Abstract
In the last 30–40 years, developed countries in particular, but also developing ones, have seen an increase in life expectancy and a decrease in infant mortality and morbidity rates. These factors are due to an increase in living standards, a decrease in differences between social classes, the increased accessibility of education to women, and the implementation of some public health measures. When certain basic social and medical measures are implemented on a large scale, their benefits are first reflected in lower infant mortality rates, and only in the second stage are such benefits reflected in decreasing neonatal mortality rates and a smaller number of stillbirths. In this study, we review the literature on these factors. We extrapolate and compare this literature with data recorded in our country in the hopes of finding the reasons why Romania ranks first in the European Union in terms of infant mortality rates. We found that lowering the infant morbidity, mortality, and congenital malformation rates is an absolute priority in Romania, which requires the involvement of decision makers in taking effective measures regarding food supplementation or enhancement using folic acid, adequate counselling of couples, monitoring of all pregnancies, setting antenatal diagnosis, implementing optimal delivery management and therapeutic approaches to problematic pregnancies in other hospitals and by involving the population in health education, avoiding occupational or in-home exposure to toxic factors, avoiding drug use, and implementing disease and infection prevention measures for pregnant women.
Highlights
In recent years, in both developed and developing countries, we have witnessed an increase in life expectancy and a decrease in infant mortality and morbidity rates due to improved standards of living, fewer differences between social classes, better access to education for women, and the implementation of public health measures [1]
When certain basic social and medical measures are implemented on a large scale, their benefits are first reflected in lower infant mortality rates, and only in the second stage do such benefits lead to decreasing neonatal mortality rates and a smaller number of stillbirths [3]
At the end of the 20th century, infant mortality amounted to about 4 million deaths each year, with about 99% of these deaths occurring in developing countries and almost half occurring at home [4]
Summary
In both developed and developing countries, we have witnessed an increase in life expectancy and a decrease in infant mortality and morbidity rates (in the neonatal period) due to improved standards of living, fewer differences between social classes, better access to education for women, and the implementation of public health measures [1]. About 1 million of the 2.7 million neonatal deaths that occurred worldwide in 2013 happened on the first day of life, and it was estimated that about two-thirds of these deaths could have been prevented by quality perinatal care [5]. In 2013, infant mortality amounted to 44% of the global mortality rate for children under 5 years of age, and in 85% of these cases, death occurred due to hypoxia during birth, perinatal infections, and prematurity or low birth weight [6]. The presence of birth defects is another important risk factor in increasing infant morbidity and mortality rates, with the prevalence of birth defects ranging from 1 to 4% worldwide [8]
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