Abstract
BackgroundThere has been a considerable decline in fetal and neonatal mortality in the Western world. The authors hypothesized that this decline has been largest for boys, since boys have a higher risk of fetal and neonatal death.MethodsThe authors used data from the Medical Birth Registry about all births in Norway to study changes during 1967–2005 in mortality for boys and girls from the 23rd week of pregnancy until one month after birth. Absolute and relative yearly changes in fetal and neonatal death rates were estimated separately for boys and girls.ResultsFrom 1967 to 2005, the average annual reduction in the overall death rate was greater for boys: 0.47 per 1000 boys (95% CI: 0.45, 0.48) and 0.37 per 1000 girls (95% CI: 0.35, 0.39). These estimates were not affected by adjustments made for changes over time in maternal characteristics. The convergence in death rates by sex was strongest for the first week after birth: average annual reduction in the early neonatal death rate was 0.24 per 1000 boys (95% CI: 0.23, 0.25) and 0.17 per 1000 girls (95% CI: 0.16, 0.18). The death rates for boys and girls also converged during pregnancy and from one week to one month after birth. The relative reduction in death rates was quite similar for boys and girls: the overall death rate fell annually by 4.4% (95% CI: 4.3, 4.6%) for boys and by 4.2% (95% CI: 4.0, 4.4%) for girls.ConclusionsDuring the period 1967–2005, the absolute reduction in fetal and neonatal death rates was greatest for boys. The relative reduction in mortality was about the same for both sexes, but the absolute reduction was greatest for boys since the mortality for boys began at a higher level. The convergence of death rates was not due to changes in the composition of mothers, suggesting that convergence has been caused by technological progress.
Highlights
There has been a considerable decline in fetal and neonatal mortality in the Western world
Among all deliveries by Norwegian women during the period 1967–2005, we studied whether the decline in fetal and neonatal death rates differed between boys and girls
Study population Since 1967, all births after 16 weeks of gestation have been reported to the Medical Birth Registry of Norway
Summary
There has been a considerable decline in fetal and neonatal mortality in the Western world. The authors hypothesized that this decline has been largest for boys, since boys have a higher risk of fetal and neonatal death. There has been a considerable decline in fetal and neonatal mortality in the Western world [1,2,3,4]. In Norway during the last forty years, the fetal death rate has declined by 70 per cent in pregnancies lasting longer than 22 weeks [9]. There has been a large decline in neonatal mortality [10]. Among all deliveries by Norwegian women during the period 1967–2005, we studied whether the decline in fetal and neonatal death rates differed between boys and girls. Separate analyses were performed for pre-term births, term births, the early neonatal period and the late neonatal period
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