Infant mortality before and during COVID-19 pandemic in a district of Istanbul

Abstract

Objective: The infant mortality rate is one of the most important indicators providing information on maternal and infant health. It can be affected by changes of social and environmental factors. The aim of this study is to evaluate infant mortality in 2019 and 2020 years at the local level, considering the beginning of the pandemic period. Methods: The population of this cross-sectional study are infants registered in a district of Istanbul in 2019 and 2020. Infant mortality rates before and during the COVID-19 pandemic were calculated. Antenatal healthcare and delivery practices in addition to the underlying risk factors for infant deaths were identified and compared by the year of mortality. All study data were collected from the district health information system. Results: Fifty-one infant deaths included in the study were residents of the district. Infant mortality rates were calculated as 4.8 and 5.1 per thousand live births for the years 2019 and 2020. Neonatal mortality rates were 3.9 and 2.7; postneonatal mortality rates were 0.9 and 2.4 per thousand live births, respectively by the years. No statistically significant difference was found between maternal and infant characteristics of the two years. The number of pregnancy follow-up records was significantly higher for the infants that died in 2020 compared to 2019. Yet, there wasn’t any difference in number of prenatal physician visits. Conclusion: Increase in the infant mortality rate during the pandemic compared to the pre-pandemic period is due to postneonatal mortality. The increase in postneonatal mortality is related to deaths caused by infections. This finding should be investigated with the healthcare accessibility and other characteristics of the infants. Our experience during the study revealed a room for improvement in access to data on always-important public health indicators, which would support evidence-based decision-making even in difficult times.