Infant Death Research Articles

Neonatal abstinence syndrome and infant mortality and morbidity: a population-based study.

Infant health among newborns with neonatal abstinence syndrome (NAS) has been understudied. We examined infant mortality and hospitalizations among infants diagnosed with NAS after birth. All live births in British Columbia (BC), Canada, for fiscal years from 2004-2005 to 2019-2020, were included (N = 696,900). NAS was identified based on International Classification of Diseases, version 10, Canadian modification (ICD-10-CA) codes; the outcomes included infant death and hospitalizations during the first year of life, ascertained from BC linked administrative data. Generalized estimating equation models were used to adjust for maternal factors. There were 2,439 infants with NAS (3.50 per 1,000 live births). Unadjusted for other factors, infant mortality was 2.5-fold higher in infants with vs. without NAS (7.79 vs. 3.08 per 1,000 live births, respectively) due to increased post-discharge mortality NAS (5.76 vs. 1.34 per 1,000 surviving infants, respectively). These differences diminished after adjustment: adjusted odds ratio (AOR) for infant death was 0.85 [95% confidence interval (CI): 0.52-1.39]; AOR for post-discharge death was 1.75 (95% CI 1.00-3.06). Overall, 22.3% infants with NAS had at least one hospitalization after post-neonatal discharge, this proportion was 10.7% in those without NAS. During the study period, discharge to foster care declined from 49.5% to 20.3% in infants with NAS. Unadjusted for other factors, infants with NAS had increased post-discharge infant mortality and hospitalizations during the first year of life. This association diminished after adjustment for adverse maternal and socio-medical conditions. Infants with NAS had a disproportionately higher rate of placement in foster care after birth, although this proportion declined dramatically between 2004/2005 and 2019/2020. These results highlight the importance of implementing integrated care services to support infants born with NAS and their mothers during the first year of life and beyond, even though NAS itself is not independently associated with increased infant mortality.

Mass Incarceration, Maternal Vulnerability, and Birth Outcomes Across U.S. Counties

ObjectivesTo examine the associations among mass incarceration, maternal vulnerability, and disparities in birth outcomes across U.S. counties, utilizing an ecological model and reproductive justice perspective was used. This study tests whether mass incarceration is associated with infant mortality and low birthweight across U.S. counties, and whether maternal vulnerability explains the relationship between mass incarceration and birth disparities.MethodsData were derived from a variety of public sources and were merged using federal FIPS codes. Outcomes from the CDC Vitality Statistics include percent low birth weight births (births below 2499 g divided by singleton births to women aged 20 to 39) and infant mortality (infant deaths per 1000 live births). Black–White rate ratios were calculated for the birth outcomes to specifically examine the large Black–White disparity in birth outcomes. The analysis controlled for urbanicity, income inequality, median household income, residential segregation, and southern region, as well as a fixed effect for state level differences.ResultsFindings show that counties with higher rates of incarceration have higher prevalence of infant mortality and low birthweight, as well as greater Black–White disparity in infant mortality. Mass incarceration is associated with increases in adverse birth outcomes and maternal vulnerability partially mediates this relationship.ConclusionsFindings provide evidence that heightened levels of incarceration affect birth outcomes for all residents at the county-level. It is imperative to address the overuse of mass incarceration in order to support adequate reproductive healthcare of vulnerable populations in the United States.

Reflections on a Career in Pediatric Neuropathology, with a Note of Gratitude.

I am honored to be asked by the journal to write this personal essay about my career in pediatric neuropathology-a life of immense satisfaction, meaning, and fulfillment. My motivation to enter this discipline is highlighted, as is my decision to perform brain research in the sudden infant death syndrome, the leading cause of postneonatal infant mortality in the United States today. I also touch upon collaborations, mentoring, and experiences along the way-especially with the light microscope. I close with thoughts about the future of the discipline from my perspective as a lifelong devotee.

Time to recovery and predictors among admitted preterm neonates in the neonatal intensive care units of public hospitals of Addis Ababa, Ethiopia, 2021

IntroductionEthiopia implemented measures to reduce preterm mortality, and much is currently being done to avoid preterm death, yet preterm death remains the top cause of infant death. As a result, evaluating median time of recovery and determinants will provide information to planners and policymakers to design strategies to improve preterm survival.MethodsHospital-based retrospective follow-up study was conducted in four selected public hospitals of Addis Ababa from September 2018 to August 2021. Data were collected using a pretested structured questionnaire. Epi-data 4.6 and STATA Version 16 were used for data entry and analysis. Kaplan-Meier survival curve, log-rank test, and median time were computed. To find predictors of time to recovery, a multivariable Cox proportional hazards regression model was fitted, and variables with a p-value less than 0.05 were considered statistically significant.ResultsA total of 466 preterm babies were included in the study of which 261 (56.1%) preterm neonates survived and were discharged from NICUs. The median time to recovery was 10 days (95% CI: 9–12). Low birth weight (Adjusted hazard-ratio [AHR]: 1.91, 95% CI: 1.2–3.06), normal birth weight (AHR: 2.09, 95% CI: 1.16–3.76), late preterm (AHR: 1.91, 95% CI: 1.02–3.55), no hospital-acquired infection (AHR: 2.19, 95% CI: 1.36–3.5), no thrombocytopenia (AHR: 1.96, 95% CI: 1.27–3.02), continuous positive airway pressure (AHR: 0.66, 95% CI: 0.48–0.91), and kangaroo mother care (AHR: 2.04, 95% CI: 1.48–2.81) were found to be independent predictors of time to recovery of preterm babies.Discussion/ConclusionThe recovery rate was found relatively low. Several predictors of preterm recovery time were discovered in the study. The majority of predictors were preventable or treatable. Therefore, emphasis should be given towards prevention and early anticipation, and management of these predictors. Studies to assess the quality of care and cause of low survival rate of preterm infants are recommended.

Asian Neonatal Network Collaboration (AsianNeo): a study protocol for international collaborative comparisons of health services and outcomes to improve quality of care for sick newborn infants in Asia – survey, cohort and quality improvement studies

IntroductionReducing neonatal deaths in premature infants in low- and middle-income countries is key to reducing global neonatal mortality. International neonatal networks, along with patient registries of premature infants, have contributed...

Implementasi Decision Tree untuk Prediksi Kelahiran Bayi Prematur

The early birth of baby in Indonesia is a case that has a very high incidence rate. According to data from the Ministry of Health in 2021, the presentation of premature babies in Indonesia is 84%. The number of infant deaths in Indonesia is still relatively high compared to other ASEAN countries. The purpose of this study was to predict the birth of premature babies with the implementation of decision tree, with this type of predictive analysis research. The population in this study is pregnant women patients with a sample of 350 pregnant women patient data covering the variables studied Age, BMI, Vaginal Discharge, History of Miscarriage, History of Prematurity and Pregnancy Spacing. The prediction was made by halving the training data by 245 and the testing data by 105. The results obtained are the variable Body Mass Index (BMI) is the riskiest factor for premature birth The decision tree model yields an AUC of 91.7%, it can be concluded that the decision tree has a good classification accuracy value.

Hubungan Tingkat Pengetahuan, Sikap dan Dukungan Tenaga Kesehatan pada Calon Pengantin (Catin) Tentang Penyakit Sifilis di Wilayah Kerja Puskesmas Kotabaru Kecamatan Keritang Kabupaten Inhil Riau Tahun 2023

Syfillis cases in Southeast Asia in 2015 amounted to 3 million. The areas that have the highest rates of syphilis transmission are Sub-Saharan Africa, the United States and Southeast Asia. Studies conducted in Africa show that there are 30% positive antenatal syphilis cases and 50% result in infant death in congenital syphilis. This research is a type of quantitative research with an analytical observational research design with a cross sectional study approach. The population in this study were all prospective brides and grooms in Keritang District, the working area of the Kotabaru Community Health Center in 2023, as of January, as many as 36 people who had bridal injections (catin) at the Community Health Center. The sampling technique used in the research was accidental sampling. Data was collected using a questionnaire and data processing using the SPSS program. Data analysis in this study was univariate and bivariate analysis using the chi-square test formula with a confidence level of 95% (0.05). The results of the study revealed that the level of knowledge of the prospective bride and groom (catin), the attitude of the prospective bride and groom (catin) and the support of health workers had a value of each variable less than 0.05 or a significance value of p<0.05, which indicated that there was a significant relationship of these three variables in prospective brides (catin) regarding syphilis in the working area of the Kotabaru health center, Keritang District, Inhil Regency, Riau in 2023.

Association between risk of infant death and birth-weight z scores according to gestational age: A nationwide study using the Finnish Medical Birth Register.

To investigate the association between infant mortality and birth weight using estimated fetal weight (EFW) versus birth-weight charts, by gestational age (GA). This nationwide population-based study used data from the Finnish Medical Birth Register from 2006 to 2016 on non-malformed singleton live births at 24-41+6 weeks of gestation (N = 563 630). The outcome was death in the first year of life. Mortality risks by birth-weight z score, defined as a continuous variable using Maršál's EFW and Sankilampi's birth-weight charts, were assessed using generalized additive models by GA (24-27+6, 28-31+6, 32-36+6, 37-38+6, 39-41+6 weeks). We calculated z score thresholds associated with a two- and three-fold increased risk of infant death compared with newborns with a birth weight between 0 and 0.675 standard deviations. The z score thresholds (with corresponding centiles in parentheses) associated with a two-fold increase in infant mortality were: -3.43 (<0.1) at 24-27+6 weeks, -3.46 (<0.1) at 28-31+6 weeks, -1.29 (9.9) at 32-36+6 weeks, -1.18 (11.9) at 37-38+6 weeks, and - 1.34 (9.0) at 39-41+6 weeks according to the EFW chart. These values were - 2.43 (0.8), -2.62 (0.4), -1.34 (9.0), -1.37 (8.5), and - 1.43 (7.6) according to the birth-weight chart. The association between birth weight and infant mortality varies by GA whichever chart is used, suggesting that different thresholds for the screening of growth anomalies could be used across GA to identify high-risk newborns.

The global burden of disease attributable to preterm birth and low birth weight in 204 countries and territories from 1990 to 2019: An analysis of the Global Burden of Disease Study.

Preterm birth and low birth weight (PBLBW), recognised globally as primary contributors to infant mortality in children under five, have not been sufficiently investigated in terms of their worldwide impact. In this study we aimed to thoroughly evaluate the contemporary trends in disease burden attributable to PBLBW. We analysed data from 204 countries and territories between 1990-2019, as sourced from the 2019 Global Burden of Disease Study. We analysed the global incidence of mortality and disability-adjusted life years (DALYs) associated with PBLBW, stratified by age, gender, year, and geographic location, alongside the socio-demographic index (SDI). We calculated the annual percentage changes to evaluate the dynamic trends over time. We employed a generalised linear model and scrutinised the relationship between the SDI and the disease burden attributed to PBLBW. In 2019, the global age-standardised rate of deaths and DALYs related to PBLBW showed significant declines. Over the period 1990-2019, both death and DALY rates displayed substantial downward trends, with similar change trends observed for both females and males. Age-specific ratios revealed a decrease in PBLBW-related deaths and DALYs with increasing age, primarily during the neonatal stages (zero to 27 days). The leading three causes of PBLBW-related DALYs in 2019 were neonatal disorders, lower respiratory infections, and sudden infant death syndrome. Furthermore, the association between SDI and PBLBW-related DALYs indicated that the age-standardised DALY rates in 204 countries and territories worldwide were negatively correlated with SDI in 2019. From 1990 to 2019, the age-standardised DALY rates decreased linearly in most regions, except sub-Saharan Africa. The persistent global burden of disease associated with PBLBW is particularly pronounced in neonates aged less than 28 days and in regions with low SDI. In this study, we highlighted the critical need for tailored interventions aimed at mitigating the detrimental effects of PBLBW to attain specific sustainable development goals, particularly those centred on enhancing child survival and overall well-being.

Analysis of some socio-economic factors affecting maternal health in Nigeria

This study examined socio-economic factors affecting maternal health in Nigeria. Mothers and children are at the highest risk of disease and death. Deaths of infants and children under-5 years are peculiar and closely related to maternal health, and the risk of death of children increases if their mothers die in childbirth. This study employed secondary data obtained from World Bank, CBN, and Nigeria Demographic and Health Survey from 1990 to 2022. Using the Error Correction Model (ECM), the data were subjected to regression analysis, where we estimated the relationship between dependent variable (maternal mortality) and independent variables (poverty rate, literacy rate, and level of government expenditure on health). The results show that poverty, literacy and government provision of healthcare facilities are major socio-economic factors affecting maternal health in Nigeria. This study therefore, recommended increase in budgetary allocation to the health sector, diversification of the economy aimed at poverty reduction, and the enforcement of free and compulsory basic education especially for the girl child, as the panacea for poor maternal health in Nigeria. Keywords: Mortality, Poverty, Literacy.

Spatial variation of short birth intervals and their determinant factors among reproductive women in Ethiopia using a geographically weighted regression model.

In low- and middle-income nations, a significant proportion of maternal and infant deaths are caused by a short birth interval (SBI). In Ethiopia, it is the main factor contributing to maternal and infant mortality. Understanding the spatial distribution of SBIs, i.e., birth intervals of less than 33 months, and the factors that influence them is important for categorizing and promoting targeted interventions. This study used a geographically weighted regression model to evaluate the factors associated with SBIs in hot areas of Ethiopia. The 2019 Ethiopian Mini Demographic and Health Survey, which is nationally representative, provided the data for this study. The first step in the two-stage cluster design used to collect the data was enumeration areas, and the second stage was households. The survey was conducted between 21 March 2019 and 28 June 2019. A hot spot analysis (local Getis-Ord Gi* statistics) was initially used to investigate spatial variation in SBIs. Geographically weighted regression was used to examine the regional variation in the relationship between SBIs and the factors that cause them. The study indicated that the overall proportion of SBIs among women in Ethiopia was 43.2%. The values for Global Moran's I (Moran's I = 0.773 and p < 0.001) showed the presence of significant SBIs clustering in Ethiopian administrative zones in Ethiopia. High-risk areas of the SBIs include Jarar, Doolo, Shabelle, Afder, Liben, Korahe, Nogob, West Harerge, Guji, Sidama, and Assosa zones. Living in a geographic region with a high proportion of uneducated women, women lacking breastfeeding practices, and followers of Orthodox religions increased the proportion of SBIs. Our full map of hot spots for short birth spacing and the factors that affect them helps in the implementation of precise public health measures for decision-makers.

A Simple and Systematic Approach to Qualitative Data Extraction From Social Media for Novice Health Care Researchers: Tutorial.

Social media analyses have become increasingly popular among health care researchers. Social media continues to grow its user base and, when analyzed, offers unique insight into health problems. The process of obtaining data for social media analyses varies greatly and involves ethical considerations. Data extraction is often facilitated by software tools, some of which are open source, while others are costly and therefore not accessible to all researchers. The use of software for data extraction is accompanied by additional challenges related to the uniqueness of social media data. Thus, this paper serves as a tutorial for a simple method of extracting social media data that is accessible to novice health care researchers and public health professionals who are interested in pursuing social media research. The discussed methods were used to extract data from Facebook for a study of maternal perspectives on sudden unexpected infant death.

Organ weights and length anthropometry measures at autopsy for sudden infant death syndrome cases and other infant deaths in the Chicago infant mortality study.

Organ weights are a possible diagnostic or pathophysiological clue to distinguishing sudden infant death syndrome (SIDS) cases from other infant deaths but suffer from major confounding. Using autopsy data from the Chicago Infant Mortality Study, a majority African-American case-control study of deceased infants under 1 year conducted 1993-96, we assessed differences in the weights of brain, thymus, kidneys, lungs, liver, spleen, total body, and four length anthropometry measures in SIDS-diagnosed infants compared to controls. Using exact and coarsened matching, we ran Bayesian linear models with these anthropometry outcomes and repeated the analyses substituting the corresponding fitted allometrically-scaled organ weight indices to account for body size. After detailed analysis and adjustment for potential confounders, we found that matched SIDS infants were generally bigger than controls, with higher mean brain, liver, spleen, thymus, lung, and total body weights, and higher mean head and chest circumference, crown-heel, crown-rump lengths. SIDS infants also had higher mean thymus, liver, spleen, lung and total body weight indices. The association with thymus weight was proportionately greater in magnitude than any other outcome measure and independent of body size. The results of these more detailed analyses are consistent with recent findings from other studies with differing racial compositions, and substantially confirm the primary organ sites for more detailed mechanistic research into the biological dysregulation contributing to underlying pathophysiology of SIDS.

Early Prediction of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants using Non-invasive Electrical Cardiometry

Abstract Background Prematurity is a term for the broad category of neonates born at less than 37 weeks' gestation following onset of the last menstrual period. Different degrees of prematurity are defined by gestational age (GA) or birth weight (BW). Prematurity is associated with approximately one- third of all infant deaths. Complications of prematurity are the underlying cause of the higher rate of infant mortality and morbidity in preterm infants compared to full term infants. Objective To identify hemodynamic changes during the first 48hrs in life using non-invasive cardiometry and how these changes can predict which infants would develop clinical and echocardiographic criteria for PDA treatment. Patients and Methods This Prospective cohort study was conducted at tertiary care hospital at the neonatal intensive care units of Ain Shams University, Children’s Hospital from October 2021 till April 2022 and performed on preterm neonates who are less than 35 weeks gestational age and admitted to the NICU of pediatric hospital. Results Hemodynamically-significant PDA group had significantly lower systolic, diastolic blood pressure and mean arterial blood pressure than hemodynamically not significant PDA group at each time of follow up and significantly higher heart rate at (12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 45, 48) hours in patients with hemodynamically-significant PDA. There was statistically significant difference between the two studied groups as regards vital data of Oxygen saturation (SpO2) and UOP which were significantly lower in hemodynamically-significant PDA. Conclusion in our prospective cohort study increased heart rate, decreased mean arterial blood pressure predict a clinically significant PDA requiring treatment. Furthermore, vital data seem to be a good non invasive tools to monitor hemodynamic changes in preterms with hemodynamically significant PDA. However, further studies with a higher number of patients are necessary to ground the outcomes of these preliminary considerations.

Addressing Disparities in Pediatric Congenital Heart Disease: A Call for Equitable Health Care.

While significant progress has been made in reducing disparities within the US health care system, notable gaps remain. This article explores existing disparities within pediatric congenital heart disease care. Congenital heart disease, the most common birth defect and a leading cause of infant death, has garnered substantial attention, revealing certain disparities within the US health care system. Factors such as race, ethnicity, insurance coverage, socioeconomic status, and geographic location are all commonalities that significantly affect health disparities in pediatric congenital heart disease. This comprehensive review sheds light on disparities from diverse perspectives in pediatric care, demonstrates the inequities and inequalities leading to these disparities, presents effective solutions, and issues a call to action for providers, institutions, and the health care system. Recognizing and addressing these disparities is imperative for ensuring equitable care and enhancing the long-term well-being of children affected by congenital heart disease. Implementing robust, evidence-based frameworks that promote responsible and safe interventions is fundamental to enduring change.

Impacts of Environmental Degradation: Forest Loss, Malaria, and Child Outcomes in Nigeria

Abstract We examine the effect of forest loss around the time of birth on infant mortality and the early childhood health of children in rural Nigeria. We find that forest loss leads to an increase in neonatal mortality—one standard deviation of forest loss is associated with a 9%–15% increase in the likelihood of death within the first month of life. The mechanism linking forest loss to infant death is maternal exposure to malaria when the child is in utero. Such exposure also results in worse birth outcomes, proxied by lower weight-for-age and height-for-age of surviving infants.

Birth Patterns in the Aftermath of the 1918 Influenza Pandemic in India: The Case of Madras City.

This paper examines the timing of one-time fluctuations in births subsequent to the 1918 influenza pandemic in Madras (now Chennai), India. After seasonally decomposing key demographic aggregates, we identified abrupt one-time fluctuations in excess births, deaths, and infant deaths. We found a contemporaneous spike in excess deaths and infant deaths and a 40-week lag between the spike in deaths and a subsequent deficit in births. The results suggest that India experienced the same kind of short-term postpandemic "baby bust" that was observed in the United States and other countries. Identifying the mechanisms underlying this widespread phenomenon remains an open question and an important topic for future research.

Neonatal outcomes of planned vaginal delivery versus planned cesarean section for breech presentation at term: Population-based study on 546,842 breech births across the United States between 2008 and 2017

IntroductionOver the last several decades, cesarean delivery has been recommended as the safest mode of delivery for breech presentations. The purpose of this study was to evaluate the outcomes of planned vaginal births with planned cesarean births in breech presenting fetuses. MethodsThis retrospective population-based cohort study utilized data from the United States’ Period Linked Birth-Infant Death Public Use Files from 2008 to 2017. All term singleton breech deliveries of a live baby without congenital anomalies were identified (n = 546,842) and divided into two cohorts: women who had a planned vaginal birth (n = 116,828), and women who had a planned cesarean section (n = 430,014). Multivariate logistic regression models, adjusted for maternal baseline characteristics, examined the associations between the planned delivery method and neonatal outcomes. ResultsIt was observed that 26.14 % of the planned vaginal birth cohort had a vaginal delivery. In adjusted analyses, undergoing a planned vaginal birth for breech delivery was associated with an increased risk of adverse neonatal outcomes including infant death, OR 1.32, 95 % CI 1.16–1.52, admission to NICU,1.23, 1.19–1.27, ventilation support at 〈 6 h of life, 1.47, 1.42–1.52, ventilation support at 〉 6 h of life, 1.19, 1.08–1.31, and Apgar score of ≤3 at 5 min, 2.27, 2.06–2.50. ConclusionIn women carrying fetuses in breech presentation, having a planned vaginal birth had a low success rate and was associated with increased risk of neonatal morbidity and mortality. Women should be carefully counselled on the risks associated with breech vaginal delivery as well as the low success rate of vaginal delivery.

Social Distancing During the COVID-19 Pandemic and Neonatal Mortality in the US

ImportanceNeonatal mortality is a major public health concern that was potentially impacted by the COVID-19 pandemic. To prepare for future health crises, it is important to investigate whether COVID-19 pandemic–related interventions were associated with changes in neonatal mortality.ObjectiveTo investigate whether social distancing during the pandemic was associated with a higher neonatal mortality rate.Design, Setting, and ParticipantsThis cohort study examined maternal-linked birth and infant death records from the National Center for Health Statistics, a population-level US database, from 2016 through 2020. The mortality rates were correlated using machine learning–based autoregressive integrated moving average (ARIMA) models with the social distancing index (SDI). The reference period was January 2016 through February 2020, and the pandemic period was March through December 2020. Statistical analysis was performed from March 2023 to May 2024.ExposuresSDI, computed from 6 mobility metrics.Main Outcomes and MeasuresThe primary outcome was neonatal mortality rate, defined as death at age less than 28 days.ResultsThe study included 18 011 173 births, of which 15 136 596 were from the reference period (7 753 555 [51.22%] male; 11 643 094 [76.92%] with maternal age of 20 to 34 years) and 2 874 577 were from the pandemic period (1 472 539 [51.23%] male; 2 190 158 [76.19%] with maternal age of 20 to 34 years). Through ARIMA-adjusted analyses, accounting for the declining mortality trend in the reference period, the mortality rates during the pandemic period did not significantly differ from the expected rates. SDI did not exhibit significant correlations with neonatal mortality (unadjusted: correlation coefficient [CC], 0.14 [95% CI, −0.53 to 0.70]; ARIMA adjusted: CC, 0.29 [95% CI, −0.41 to 0.77]), early neonatal mortality (unadjusted: CC, 0.33 [95% CI, −0.37 to 0.79]; ARIMA adjusted: CC, 0.45 [95% CI, −0.24 to 0.84]), and infant mortality (unadjusted: CC, −0.09 [95% CI, −0.68 to 0.57]; ARIMA adjusted: CC, 0.35 [95% CI, −0.35 to 0.80]). However, lag analyses found that SDI was associated with higher neonatal and early neonatal mortality rates with a 2-month lag period, but not with infant mortality rate. SDI was also associated with increases in 22-to-27 weeks’ and 28-to-32 weeks’ preterm delivery with a 1-month lag period.Conclusions and RelevanceIn this population-level study of National Center for Health Statistics databases, neonatal, early neonatal, and infant mortality rates did not increase during the initial COVID-19 pandemic period. However, associations were observed between the pandemic period social distancing measures and higher rates of neonatal and early neonatal mortality, as well as preterm birth rate with a lag period, suggesting the importance of monitoring infant health outcomes following pandemic-related population behavior changes.

Infant and child mortality in Afghanistan: A scoping review.

Since 1990, global child and infant mortality rates have typically stabilized or decreased due to improved healthcare, vaccination rollouts, and international funding. However, Afghanistan continues to face the highest child and infant mortality rates globally, with 43 deaths per 1000 live births. This study aims to examine the factors contributing to this high mortality rate and propose interventions to address the issue. A comprehensive literature search was conducted using databases such as Google Scholar and PubMed, focusing on articles published in English within the last 10 years (2013-2023). The search terms included "Child mortality," "Infant mortality," "SIDS," "COVID-19," and "Afghanistan." Original studies, systematic reviews, case studies, and reports meeting the inclusion criteria were selected for analysis. Additional sources from organizations such as UNICEF, the World Bank Group, WHO, and EMRO were also reviewed. The study findings reveal significant challenges contributing to Afghanistan's high infant and child mortality rates. These challenges include birth defects, preterm birth, malnutrition, sudden infant death syndrome (SIDS), traumatic injuries, fatal infections, infanticide, and abuse. The ongoing conflict, insecurity, and humanitarian crises further exacerbate the situation, leading to increased child casualties. Despite efforts by international agencies like UNICEF to provide vaccines and maternal education, the infant mortality rate remains high. In conclusion, Afghanistan's child and infant mortality rates are of significant concern, and it is imperative that action be taken to reduce the incidence of child and infant mortality rates.