Neo-natal mortality patterns in rural Bangladesh.

Abstract

The pattern of neonatal mortality in rural Bangladesh was assessed in 984 mothers who had delivered a live-born child by a home on the 28th day of the birth of the baby. Neonatal mortality in this group of mothers was found to be 70/1000 live births. The main causes of neonatal death were birth injury (17%) tetanus neonatorum (38%) respiratory distress syndrome (13%) and infection of respiratory system (17%). Neonatal mortality for premature newborns was 222.2/1000 live births compared to 40.1 for mature newborns. All pregnant women from Jan. 1-Dec. 31 1985 were recruited into this study from the 3 unions of Ghatail Upazila Tangail district. Family Welfare visitors did the interviewing using pretested structured questionnaires. Mean age and number of living children of the respondents were 25.9 years and 2.9 children respectively. More than 81% of the respondents were illiterate and 95% were muslims. The prevalence of low birthweight was 17%. Among the neonatal deaths 13% occurred within 24 hours 17% with 1-3 days 35% from 4-6 days and 35% from 7-28 days. The % of deaths in neonates born to mothers aged 35 and above was 13% while in mothers aged 15-19 and 20-24 it was 3 and 4% respectively. Women who had born 7 or more children suffered 16% neonatal deaths compared to 2 and 4% by women who had experienced 1 and 2 previous pregnancies. Neonatal deaths was higher for Muslim women compared to Hindus (7% against 6%). This could be the effect of better hygiene among the Hindus particularly in rural Bangladesh. Causes of deaths were also related to the age of the newborns. Interventions such as vaccination training of TBAs in safe birth practices promotion of high risk pregnancy screening creation of safe domiciliary delivery services and provision of sterile equipment for cutting and tying the cord may prevent neonatal death. Better attention to antenatal care and nutrition education should also have a positive impact on reducing prematurity. Family planning promotion will also have a beneficial effect. (authors modified)