Infant mortality in rural Bangladesh: an analysis of causes during neonatal and postneonatal periods.

Abstract

Reports on a study undertaken in Chittagong district of Bangladesh to examine the causes and some of the factors contributing to neonatal and postneonatal mortality and to identify the population at highest risk. A cohort of 1351 infants born between July 1976 and June 1977 was longitudinally followed up for 1 year in the Teknaf Dysentery Project demographic surveillance system. Results of the survey show an overall infant mortality rate of 160/1000 live births. Neonatal and postneonatal components were 89 and 71/1000 births respectively. Major causes of neonatal and postneonatal death were: tetanus (21%); pneumonia (19%); prematurity (12%); malnutrition (8%); diarrheal diseases (7%); and fever (6%). Tetanus premaurity and congenital abnormalities were the commonest causes of neonatal death whereas pneumonia malnutrition diarrheal disease and fever were the most important causes during the postneonatal period. Complications in delivery were significantly correlated with increased risk of neonatal mortality. The age of the mother was also a determinant of neonatal and mortality. The age of the mother was also a determinant of neonatal and postneonatal viability with mothers under the age of 20 having the greatest risk of death of her newborn. The age range 25-29 years conferred the greatest protection on neonates and postneonates. When the age of the mother is controlled parity is positively related to neonatal postneonatal and infant mortality rate. Large family size also correlates positively with the mortality rate.