Low Infant Mortality Research Articles

Diferencias epidemiológicas podrían explicar la mayor mortalidad infantil de Chile comparada con Cuba

Cuba has the lowest infant mortality rate in Latin America, while Chile has an infant mortality rate above the average of Organization for Economic Cooperation and Development (OECD) countries.To compare the epidemiology of infant mortality between Chile and Cuba in order to find characteristics that may explain the differences found.Comparative analysis between Chile and Cuba of infant mortality rate, causes of mortality, live birth weight, and maternal age, in 2015.Cuba had a lower infant, neonatal, early and late mortality than Chile, with no differences in post-neonatal mortality. Chile had a higher infant mortality due to, alterations of the nervous system, urinary system, chromosomal alterations, respiratory distress syndrome, and disorders related to the short duration of gestation. Chile had a higher frequency of mothers ≥ 35 years old and live births weighing <2,500 g. The possible effects of health inequities could not be analyzed due to lack of data.It is possible to attribute the lower infant mortality rate in Cuba to: selective abortion due to congenital malformations and chromosomal anomalies, lower epidemiological risk of the Cuban pregnant population, and lower frequency of live births with low birth weight.

Age patterns of under-5 mortality in sub-Saharan Africa during 1990-2018: A comparison of estimates from demographic surveillance with full birth histories and the historic record.

BACKGROUNDEstimates of under-5 mortality (U5M) for sub-Saharan African populations often rely heavily on full birth histories (FBHs) collected in surveys and model age patterns of mortality calibrated against vital statistics from other populations. Health and Demographic Surveillance Systems (HDSSs) are alternate sources of population-based data in much of sub-Saharan Africa, which are less formally utilized in estimation.OBJECTIVEIn this study we compare the age pattern of U5M in different African data sources (HDSSs, Demographic and Health Surveys (DHS), and Multiple Indicator Cluster Surveys (MICS)), and contrast these with the historical record as summarized in the Human Mortality Database and model age patterns.METHODSWe examined the relative levels of neonatal, postneonatal, infant, and child mortality across data sources. We directly compared estimates for DHS and MICS subnational regions with HDSS, and used linear regression to identify data and contextual attributes that correlated with the disparity between estimates.RESULTSHDSS and FBH data suggests that African populations have higher levels of child mortality and lower infant mortality than the historic record. This age pattern is most explicit for Western African populations, but also characterizes data for other subregions. The comparison between HDSS and FBH data suggests that FBH estimates of child mortality are biased downward. The comparison is less conclusive for neonatal and infant mortality.CONTRIBUTIONThis study questions the practice of using model age patterns derived from largely high-income settings for inferring or correcting U5M estimates for African populations. It also highlights the considerable uncertainty around the consistency of HDSS and FBH estimates of U5M.

The Investigation of Streptococcus Agalactiae Colonization in Last Trimester Pregnants by Using Standard Culture and Molecular Methods

Objective: We aimed to detect and compare group B streptococcus (GBS) colonization in pregnant women at third trimester using real-time polymerase chain reaction (real-time PCR) and culture methods. Methods: Vaginal swab specimens were taken for screening of GBS from 100 women between 35-37 weeks of gestation who were attending to antenatal outpatient unit of Obstetrics and Gynecology Department of Cerrahpasa Medical Faculty from May 2014 to September 2014. Results: Rates of GBS colonization was %5 and %7 by culture and real-time PCR methods, respectively. Using culture as the gold standard; sensitivity and specificity for real-time PCR were 100% and 97.9%, respectively. Any significant difference was not detected between GBS colonization with age groups, education levels, number of previous pregnancies, smoking habits, history of antibiotic use, and contraceptive method. Conclusion: Real-time PCR technique has proven to be as sensitive as the culture method. Also, real-time PCR may provide a rapid diagnostic tool for GBS detection potentially allowing a more effective intrapartum antibiotic prophylaxis and lower infant morbidity and mortality. However, the inability to use PCR test in every laboratory and its high cost creates a handicap.

Do Antibodies to Malaria Surface Antigens Play a Role in Protecting Mothers From Maternal Anemia?

Pregnancy-associated malaria (PAM) caused by Plasmodium falciparum can result in detrimental outcomes for both mother and infant, including low infant birth weight, preterm birth, maternal anemia, spontaneous abortion, and maternal and/or infant mortality. Maternal anemia is a particularly complex outcome, as the body must both maintain erythropoiesis and tolerance of the growing fetus, while directing a Th1 response against the parasite. Underlying the pathogenesis of PAM is the expression of variant surface antigens (VSAPAM) on the surface of infected red blood cells (iRBC) that mediate sequestration of the iRBC in the placenta. Naturally acquired antibodies to VSAPAM can block sequestration and activate opsonic phagocytosis, both associated with improved pregnancy outcomes. In this review, we ask whether VSAPAM antibodies can also protect mothers against malarial anemia. Studies were identified where VSAPAM antibody titres and/or function were associated with higher maternal hemoglobin levels, thus supporting additional protective mechanisms for these antibodies against PAM. Yet these associations were not widely observed, and many studies reported no association between protection from maternal anemia and VSAPAM antibodies. We discuss the epidemiological, biological and technical factors that may explain some of the variability among these studies. We appraise the current evidence of these complex interactions between PAM-specific immunity and maternal anemia, propose potential mechanisms, and discuss knowledge gaps.

Why Employment During and After COVID-19 Is a Critical Women's Health Issue.

Why Employment During and After COVID-19 Is a Critical Women's Health Issue.

Epidemiological difference could explain the higher infant mortality in Chile compared with Cuba

BackgroundCuba has the lowest infant mortality rate in Latin America, while Chile has an infant mortality rate above the average of the Organisation for Economic Co-operation and Development (OECD) countries. ObjectiveTo compare the epidemiology of infant mortality between Chile and Cuba in order to find characteristics that may explain the differences found. MethodComparative analysis between Chile and Cuba of infant mortality rate, causes of mortality, live birth weight, and maternal age, in 2015. ResultsCuba had a lower infant, neonatal, early and late mortality than Chile, with no differences in post-neonatal mortality. Chile had a higher infant mortality due to, alterations of the nervous system, urinary system, chromosomal alterations, respiratory distress syndrome, and disorders related to the short duration of gestation. Chile had a higher frequency of mothers ≥35 years old and live births weighing ≤2.500 g. The possible effects of health inequities could not be analysed due to lack of data. ConclusionsIt is possible to attribute the lower infant mortality rate in Cuba to: selective abortion due to congenital malformations and chromosomal anomalies, lower epidemiological risk of the Cuban pregnant population, and lower frequency of live births with low birth weight.

The Cuban revolution and infant mortality: A synthetic control approach

The Cuban government often boasts that the country’s infant mortality rate has been low and falling since Fidel Castro’s revolution in 1959. However, because many Latin American countries have experienced similar decreases, and because Cuba historically enjoyed lower infant mortality rates than the rest of Latin America, it is unclear whether the government should get credit. We use the fact that Cuba underwent momentous and unique political changes to consider the effect of Castro’s regime on infant mortality. We employ a synthetic control method to ascertain how much of the reduction, if any, can be attributed to the regime. We find that in the first decade of the regime, infant mortality increased relative to the counterfactual, but that—after the introduction of Soviet subsidies—infant mortality partially reverted to trend. To measure the effect of the subsidies, we run a second synthetic control test concerning the collapse of the Soviet Union and the accompanying end of the subsidies. This control suggests that the subsidies played no important role.

The Effectiveness of Using Emodemo Methods on Knowledge of Pregnant Women's Nutritional Needs

KEK in pregnant women can increase the risk of premature birth, low birth weight , maternal and infant mortality. Lack of knowledge about nutritional needs is one of the causes of KEK in pregnant women. The purpose of this study was to determine the effectiveness of using the emodemo method on knowledge of the nutritional needs of pregnant women. Research Pre-experimental design with one group pretest posttest desaign design. The population of all pregnant women at PMB Nanik Sidoarjo was 30 samples by means of purposive sampling carried out for 3 months, namely June-August 2020. Data collection was in the form of a questionnaire. Statistical test using the Wilcoxon Sign Rank Test. The statistical test results obtained a significance value of 0.000 (p value &lt;0.005) which means that there is an effect of using the emodemo method on knowledge of the nutritional needs of pregnant women.

The Hispanic/Latinx Perinatal Paradox in the United States: A Scoping Review and Recommendations to Guide Future Research.

For decades, epidemiologists have documented a health advantage among Hispanic/Latinx individuals who live in the United States, despite their significant socioeconomic barriers. This observation is often described as the "Hispanic paradox." In this scoping review, we aimed to summarize literature published on Hispanic/Latinx perinatal outcomes over the past two decades and place these findings within the context of the overarching "Healthy Immigrant" paradox. Studies were eligible for inclusion if they utilized large population datasets to describe rates of preterm birth, low birth weight and infant mortality among Hispanic/Latinx women living in the United States. To focus on the most recent trends, studies were excluded if they were published prior to the year 2000. Globally, Hispanic/Latinx women appear to continue to have improved perinatal outcomes compared to non-Hispanic Black infants, while rates of adverse outcomes appear similar for Hispanic/Latinx and non-Hispanic White women. However, our review emphasizes the heterogeneity of outcomes experienced by Hispanic/Latinx women. The epidemiologic advantage among Hispanic/Latinx women and their infants may be largely concentrated among specific national origin subgroups or among recently arrived foreign-born Hispanic/Latinx women. Given the disparities that exist among Hispanic/Latinx women, we provide a summary of themes to explore in future research and methodologic recommendations that may assist in identifying important subgroup differences and their determinants.

Characterising variability and predictors of infant mortality in urban settings: findings from 286 Latin American cities

BackgroundUrbanisation in Latin America (LA) is heterogeneous and could have varying implications for infant mortality (IM). Identifying city factors related to IM can help design policies that promote infant health...

Age and Location in Severity of COVID-19 Pathology: Do Lactoferrin and Pneumococcal Vaccination Explain Low Infant Mortality and Regional Differences?

Two conundrums puzzle COVID-19 investigators: 1) morbidity and mortality is rare among infants and young children and 2) rates of morbidity and mortality exhibit large variances across nations, locales, and even within cities. It is found that the higher the rate of pneumococcal vaccination in a nation (or city) the lower the COVID-19 morbidity and mortality. Vaccination rates with Bacillus Calmette-Guerin, poliovirus, and other vaccines do not correlate with COVID-19 risks, nor do COVID-19 case or death rates correlate with number of people in the population with diabetes, obesity, or adults over 65. Infant protection may be due to maternal antibodies and antiviral proteins in milk such as lactoferrin that are known to protect against coronavirus infections. Subsequent protection might then be conferred (and correlate with) rates of Haemophilus influenzae type B (Hib) (universal in infants) and pneumococcal vaccination, the latter varying widely by geography among infants, at-risk adults, and the elderly. Also see the video abstract here https://youtu.be/GODBYRbPL00.

Toward Predicting Infant Developmental Outcomes From Day-Long Inertial Motion Recordings

As improvements in medicine lower infant mortality rates, more infants with neuromotor challenges survive past birth. The motor, social, and cognitive development of these infants are closely interrelated, and challenges in any of these areas can lead to developmental differences. Thus, analyzing one of these domains - the motion of young infants - can yield insights on developmental progress to help identify individuals who would benefit most from early interventions. In the presented data collection, we gathered day-long inertial motion recordings from N = 12 typically developing (TD) infants and N = 24 infants who were classified as at risk for developmental delays (AR) due to complications at or before birth. As a first research step, we used simple machine learning methods (decision trees, k-nearest neighbors, and support vector machines) to classify infants as TD or AR based on their movement recordings and demographic data. Our next aim was to predict future outcomes for the AR infants using the same simple classifiers trained from the same movement recordings and demographic data. We achieved a 94.4% overall accuracy in classifying infants as TD or AR, and an 89.5% overall accuracy predicting future outcomes for the AR infants. The addition of inertial data was much more important to producing accurate future predictions than identification of current status. This work is an important step toward helping stakeholders to monitor the developmental progress of AR infants and identify infants who may be at the greatest risk for ongoing developmental challenges.

SKRINING ANEMIA DAN PEMBERIAN SUPLEMENTASI FE PADA IBU HAMIL DAN WANITA USIA SUBUR (WUS) SEBAGAI UPAYA PENCEGAHAN ANEMIA KEHAMILAN

Background: One of the causes of high maternal and infant mortality rates (IMR) is anemia of pregnancy and chronic energy deficiency (KEK). Anemia and KEK in pregnant women can increase the risk of low birth weight babies (LBW), premature birth, maternal and infant mortality and stunting (short children). To prevent this from happening, it is necessary to carry out screening and Fe supplementation as a preventive measure to prevent anemia in pregnancy. Activity This community service aims to screen for anemia and KEK pregnant women and women of childbearing age (WUS) as well as the provision of Fe supplementation for prevent iron deficiency anemia. Method: The method used is involving community as a form of empowerment such as measuring LiLA and levels of hemoglobin (Hb), BMI, and distribution of Fe supplementation. Besides that, it is also done education about anemia in pregnancy. The population in this activity is women aged fertile 15-40 years, a total of 42 people in Sambirobyong Hamlet, Pangkur Village, Ngawi Regency. Results: The results show that from 42 women of childbearing age in the hamlet Sambirobyong were screened, there were 3 people (7%) women of childbearing age temporary anemia 1 person (2%) with anemia status plus KEK. From 4 WUS people for age &lt;20 years as many as 2 people (50%) with 1 person condition pregnant with anemia and 1 non-pregnant with anemia. While 2 people (50%) aged &gt;35 years with 1 pregnant condition with anemia + KEK and 1 non-pregnant people with anemia. There is 1 person (2%) experiencing the risk of SEZ. Conclusion: Screening results show that anemia and KEK are more common WUS group aged &lt;20 years and &gt;35 years. It is necessary to carry out periodic evaluations every months and giving Fe supplementation to WUS who are still anemic and the risk of KEK and education on the importance of quality nutrition to prevent these complications.

Health Status in the Islamic Republic of Iran, Middle East and North Africa Countries: Implications for Global Health

The aim of this study was to evaluate the health status of the Iranians following the sustainable development goals' (SDGs) introduction and the recent health reform implementation in Iran and to compare with those of the Middle East and North Africa region (MENA) and global average. This comparative study used secondary data to investigate socio-demographic and health status indicators. The sources included census, population-based surveys and death registries. Global and regional health status indicators were obtained from international databases including WHO, the World Bank and the Institute for Health Metric and Evaluation (IHME). Life expectancy and human development index improved following the reform implementation. Among causes of death, 74.6% were attributed to non-communicable diseases (NCDs). There was an increasing trend in risk factors for NCDs in Iran, while at the same time neonatal, infant and under-5 mortality rates reduced. Compared to the MENA, Iran has a lower maternal mortality ratio, neonatal, infant, and under-5 mortality rates, and a higher life expectancy. NCDs and road traffic injuries accounted for a larger portion of disability-adjusted life years in Iran compared to the MENA and worldwide. Actions against communicable diseases and road traffic injuries are required together with continued efforts to address NCDs. Although based on the results, Iran has relatively high rankings, there is a need to develop a roadmap to accelerate achieving global health goals and SDGs targets.

Determinants of infant mortality in Sierra Leone: applying Cox proportional hazards model

PurposeThe aim of this paper is to examine biological, maternal and socioeconomic determinants of infant mortality in Sierra Leone.Design/methodology/approachIt uses an analytical framework and Cox proportional hazards regression to break down the effects of factors determining infant mortality. Factors utilized in the empirical investigation include sex of the child, birth size, birth spacing, mother's working status, age of mother, antenatal care, postnatal care, mother's anemia level, religion, mother's education and wealth status.FindingsResults suggest that birth spacing of three years and above associated with a reduced risk of infant mortality contrasted with short birth intervals. Children born to nonanemic mothers have a lower hazard (22%) of infant mortality compared to those born to anemic mothers (HR = 0.78; 95% CI: 0.64–0.96). At least one antenatal care visit by mothers lowers infant mortality rate by 41% compared to no antenatal visits at all ( HR = 0.59; 95% CI: 0.36–0.96). Similarly, infants whose mothers have received postnatal care are at lower risk (31%) of dying than those whose mothers have not received (HR = 0.69; 95% CI: 0.52, 0.93). Infant mortality is likely to decrease with the increase in the birth order.Practical implicationsThe family health and planning programs should aim at educating men and women about the usefulness of birth spacing methods.Originality/valueThis paper might be the first attempt to analyze the determinants of infant mortality by utilizing a methodological framework and Cox regression.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-08-2019-0478.

Listening to Women: Understanding and Challenging Systems of Power to Achieve Reproductive Justice in South Carolina

AbstractSouth Carolina women, especially low‐income women and women of color, face greater disparities in reproductive health outcomes, including low birth weight, preterm delivery, infant mortality, and maternal mortality, than do women nationally. The purpose of this study was to utilize a reproductive justice framework in which reproduction is considered a woman‐centered experience (as opposed to a social issue to be solved) to understand the reproductive experiences of women in South Carolina. We conducted 70 in‐depth interviews with women aged 19–78 years and analyzed these interviews using a constant comparative method. Study findings revealed that participants faced the consequences of oppressive systems of power when accessing reproductive health care, including high costs and lack of adequate health insurance coverage. Participants recognized the complexity of navigating reproduction in a conservative social context (i.e., South Carolina), further “compounded” by their gender and race. Women of color specifically noted challenges to reproductive care based on historical injustices and discrimination, including racial bias in hospital settings and aversion to certain contraceptive methods (e.g., IUD). Participants described the need to exercise reproductive autonomy and to have a “voice” in order to make desired lifestyle choices (e.g., career, motherhood) to overcome these challenges. Study findings evidence the women‐centered experience of reproduction within a specific sociogeopolitical context in order to uncover the challenges and opportunities to improving women's reproductive health in South Carolina.

Eviction and Pediatric Health Outcomes in Chicago.

According to Eviction Lab there were 6877 evictions in Chicago in 2016. The rate was "1.1%" and came out to 18.79 evictions per day in Chicago in 2016. The presence of children in a household (HH) poses a greater risk for eviction than race or gender. Census tract-level data from the Chicago Department of Public Health, the Eviction Lab and American Community Survey was used to assess the relationship between eviction and pediatric health outcomes for 653 census tracts in Chicago. Correlation matrices and linear regression models were used to evaluate the relationship between eviction and health outcomes. Regression models were adjusted for the following: (1) female-led family HH with less than a high school degree and below poverty and (2) race/ethnicity. Compared to White Non-Hispanic HH, predominantly Black and Hispanic HH had higher rates of very low birth weight (VLBW), infant mortality (IM), eviction filings, and evictions. All covariates were found to be significantly correlated (p < 0.01). Eviction filing rates and eviction rates were significant predictors for both VLBW and IM in both unadjusted and adjusted models (p < 0.05). Though we cannot conclude causality, these results suggest that census tracts which experience high rates of eviction also experience high rates of VLBW and IM and this relationship should be further investigated.

Heroes and Toilers: Work as Life in Postwar North Korea, 1953–1961

Heroes and Toilers: Work as Life in Postwar North Korea, 1953–1961

Environmental degradation and population health outcomes: a global panel data analysis.

This study investigates the relationship between environmental degradation and population health using a global panel data of 180 countries from 1990 to 2016. The empirical analysis is conducted using fixed-effects approach based on Hausman test. Moreover, two-stage least squares (2SLS) and system-generalized method of moments (SGMM) are used to deal with the endogenous nature of environmental degradation. The indicators of life expectancy and infant mortality are used to measure population health, whereas environmental degradation is measured by CO2 emissions. The empirical findings show that environmental degradation negatively influences population health outcomes. It implies that countries having a high level of environmental degradation experience low life expectancy and high infant mortality rates. Findings of the study suggest that health-related reforms need to be aligned with policies which ensure lower environmental degradation.

Household fuel use and adverse pregnancy outcomes in a Ghanaian cohort study

BackgroundAccruing epidemiological evidence suggests that prenatal exposure to emissions from cooking fuel is associated with increased risks of adverse maternal and perinatal outcomes including hypertensive disorders of pregnancy, low birth weight, stillbirth and infant mortality. We aimed to investigate the relationship between cooking fuel use and various pregnancy related outcomes in a cohort of urban women from the Accra region of Ghana.MethodsSelf-reported cooking fuel use was divided into “polluting” (wood, charcoal, crop residue and kerosene) and “clean” fuels (liquid petroleum gas and electricity) to examine 12 obstetric outcomes in a prospective cohort of pregnant women (N = 1010) recruited at < 17 weeks of gestation from Accra, Ghana. Logistic and multivariate linear regression analyses adjusted for BMI, maternal age, maternal education and socio-economic status asset index was conducted.Results34% (n = 279) of 819 women with outcome data available for analysis used polluting fuel as their main cooking fuel. Using polluting cooking fuels was associated with perinatal mortality (aOR: 7.6, 95%CI: 1.67–36.0) and an adverse Apgar score (< 7) at 5 min (aOR:3.83, 95%CI: (1.44–10.11). The other outcomes (miscarriage, post-partum hemorrhage, pre-term birth, low birthweight, caesarian section, hypertensive disorders of pregnancy, small for gestational age, and Apgar score at 1 min) had non-statistically significant findings.ConclusionsWe report an increased likelihood of perinatal mortality, and adverse 5-min Apgar scores in association with polluting fuel use. Further research including details on extent of household fuel use exposure is recommended to better quantify the consequences of household fuel use.Study registrationGhana Service Ethical Review Committee (GHS-ERC #: 07–9-11).