Changes In Neonatal Mortality Rates Research Articles

Neonatal mortality in countries of the Americas, 2000-2020: trends, inequalities, and target-setting.

To analyze temporal trends and inequalities in neonatal mortality between 2000 and 2020, and to set neonatal mortality targets for 2025 and 2030 in the Americas. A descriptive ecological study was conducted using 33 countries of the Americas as units of analysis. Both the percentage change and average annual percentage change in neonatal mortality rates were estimated. Measurements of absolute and relative inequality based on adjusted regression models were used to assess cross-country social inequalities in neonatal mortality. Targets to reduce neonatal mortality and cross-country inequalities were set for 2025 and 2030. The estimated regional neonatal mortality rate was 12.0 per 1 000 live births in 2000-2004 and 7.4 per 1 000 live births in 2020, representing a percentage change of -38.3% and an average annual percentage change of -2.7%. National average annual percentage changes in neonatal mortality rates between 2000-2004 and 2020 ranged from -5.5 to 1.9 and were mostly negative. The estimated excess neonatal mortality in the 20% most socially disadvantaged countries, compared with the 20% least socially disadvantaged countries, was 17.1 and 9.8 deaths per 1 000 live births in 2000-2004 and 2020, respectively. Based on an extrapolation of recent trends, the regional neonatal mortality rate is projected to reach 7.0 and 6.6 neonatal deaths per 1 000 live births by 2025 and 2030, respectively. National and regional health authorities need to strengthen their efforts to reduce persistent social inequalities in neonatal mortality both within and between countries.

Is the decline in neonatal mortality in northern Ghana, 1996–2012, associated with the decline in the age of BCG vaccination? An ecological study

ObjectiveTo examine the association between early Bacille Calmette-Guerin (BCG) vaccination and neonatal mortality in northern Ghana.MethodsThis ecological study used vaccination and mortality data from the Navrongo Health and Demographic Surveillance...

Association Between Temporal Changes in Neonatal Mortality and Spontaneous and Clinician-Initiated Deliveries in the United States, 2006-2013

Preterm and postterm deliveries have declined since 2005 in the United States, but the association between these changes and neonatal mortality remains unknown. To estimate changes in the gestational age distribution among spontaneous and clinician-initiated deliveries between 2006 and 2013 and associated changes in neonatal mortality. A retrospective cohort analysis was conducted of 22 million singleton live births without major malformations in the United States from 2006 to 2013. Data analysis was performed from August to October 2017. Changes in gestational age distribution among spontaneous and clinician-initiated deliveries at extremely preterm (20-27 weeks), very preterm (28-31 weeks), moderately preterm (32-33 weeks), late preterm (34-36 weeks), early term (37-38 weeks), term (39-40), late term (41 weeks), and postterm (42-44 weeks) gestations and changes in neonatal mortality rates at less than 28 days between 2006 and 2013. These changes were estimated from log-linear Poisson regression models with robust variance, adjusted for confounders. Among 22 million births, 12 493 531 (56.7%) were spontaneous and 9 557 815 (43.3%) were clinician-initiated deliveries. Among spontaneous deliveries, the proportion of births at 20 to 27, 28 to 31, 32 to 33, 34 to 36, and 37 to 38 weeks declined. Among clinician-initiated deliveries, the proportion of births at 34 to 36 and 37 to 38 weeks declined and the proportion at 39 to 40 weeks increased. Among spontaneous deliveries, overall neonatal mortality rates declined from 1.8 to 1.3 per 1000 live births, mainly at 20 to 27 weeks (adjusted annual decline, 1%; 95% CI, -2% to -1%) and 28 to 31 weeks (adjusted annual decline, 6%; 95% CI, -8% to -5%). Among clinician-initiated deliveries, overall mortality rates remained unchanged (2.1 to 2.2 per 1000 live births). However, mortality rates declined (0.6 to 0.5 per 1000 live births) at 39 to 40 weeks by 1% (95% CI, -3% to -0.4%) annually, adjusted for confounders. In the United States, there was a decline in spontaneous deliveries associated with an overall decline in neonatal mortality. Although clinician-initiated deliveries increased at 39 to 40 weeks, neonatal mortality at that gestation declined.

Neonatal mortality in the urban and rural China between 1996 and 2013: a retrospective study

One of the proposed United Nations post-2015 sustainable development goals is to eliminate avoidable neonatal deaths by 2030. This study aims to examine changes in neonatal mortality rate (NMR) and cause-specific NMR in urban and rural areas to guide renewed efforts to further reduce NMR in China. This retrospective study used 18 y of consecutive data from the National Under-5 Child Mortality Surveillance System. Urban NMR decreased from 11.0 to 4.0 deaths per 1,000 live births, and rural NMR was decreased births from 26.0 to 8.1 deaths per 1,000 live births between the periods of 1996-1998 and 2011-2013. Rural NMR was about two times as much as urban NMR in 2011-2013. Approximately four-fifths of neonatal deaths occurred within less than 7 d after birth. In 2011-2013, the three leading causes of early neonatal death were premature delivery, intrapartum-related conditions, and congenital abnormalities; the three causes of death in late neonates were classification premature delivery, congenital abnormalities, and pneumonia. China has made substantive progress in reducing NMR; however, the disparity in NMR between urban and rural areas still exists. More effort should be made to prevent and manage premature delivery and congenital abnormalities, especially in rural areas.