scholarly journals Infant mortality: comparison between two birth cohorts from Southeast and Northeast, Brazil

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):  
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. 


2019 ◽  
Vol 2 (1) ◽  
pp. 6-10
Author(s):  
Hapi Apriasih ◽  
Tupriliany Danefi

Seiring dengan  perkembangan zaman, masalah remaja makin bertambah di mana-mana khususnya di Indonesia.  Masa remaja adalah masa peralihan dari masa anak-anak ke masa dewasa. Masalah remaja di zaman ini bukanlah baru terjadi, tapi dari tahun sebelum-sebelumnya sudah sering terjadi, dimana masalah pada remaja yaitu pergaulan bebas,  tawuran, memakai narkoba, menonton film porno, meminum minuman alkohol, pesta pora dan masih banyak lagi masalah yang terjadi pada remaja.  Dan sekarang ini ada juga anak-anak yang masih duduk di bangku sekolah seperti SD, maupun SMP dan SMA sudah ada yang merokok, pergaulan bebas, meminum alkohol, menonton film porno, dan bahkan ada yang sudah hamil di luar nikah. Ini semua terjadi karena kurang adanya pengawasan dari orangtua atau keluarga, guru, dan pemerintah.  Masalah remaja tentunya  tak jarang lagi mendengar atau menonton dan bahkan melihat yang terjadi disekitar kita. Berdasarkan hasil Survei Kesehatan berbasis Sekolah di Indonesia tahun 2015 (GSHS) dapat terlihat gambaran faktor risiko kesehatan pada pelajar uisa 12-18 tahun secara nasional sebanyak 41,8 % laki-laki dan 4,1 % perempuan mengaku pernah merokok, 32,82 % doantara merokok pertama kali pada umur < 13 tahun. Gambaran faktor resiko kesehatan lainnya adalah perilaku seksual dimana didapatkan 8,26 % pelajara laki-laki dan 4,17 pelajara perempuan usia 12-18 tahun pernah melakukan hubungan seksual. Perilaku seks pranikah tentunya memberikan dampak yang luas pada remaja terutama berkaitan dengan penularan penyakit dan kehamilan yang tidak diinginkan serta aborsi. Kehamilan pada remaja tidak hanya berpengaruh terhadap kondisi fisik, mental dan sosial remaja tetapi juga meningkatkan resiko kematian bayi dan balita, seperti yang ditunjukkan SDKI 2012 dimana kehamilan dan persalinan pada ibu dibawah umur 20 tahun memiliki kontribusi dalam tingginya Neonatal Mortality Rate (34/1000 KH), Postnatal Mortality Rate (16/1000 KH), Infant Mortality Rate (50/1000 KH) dan under -5 Mortality Rate (61/1000 KH). Laporan triwulan Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan (Ditjen P2PL) mulai 1987 sampai dengan Maret 2017 menunjukkan bahwa tingginya angka kejadian AIDS di kelompok usia 20-29 tahun mengindikasikan kelompok tersebut pertama kali terkena HIV pada usia remaja. Di Desa Cikunir merupakan desa di wilayah Puskesmas Singaparna yang terdiri dari 3 dusun yaitu Gunung Kawung, Pameungpeuk, dan Anggaraja. Melalui kegiatan praktik kerja nyata mahasiswa Program Studi Kebidanan STIKes Respati Tasikmalaya melalui focus grup discucion (FGD) diperoleh informasi dari 35 responden remaja sebagai berikut 48,7 % belum mengetahui kesehatan reproduksi khususnya terkait infeksi menular seksual, 45,71 % sudah mempunyai pcar, 51,43 % tidak mengetahui tentang HIV/AIDS, 22,86% tidak mengetahui dampai pernikahan dini, dan 11,43 % setuju dengan pernikahan dini. Berdasarkan data tersebut diketahui bahwa pengetahuan remaja tentang kesehatan reproduksi remaja masih kurang dan akan berdampak pada permasalahan yang serius maka menjadi hal yang sangat penting untuk adanya upaya dalam hal peningkatan pengetahuan remaja , oleh karena diselenggarakan kegiatan penyuluhan tentang personal higyene dan masa pubertas pada remaja.


2001 ◽  
Vol 35 (3) ◽  
pp. 256-261 ◽  
Author(s):  
Marcelo Zubaran Goldani ◽  
Marco Antonio Barbieri ◽  
Heloisa Bettiol ◽  
Marisa Ramos Barbieri ◽  
Andrew Tomkins

OBJECTIVE: Data from municipal databases can be used to plan interventions aimed at reducing inequities in health care. The objective of the study was to determine the distribution of infant mortality according to an urban geoeconomic classification using routinely collected municipal data. METHODS: All live births (total of 42,381) and infant deaths (total of 731) that occurred between 1994 and 1998 in Ribeirão Preto, Brazil, were considered. Four different geoeconomic areas were defined according to the family head's income in each administrative urban zone. RESULTS: The trends for infant mortality rate and its different components, neonatal mortality rate and post-neonatal mortality rate, decreased in Ribeirão Preto from 1994 to 1998 (chi-square for trend, p<0.05). These rates were inversely correlated with the distribution of lower salaries in the geoeconomic areas (less than 5 minimum wages per family head), in particular the post-neonatal mortality rate (chi-square for trend, p<0.05). Finally, the poor area showed a steady increase in excess infant mortality. CONCLUSIONS: The results indicate that infant mortality rates are associated with social inequality and can be monitored using municipal databases. The findings also suggest an increase in the impact of social inequality on infant health in Ribeirão Preto, especially in the poor area. The monitoring of health inequalities using municipal databases may be an increasingly more useful tool given the continuous decentralization of health management at the municipal level in Brazil.


Geographies ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 47-62
Author(s):  
Ujjwal Das ◽  
Barkha Chaplot ◽  
Hazi Mohammad Azamathulla

Skilled birth attendance and institutional delivery have been advocated for reducing maternal, neonatal mortality and infant mortality (NMR and IMR). This paper examines the role of place of delivery with respect to neo-natal and infant mortality in India using four rounds of the Indian National Family Health Survey conducted in 2015–2016. The place of birth has been categorized as “at home” or “public and private institution.” The role of place of delivery on neo-natal and infant mortality was examined by using multivariate hazard regression models adjusted for clus-tering and relevant maternal, socio-economic, pregnancy and new-born characteristics. There were 141,028 deliveries recorded in public institutions and 54,338 in private institutions. The esti-mated neonatal mortality rate in public and private institutions during this period was 27 and 26 per 1000 live births respectively. The study shows that when the mother delivers child at home, the chances of neonatal mortality risks are higher than the mortality among children born at the health facility centers. Regression analysis also indicates that a professionally qualified provider′s antenatal treatment and assistance greatly decreases the risks of neonatal mortality. The results of the study illustrate the importance of the provision of institutional facilities and proper pregnancy in the prevention of neonatal and infant deaths. To improve the quality of care during and imme-diately after delivery in health facilities, particularly in public hospitals and in rural areas, accel-erated strengthening is required.


2015 ◽  
Vol 31 (7) ◽  
pp. 1437-1450 ◽  
Author(s):  
Antônio Augusto Moura da Silva ◽  
Rosângela Fernandes Lucena Batista ◽  
Vanda Maria Ferreira Simões ◽  
Erika Barbara Abreu Fonseca Thomaz ◽  
Cecília Cláudia Costa Ribeiro ◽  
...  

The objective of this study was to analyze changes in perinatal health in two birth cohorts started in 1997/1998 and 2010, respectively, in São Luís, Maranhão State, Brazil. A total of 2,493 live born infants were included in 1997/1998 and 5,166 in 2010. Low birth weight (LBW) rate did not change (8.5% in 1997/1998 and 8.6% in 2010). Preterm birth (PTB) rate also remained stable (13.2% in 1997/1998 and 13% in 2010). Teenage deliveries and births to single mothers decreased. Maternal schooling and prenatal care coverage increased. Intrauterine growth restriction (IUGR) decreased from 13.3% to 10.6% (p < 0.001). The perinatal mortality rate decreased from 36.6 to 20.7 per 1,000 (p < 0.001) and the infant mortality rate (IMR) dropped from 28.5 to 12.8 per 1,000 (p < 0.001). The cesarean rate increased from 34.1% to 47.5% (p < 0.001). In conclusion, despite favorable changes in socio-demographic, behavioral, and health service factors and decreasing rates of IUGR and perinatal and infant mortality, LBW and PTB remained stable, while the cesarean rate increased.


2021 ◽  
Vol 110 ◽  
pp. 02006
Author(s):  
Ludmila Borisova ◽  
Galina Zhukova ◽  
Anna Kuznetsova ◽  
Julie Martin

The paper analyzes the socio-economic and demographic indicators of life expectancy in the countries of the world. Methods of regression analysis and machine learning are used. Statistically significant indicators that affect life expectancy around the world have been identified. When analyzing the data using machine learning methods, 13 of the 14 analyzed indicators were statistically significant. Significant indicators, in addition to those selected in the regression analysis, were 3: the under-five infant mortality rate (per 1,000 live births), the Net Barter Terms of Trade Index (2000 = 100), and Imports of goods and services (in % of GDP) (in the regression analysis, only the infant death rate was significant). In addition, it should be noted that there is a significant decrease in the under-five infant mortality rate (per 1,000 live births) for the EU, CIS and South-East Asian countries compared to the border set in the study for all countries: 4.65 vs. 34.9, a decrease in the birth rate from 2.785 to 1.85, a sharp increase in exports of goods and services: from 23.17 to 80.59, a halving in imports of goods and services, a drop in population growth from 2.105 to 0.85. The performed statistical analysis strongly supports the use of machine learning methods in identifying statistically significant relationships between various indicators that characterize the development of countries, if there are gaps in the data.


2019 ◽  
pp. tobaccocontrol-2019-054923 ◽  
Author(s):  
Thomas Hone ◽  
Andre Salem Szklo ◽  
Filippos T Filippidis ◽  
Anthony A Laverty ◽  
Isabela Sattamini ◽  
...  

ObjectiveTo examine the associations of partial and comprehensive smoke-free legislation with neonatal and infant mortality in Brazil using a quasi-experimental study design.DesignMonthly longitudinal (panel) ecological study from January 2000 to December 2016.SettingAll Brazilian municipalities (n=5565).ParticipantsInfant populations.InterventionSmoke-free legislation in effect in each municipality and month. Legislation was encoded as basic (allowing smoking areas), partial (segregated smoking rooms) or comprehensive (no smoking in public buildings). Associations were quantified by immediate step and longer term slope/trend changes in outcomes.Statistical analysesMunicipal-level linear fixed-effects regression models.Main outcomes measuresInfant and neonatal mortality.ResultsImplementation of partial smoke-free legislation was associated with a −3.3 % (95% CI −6.2% to −0.4%) step reduction in the municipal infant mortality rate, but no step change in neonatal mortality. Comprehensive smoke-free legislation implementation was associated with −5.2 % (95% CI −8.3% to −2.1%) and −3.4 % (95% CI −6.7% to −0.1%) step reductions in infant and neonatal mortality, respectively, and a −0.36 (95% CI −0.66 to−0.06) annual decline in the infant mortality rate. We estimated that had all smoke-free legislation introduced since 2004 been comprehensive, an additional 10 091 infant deaths (95% CI 1196 to 21 761) could have been averted.ConclusionsStrengthening smoke-free legislation in Brazil is associated with improvements in infant health outcomes—particularly under comprehensive legislation. Governments should accelerate implementation of comprehensive smoke-free legislation to protect infant health and achieve the United Nation’s Sustainable Development Goal three.


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.


2016 ◽  
Vol 48 (5) ◽  
pp. 306
Author(s):  
Made Lndah Nastiti Utami Budha ◽  
Wayan Retayasa ◽  
Made Kardana

Background The first week of life of a neonate is a critical period.In Asia, early neonatal mortality rate remains high.Objective To investigate early neonatal mortality rate and the riskfactors in Wangaya Hospital.Methods A cross sectional study was carried out retrospectivelyon neonates registered at Perinatology Unit, Wangaya HospitalDenpasar, Bali since January 2006. The study was done fromOctober to November 2007. Data was obtained from medicalrecord, analyzed as univariate using chi-square test or Fisher'sexact test and multivariate logistic regression analysis model.Results Early neonatal mortality rate in Wangaya Hospital was 38.7per 1000 livebirths. Univariate analyses showed that there werefive significant risk factors of early neonatal death, i.e., respiratorydistress, asphyxia, birth weight less than 2500 grams, sepsis, andgestational age less than 3 7 weeks. Multivariate analysis showedthat those five variables were significant as risk factors of earlyneonatal death i.e., OR (95% confidence interval) for respiratorydistress: 16.8 (3.7 to 76.6)], asphyxia: 13.5 (6.1 to 29.9)], birthweight <2500 grams: 8.1 (3.3 to 19.9)], sepsis: 7.3 (3.1 to 17.1),and gestational age <37 weeks: 3.5 (1.6 to 7.8)].Conclusions Early neonatal mortality rate in Wangaya Hospitalremains high. Respiratory distress, asphyxia, birth weight <2500gram, sepsis, and gestational age <37 weeks were independent riskfactors of early neonatal death.


Author(s):  
Ekaterina Kvasha

Infant mortality in Russia has been decreasing for several decades. In 2011, however, Russia’s infant mortality rate reached a level (7.4 per 1000 live births) more than three times higher than in countries with minimal levels. In April 2012, Russia adopted new definitions of live births and stillbirths, which are much closer to the corresponding WHO definitions than those used before. The transition to these new definitions was meant to increase the rates of perinatal, early neonatal and infant mortality in general for children weighing up to 1000 grams – those concerned by the changed definition. This paper analyzes the changes in the structure and dynamics of death in children under one year of age since the transition to the new definitions of live births and stillbirths, according to birth weight and period of death based on official and medical statistics. It looks at the possibility of distortion of both infant and perinatal mortality and their components. Particular attention is given to an analysis of the structure of infant mortality by age and cause of death in Russia in comparison with other countries. The regional aspect of changes in infant mortality for 2011-2012 is also studied herein. The analysis is based on data from official and medical statistics.


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