Sri Lanka (10.3), Pakistan (9.8), Bangladesh (9.4), and India (7.2). The highest SMR was observed in the following countries: Pakistan (5.9), Bangladesh (5.6), Afghanistan (5.1), India (4.9), and Maldives (4.1). The correlation between SIR of lip and oral cavity cancer and HDI was -0.378 (p=0.010), with life expectancy at birth at -0.324 (p=0.028), mean years of schooling at -0.283 (p=0.057), and level of income per each person of the population at -0.279 (p=0.060). Moreover, the correlation was -0.664 (p≤0.001) between SMR and HDI. Conclusion: A significant reverse correlation was seen between the incidence and mortality rate of lip and oral cavity cancer and the HDI in Asia. The incidence and mortality of this type of cancer was high in developing or less developed countries.   


2019 ◽  
Author(s):  
Rose Chengo ◽  
Frida Mowo ◽  
Clifford Silver Tarimo ◽  
Michael Johnson Mahande

Abstract Introduction Globally, approximately 15 million babies are born before term each year. Of these, more than 1 million die within the first 28 days of their life. Understanding the mortality rate and its predictors during neonatal period among preterm babies is crucial to help designing interventions to avert the situation. This study aimed to determine the neonatal mortality rate and associated factors among preterm babies born in Moshi Municipality, Tanzania. Methodology A prospective cohort study was conducted in three hospitals in Moshi Municipality from December 2016 to May 2017. All live births at gestational age of <37 weeks and those of <24 hours were studied. Babies who died prior to gestation age assessment and those whose mother did not consent were excluded. Cox regression model was used to estimate maternal and fetal factors associated with neonatal mortality. A p-value of <0.05 was considered statistically significant. Results A total of 311 of preterm babies were recruited from 265 mothers and were followed for 28 days. The neonatal mortality rate was 6.5deaths per 1,000 preterm live births (95% CI: 4.83-8.61). It was higher among extremely preterm babies compared to very preterm ones (HR: 38.24; 95% CI: 16.62-87.96) versus (HR: 8.01; 95% CI: 3.96-16.20) respectively. Apgar score of <7 at 1st minute (HR: 14.03; 95% CI: 7.27-27.06), respiratory distress syndrome (HR: 8.14; 95% CI: 4.27-15.54) and antepartum hemorrhage (HR: 3.32; 95% CI: 1.49-7.39) were significantly associated with neonatal mortality. Conclusion Preterm birth complication is the major cause of neonatal death in the study setting. Interventions to address the identified risk factors may reduce neonatal mortality among preterm babies.


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