scholarly journals Comparison of child mortality by characteristics at birth in England and in Sweden using linked administrative data

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Anna Zylbersztejn ◽  
Ruth Gilbert ◽  
Anders Hjern ◽  
Pia Hardelid
Keyword(s):  
Risk Factors ◽  
Early Childhood ◽  
Child Mortality ◽  
Early Life ◽  
Congenital Malformations ◽  
Mortality Rates ◽  
Birth Cohorts ◽  
Policy Makers ◽  
Live Births ◽  
Administrative Health Databases

ABSTRACT ObjectivesEngland has one of the highest child mortality rates in Western Europe, while Sweden has one of the lowest. These differences suggest that improvements in early life mortality should be achievable in England. However, policy makers need to know when in the life course to target interventions to prevent the largest number of deaths in early life, e.g. by addressing the prevalence of risk factors at birth (such as preterm birth or low birthweight), or improving the care of babies after birth. This study aims to compare child mortality in England and in Sweden using whole country birth cohorts based on linked administrative health databases in order to determine whether the disparities are driven by risk factors operating before or after birth. ApproachWe created birth cohorts from a national birth register (Sweden) and a hospital admission database (England). These were linked to longitudinal hospital data and death registration data. All singleton live births for 2003-2012 were included and followed from birth up to five years. We compared mortality in England and in Sweden using Cox proportional hazard model with characteristics at birth (gestation, birthweight, gender, maternal age, congenital malformations), socio-economic status and country as covariates. ResultsThe study cohort comprised 1,047,192 children in Sweden and 6,117,693 children in England. 2,820 of cohort children died in Sweden (0.3%) and 28,434 in England (0.5%). Preliminary results showed that under-5 mortality was almost twice as high in England as in Sweden (5.1 deaths per 1000 live births, 95% confidence interval (CI): 5.0/1000-5.2/1000 vs 3.0/1000, 95% CI: 2.9/1000-3.2/1000). Mortality rates were 45% higher in England during infancy, but only 15% higher in early-childhood (1-4 years). Children with congenital malformations were at similar risk of death in England (33.9/1000, 95% CI: 32.9/1000-34.8/1000) as in Sweden (32.7/1000, 95% CI: 29.5/1000-35.8/1000). The prevalence of congenital malformations, however, was twice as high in England (5.1% vs 2.6%). ConclusionsOur preliminary results suggest that the disparities in early-childhood mortality were partly driven by increased prevalence of congenital malformations in England relative to Sweden, as mortality rates within this group were comparable. Individual-level data from birth cohorts constructed using linked administrative health databases enable comparing mortality among children with the same combinations of risk factors at birth. Such analyses can inform policy makers whether resources to prevent early-life mortality are most effectively targeted at improving the health of pregnant women, neonatal care, or supporting families with young children.

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 ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Protective Factor ◽  
Infant Mortality Rate ◽  
Northeast Brazil ◽  
Birth Cohorts ◽  
Neonatal Mortality Rate ◽  
Live Births

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.

scholarly journals 1459Socioeconomic position influence on the early-life individual exposome in the Italian NINFEA birth cohort

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Costanza Pizzi ◽  
Chiara Moccia ◽  
Giovenale Moirano ◽  
Antonio d'Errico ◽  
Milena Maule ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urban Environment ◽  
Birth Cohort ◽  
Environmental Risk ◽  
Early Life ◽  
Diversity Index ◽  
Hierarchical Cluster ◽  
Environmental Risk Factors ◽  
Birth Cohorts ◽  
Exposure Pattern

Abstract Background Early exposure to unhealthy lifestyles and environmental risk factors is known to affect health throughout the life-course. There is also evidence that the exposure patterns are influenced by the socioeconomic position (SEP). Methods We use the data of the Turin participants of the Italian NINFEA birth cohort (n∼2500) to study how family SEP drives the early life exposome. SEP at birth is measured through the EHII (Equivalized Household Income Indicator), while the exposome includes urban environment, diet and lifestyle exposures measured during infancy. We use standard regression models to evaluate the effect of EHII on each exposome variable accounting for multiple comparison and potential confounders (Drivers-Exposome Wide Association Study – DExWAS) and the hierarchical clustering on the principal components approach to identify groups with similar exposure pattern. Results The DExWAS show that low EHII is associated with lower consumption of fruit and vegetables, lower levels of NO2, building and facilities densities, traffic, walkability and connectivity index, higher land-use diversity index, and higher exposure to pets. The hierarchical cluster analysis identifies three groups, with subjects belonging to the cluster characterized by higher level of urban environment risk factors and a healthier diet having a higher mean EHII. Conclusions These SEP-early life exposome analyses will be replicated in several European birth cohorts participating in the H2020 ATHLETE and LifeCycle projects. Key messages In the Italian city of Turin children from low SEP family are exposed to higher levels of environmental risk factors and unhealthy lifestyles during infancy.

scholarly journals Patterns of growth in childhood in relation to adult schooling attainment and IQ in 6 birth cohorts in low and middle-income countries: evidence from COHORTS

2020 ◽  
Author(s):  
Natalia E Poveda ◽  
Fernando P Hartwig ◽  
Cesar G Victora ◽  
Linda S Adair ◽  
Fernando C Barros ◽  
...  
Keyword(s):  
Human Capital ◽  
Early Childhood ◽  
Early Life ◽  
Linear Growth ◽  
Relative Weight ◽  
Childhood And Adolescence ◽  
Birth Cohorts ◽  
Middle Income ◽  
Middle Income Countries ◽  
School Attainment

SummaryBackgroundGrowth faltering has been associated with poor intellectual performance. The relative strengths of associations between growth in early and in later childhood remain underexplored. We examined the association between growth in childhood and adolescence and adult human capital in five low- or middle-income countries (LMICs).MethodsWe analyzed data from six prospective birth cohorts of five LMICs (Brazil, Guatemala, India, the Philippines, and South Africa). We assessed the associations of measures of height and relative weight at four ages (birth, at around age 2 years, mid-childhood (MC), adulthood), with two dimension of adult human capital (schooling attainment and IQ).FindingsIn site- and sex-pooled analyses, size at birth and linear growth from birth to around 2 years of age were positively associated with schooling attainment and adult IQ. Linear growth from age 2 years to MC and from MC to adulthood was not associated with higher school attainment or IQ. Change in relative weight in early childhood was not associated with either outcome. Relative weight in MC and in adulthood were inversely associated with schooling attainment but were not associated with adult IQ.InterpretationLinear growth in the first 1,000 days is a predictor of schooling attainment and IQ in adulthood in LMICs. Linear growth in later periods was not associated with either of these outcomes. Changes in relative weight had inconsistent association with schooling and IQ in adulthood.FundingBill and Melinda Gates Foundation (OPP1164115)Research in contextEvidence before this studyEarly life growth faltering has been associated with poor cognitive and intellectual performance in childhood and poorer schooling outcomes in children and adults. There is a paucity of data about how growth in specific age intervals over the course of childhood and adolescence relates to attained schooling and adult cognitive performance.We conducted a literature search using the terms (growth [Title/Abstract]) AND ((school [Title/Abstract] OR schooling [Title/Abstract]) AND (intelligence [Title/Abstract] OR IQ [Title/Abstract]) OR (human capital [Title/Abstract]) in Pubmed. The search yielded 536 publications from 1965 to 2020. We screened titles and selected 31 publications that included linear growth and our outcomes of interest, namely school attainment and intelligence quotient (IQ). Additionally, we checked reference lists of selected articles and identified eleven papers that were not displayed in the initial electronic query. We therefore reviewed 42 abstracts and identified 24 unique studies conducted in low and middle-income countries (LMICs). Fourteen of them investigated the association of birth size and/or early-life size with schooling or IQ, or with both outcomes during childhood. Three studies investigated the association between linear growth in early childhood and schooling and intelligence in adults, one studied the association between early-life undernutrition and IQ in early adulthood and another six publications investigated the association between growth and school attainment in adults. Economists have also studied the relationship between stunting or linear growth and schooling in LMICs, but to our knowledge not the relative importance of growth during specific age intervals.Added value of this studyThis is an analysis of the associations between child and adolescent growth and two dimensions of human capital (schooling attainment and IQ) in adulthood in six birth cohorts from five LMICs. The evidence of long-term associations of linear growth with adult IQ is scarce and the few published studies have analyzed data from a single country. In the present study, we found that size at birth and linear growth from birth to around 2 years of age were positively associated with both schooling and IQ in adulthood. Linear growth between early and mid-childhood (MC)was not associated with higher school attainment or IQ in adjusted models. Linear growth from MC to adulthood was not associated with IQ in men or women, and was inversely associated with schooling attainment in women only. Change in relative weight in early childhood was positively associated with schooling attainment only in minimally adjusted models. Relative weight measures in MC and adulthood were inversely associated with schooling attainment. Change in relative weight between MC and adulthood was not associated with adult IQ.Implications of all the available evidenceWe confirmed in multiple cohorts that birth size and linear growth from birth to age 2 years are predictors of schooling attainment and adult IQ. Linear growth in early life was the strongest predictor of these two human capital dimensions in adulthood among individuals in LMICs. We did not find evidence that supports the notion that linear growth in adolescence contributes to a better cognitive performance in adulthood. Thus, our results inform the more effective timing of nutritional and other interventions to improve linear growth and human capital in the long-term.

Spatial Modeling of Risk Factors for Gender-Specific Child Mortality

2005 ◽  
pp. 2584-2591
Author(s):  
Mohammad Ali ◽  
Christine Ashley ◽  
M. Zahirul Haq ◽  
Peter Kim Streatfield
Keyword(s):  
Risk Factors ◽  
Child Mortality ◽  
Spatial Modeling ◽  
Child Survival ◽  
Developed Countries ◽  
Mortality Rates ◽  
The State ◽  
National Organizations ◽  
Gender Specific ◽  
Global Reduction

The global reduction of child mortality has been a priority of international and national organizations for the last few decades. Despite widespread global efforts to improve child survival, the latest UNICEF report on the State of the World’s Children 2000 (UNICEF, 2000) indicates that child mortality rates continue to remain higher in lesser developed countries (LDCs), and in some areas, girls continue to die at a greater rate than boys.

Effects of Birth Cohorts on the Irritable Bowel Syndrome Support Early-Life Risk Factors

2015 ◽  
Vol 60 (7) ◽  
pp. 2112-2118 ◽  
Author(s):  
Neil R. Brummond ◽  
G. Richard Locke ◽  
Rok Seon Choung ◽  
Joseph Y. Chang ◽  
Cathy D. Schleck ◽  
...  
Keyword(s):  
Risk Factors ◽  
Irritable Bowel Syndrome ◽  
Early Life ◽  
Birth Cohorts ◽  
Irritable Bowel

scholarly journals Early life risk factors of being overweight at 10 years of age: results of the German birth cohorts GINIplus and LISAplus

2013 ◽  
Vol 67 (8) ◽  
pp. 855-862 ◽  
Author(s):  
Z Pei ◽  
◽  
C Flexeder ◽  
E Fuertes ◽  
E Thiering ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Life ◽  
Birth Cohorts

scholarly journals Child mortality associated with maternal HIV status: a retrospective analysis in Rwanda, 2005-2015

2021 ◽  
Vol 6 (5) ◽  
pp. e004398
Author(s):  
Eric Remera ◽  
Frédérique Chammartin ◽  
Sabin Nsanzimana ◽  
Jamie Ian Forrest ◽  
Gerald E Smith ◽  
...  
Keyword(s):  
Higher Education ◽  
Child Mortality ◽  
Scale Up ◽  
Mortality Rates ◽  
Hiv Treatment ◽  
Hiv Status ◽  
Multivariable Logistic Regression Model ◽  
Live Births ◽  
Maternal Hiv ◽  
Hiv Negative

IntroductionChild mortality remains highest in regions of the world most affected by HIV/AIDS. The aim of this study was to assess child mortality rates in relation to maternal HIV status from 2005 to 2015, the period of rapid HIV treatment scale-up in Rwanda.MethodsWe used data from the 2005, 2010 and 2015 Rwanda Demographic Health Surveys to derive under-2 mortality rates by survey year and mother’s HIV status and to build a multivariable logistic regression model to establish the association of independent predictors of under-2 mortality stratified by mother’s HIV status.ResultsIn total, 12 010 live births were reported by mothers in the study period. Our findings show a higher mortality among children born to mothers with HIV compared with HIV negative mothers in 2005 (216.9 vs 100.7 per 1000 live births) and a significant reduction in mortality for both groups in 2015 (72.0 and 42.4 per 1000 live births, respectively). In the pooled reduced multivariable model, the odds of child mortality was higher among children born to mothers with HIV, (adjusted OR, AOR 2.09; 95% CI 1.57 to 2.78). The odds of child mortality were reduced in 2010 (AOR 0.69; 95% CI 0.59 to 0.81) and 2015 (AOR 0.35; 95% CI 0.28 to 0.44) compared with 2005. Other independent predictors of under-2 mortality included living in smaller families of 1–2 members (AOR 5.25; 95% CI 3.59 to 7.68), being twin (AOR 4.93; 95% CI 3.51 to 6.92) and being offspring from mothers not using contraceptives at the time of the survey (AOR 1.6; 95% CI 1.38 to 1.99). Higher education of mothers (completed primary school: (AOR 0.74; 95% CI 0.64 to 0.87) and secondary or higher education: (AOR 0.53; 95% CI 0.38 to 0.74)) was also associated with reduced child mortality.ConclusionsThis study shows an important decline in under-2 child mortality among children born to both mothers with and without HIV in Rwanda over a 10-year span.

scholarly journals International financial organisations and global child mortality rates

2021 ◽  
Author(s):  
Elias Nosrati
Keyword(s):  
Child Mortality ◽  
Large Scale ◽  
Causal Effect ◽  
Mortality Rates ◽  
Policy Reforms ◽  
Live Births ◽  
Child Deaths ◽  
The World ◽  
Aggregate Effect ◽  
The International Monetary Fund

This paper makes a contribution to the sociology and political economy of "successful societies" by investigating how children’s health across the world is impacted by multilateral financial organisations. In particular, I assess the causal effect of domestic policy reforms mandated by the International Monetary Fund (IMF) on child mortality rates across 176 countries between 1990 and 2017 using instrumental variables. I find that IMF programmes cause up to 90 excess under-5 deaths per 1,000 live births (95% CI: 50–130). This aggregate effect appears to be driven by large-scale privatisation reforms, which cause up to 132 excess child deaths per 1,000 live births (95% CI: 72–191).

scholarly journals An Inventory of European Birth Cohorts

2020 ◽  
Vol 17 (9) ◽  
pp. 3071
Author(s):  
Claudia Pansieri ◽  
Chiara Pandolfini ◽  
Antonio Clavenna ◽  
Imti Choonara ◽  
Maurizio Bonati
Keyword(s):  
Risk Factors ◽  
Early Life ◽  
Allergic Diseases ◽  
Publicly Funded ◽  
Birth Cohorts ◽  
Research Topics ◽  
Data Merging ◽  
Research Questions ◽  
Methodological Aspects

Many birth cohorts have been carried out. We performed a review of European birth cohorts to see the countries involved, provide a panorama of the current research topics and design, and, more generally, provide input for those creating collaborations and laying out guidelines aimed at unifying cohort methodologies to enable data merging and maximize knowledge acquisition. We searched PubMed and Embase for articles referring to longitudinal, prospective European birth cohorts and searched online cohort inventories. We found references to 111 birth cohorts, 45 of which began enrolment at birth. These cohorts began between 1921 and 2015 and represented 19 countries, with varying sample sizes (236 to 21,000 children). As of 5 January 2020, were still recruiting. The main areas addressed were allergic diseases (14 cohorts) and environmental exposure (f12 cohorts) and most cohorts were publicly funded. Given the large costs of running cohorts and the importance of long follow-up periods in identifying the risk factors for disorders thought to have a perinatal/early life etiology, current cohorts must be designed to answer research questions considering several aspects, from genetic ones to psychological, social, and environmental ones. Furthermore, universally recognized methodological aspects are needed to permit the comparison and merging of cohort data.

scholarly journals Baseline Socio-Demographic and Mortality Profile of a Peri-urban Coastal Community in Karachi, Pakistan Before the Introduction of a Comprehensive Maternal, Newborn and Child Health Intervention Package

2021 ◽  
Author(s):  
Muhammad Ilyas ◽  
Kanwal Nayani ◽  
Ameer Muhammad ◽  
Yasir Shafiq ◽  
Benazir Baloch ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Child Health ◽  
Neonatal Mortality ◽  
Child Mortality ◽  
Mortality Rates ◽  
Evidence Based ◽  
Intervention Package ◽  
Newborn And Child Health ◽  
Live Births ◽  
And Child Health

Abstract Objective Pakistan has the highest neonatal mortality rate and one of the highest under-5 mortality rates in the world, at 42 deaths and 74 deaths per thousand live births respectively. We undertook implementation of an evidence-based maternal, newborn and child health (MNCH) intervention package to reduce under-five mortality in Rehri Goth, a peri-urban coastal community on the outskirts of Karachi, Pakistan. This paper aims to present the socio-demographic and under-5 mortality profile of Rehri Goth prior to implementation of the intervention package. We conducted a detailed census of all households on socio-demographic variables. ResultsOver the course of the census period, 6,962 households were visited. The total population of Rehri Goth was found to be 42,980. The male to female ratio was 52:48. Among adults aged 15 years and above, 67.1% had no formal education. The neonatal mortality and under-five mortality rates were 59 and 109 deaths per 1,000 live births respectively. Rehri Goth has a baseline child mortality rate that is higher than the national average in Pakistan. This provides an opportunity to deliver an evidence-based, targeted MNCH package to reduce child mortality.

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