The UN recommends a Caesarean section rate of 5–15% to optimally minimize maternal and neonatal mortality rates.4,20 This recommendation presumes that these Caesarean sections are performed in a timely manner on appropriate women. adaptation of the Aberdeen classification was used because it identifies the potential for both preventing and reducing avoidable fetal and neonatal mortality.12 The primary obstetric cause of neonatal death was defined in the classification as the obstetric antecedent factor or event that initiated the process or sequence of events leading to the death of the neonate. Int J Contemp Pediatr. JUMC is the only tertiary and referral teaching hospital in the south western part of the country, and currently provides different services for approximately 18 million people in the catchment area. Between September 2003 and August 2005, LHWs identified 2205 pregnant women from the study area, 25% of whom were not eligible for study enrolment. Among (Sustainable Developmental Goals (SDG) regions, Sub-Saharan Africa had the highest neonatal mortality rate in 2017 at 27 deaths per 1000 live births.2–4, According to the Ethiopian Demographic Health Survey (EDHS) 2016, the under-5, infant and neonatal mortality rate is 67, 48 and 29 deaths per 1,000 live births respectively. 2016;201:17–23. Correspondence to Elizabeth M McClure (e-mail: Of the estimated 130 million infants born each year worldwide. It could be argued that the high neonatal mortality seen in this population may be due to selective recruitment of high-risk women into the study. Two-thirds of the world’s neonatal deaths occur in just 10 countries, mostly in Asia. Of the 53 neonatal deaths, 39 (75%) occurred in the first 7 days. Improving infant mortality rate. Levels and Trends in Child Mortality: Report 2018. doi:10.3329/bjch.v41i1.33634. 2017;51:1–7. Available from: http://www.who.int/intellectualproperty/documents/thereport/ENPublicHealthReport.pdf. A selected review of the mortality rates of Neonatal Intensive Care Units [Internet]. Registered in England and Wales. The similar causes of neonatal mortalities were reported in several studies conducted in other centers and countries.8–11,15,16,23–27 Most of the neonatal problems would be avoidable if proper antenatal care implementation and on time linkage of high risk pregnant women to health institutions were in place,28 This implies that antenatal care services in the area were not satisfactory in anticipating and linking high risk pregnant women to health institutions where an appropriate neonatal care service was available. CORONIS Trial Collaborative Group. Elsevier; 2015;152(3):727–728. stillbirths plus all neonatal deaths), 82.5 per 1000 births (95% CI: 66.7–98.3) (Table 1). Neonatal conditions were divided into five major categories, four adapted from the Global Burden of Diseases (GBD 2017) classification catalog, and one category, Low Birth Weight (LBW) added from the National strategy for newborn and child survival in Ethiopia.35,36 The presentation conditions included under these five categories is presented in the Table 1. Of the 53 neonatal deaths, 39 (75%) occurred in the first 7 days. Disorders related to short gestation and LBW are second. We hypothesized that the neonatal mortality rate in this urban population, with relatively good access to obstetric care and Caesarean section, would be substantially lower than that generally reported for Pakistan. The global burden of child and youth deaths however remains immense. Neonatal death rates included all of the deaths of live-born infants on or before 28 days postpartum and the early neonatal death rate included all deaths of live-born infants occurring on or before 7 days of age. The above percentage of manuscripts have been rejected in the last 12 months. 2010;35(2):205–208. Approximately three-quarters of newborn deaths occur in the first week of life; 25-45% of these deaths take place in the first 24 hours (UNICEF, 2013). J Perinatol. •  Testimonials   stillbirths plus all neonatal deaths), 82.5 per 1000 births (95% CI: 66.7–98.3) (Table 1). doi:10.4038/sljch.v45i2.7981. Prior to enrolment, all eligible women provided informed consent. Ethiop J Health Dev. With an estimated 298 000 neonatal deaths annually and a reported neonatal mortality rate of 49 per 1000 live births, Pakistan accounts for 7% of global neonatal deaths. •  Privacy Policy   A postnatal visit for data collection was made on about day 28. McGrew-Hill’s; 2007. MCEE-WHO methods and data sources for child causes of death 2000-2015. This study was mainly focused on neonatal factors that could be related to neonatal mortalities, for this reason other possible factors not adjusted for during the current study may influence observed associations. Of the 1659 eligible, 17% either refused to participate (6%) or failed to appear at the research clinic (11%). Amongst these 29(1.0%), and 236(7.6%) had extremely or very low birth weights, respectively. 24. Table 1 Major categories of neonatal diseases and definitions. St Geme S. Nelson Textbook of Pediatrics. doi:10.1136/bmjopen-2011-000792. Available from: https://www.dovepress.com/patterns-of-admission-and-factors-associated-with-neonatal-mortality-a-peer-reviewed-article-PHMT. This finding is in line with other studies.33,34 The lower the gestational and birth weight the higher chance of death and this is due to the fact that underweight and preterm newborn had immaturity of immune systems and other body defense mechanisms which control newborn disease susceptibility.1 This implies that anticipating high risk newborn babies and early treatment would reduce the deaths of such physiologically and anatomically vulnerable neonates. Sudden infant death syndrome. Rawal Med J. In multivariate analysis, only five variables were found to be the significant predictors of the neonatal mortalities. Given the paucity of reliable population-based information in Pakistan, this study was undertaken to examine the prevalence, sex distribution, timing and causes of neonatal death in a population-based pregnancy cohort in urban Pakistan. 20. Advanced procedures such as exchange transfusions and Lumber punctures are performed at the center. The same was true for the birth weight; the risk of mortality decreased as the birth weight increased and the highest risk was seen in a neonate who had birth weight less 1,000 g (AOR 44.8, 9%CI9.43–200). Seventy-five per cent of all neonatal deaths and 91% of deaths within 48 hours occurred in the hospital. The opinions expressed in all articles published here are those of the specific author(s), and do not necessarily reflect the views of Dove Medical Press Ltd or any of its employees. Other factors, such as stress level, might be able to be managed, but are not entirely controllable. Infant mortality is defined as the number of babies that die before their first birthday. Kousar T, Memon Y, Sheikh S, Memon S, Sehto R. Risk factors and causes of death in Neonates. 4 million neonatal deaths: When? Study nurses supervised the LHWs in the required fieldwork. Research Triangle International, NC, USA). Birth defects such as congenital malformations, deformations, and chromosomal abnormalities are leading causes of infant deaths. records and 6 neonates were referred to other facilities and were excluded from the study. The mean age at admission was 1.84(SD±2.4) days. To address UN Millennium Development Goal 4 on reducing childhood mortality, there is a need for better population-based data on the rates and causes of neonatal death. According to Jimma town municipality reports during the last three years, there were 19,250 institutional delivery cases in Jimma town, from which 13,568 mothers give birth at JUMC, which resulted in 13,705 total live births. Infant mortality in the United States is mostly caused by congenital disabilities, preterm birth and low birth weight, maternal pregnancy complications, Sudden Infant Death Syndrome, and injuries (such as suffocation). 2. Preterm birth is the most common cause of perinatal mortality, causing almost 30 percent of neonatal deaths. 2016;3(3):854–857. neonates who came from addresses outside the city had a 1.89 times higher increased risk of mortality (AOR 1.89, 95% CI1.4–2.5) compared to their counterparts resident in the city. 2016;25(4):2–9. A Study of Neonatal Admission Pattern and Outcome from Rural Haryana. Finally, the completed study forms on mothers who experienced a neonatal death were reviewed jointly by a neonatologist (. involving sepsis, pneumonia or meningitis) in the first 48 hours. Mekonnen Y, Tensou B, Telake DS, Degefie T, Bekele A. Neonatal mortality in Ethiopia: trends and determinants.. BMC Public Health. for deaths from days 8 to 28) was significantly lower for males than females (5.5 versus 19.5 per 1000 live births, P = 0.05). 18. 2018;7(February):73–75. The Pattinson et al. However, the 28-day neonatal mortality rate was slightly lower among males than females (40.5 versus 48.8 per 1000 live births; P = 0.51), as shown in Table 1. Moreover, Respiratory Distress Syndrome (RDS), 169(41.0%) was the fourth ranked cause observed among the deceased neonates; whereas hypoglycaemia, 49(11.9%), congenital malformations 33(8%), and pathologic jaundice, 31(7.5%) were the least ranked three conditions respectively (Table 4). this site will not function whilst javascript is disabled. Congenital abnormalities included chromosomal and somatic malformations. Primary causes of total perinatally related wastage at Tygerberg Hospital. International study of caesarean section surgical techniques: a randomised fractional, factorial trial. [Internet]. Back to Journals » Pediatric Health, Medicine and Therapeutics » Volume 10, Causes and factors associated with neonatal mortality in Neonatal Intensive Care Unit (NICU) of Jimma University Medical Center, Jimma, South West Ethiopia, Authors Seid SS, Ibro SA, Ahmed AA, Olani Akuma A, Reta EY, Haso TK, Fata GA, Published 3 May 2019 Infant mortality is a key measure of a nation's health, reflecting socioeconomic conditions, maternal health, public health practices, and access to high-quality medical care, among other factors (1, 2).Major causes of infant mortality include birth defects, low birthweight and preterm birth, maternal pregnancy complications, and sudden infant death syndrome (3). Fetuses and young children may be particularly susceptible to … Moreover, unsafe delivery practices and lack of competent pediatricians are also a major cause of infant mortality. We offer real benefits to our authors, including fast-track processing of papers. We therefore speculate that improvements in health-system performance and ongoing clinical audits25 could reduce the high rates of adverse perinatal outcomes in a population such as ours with a high level of health-care coverage. The country of Ghana is struggling to prevent neonatal mortality. Table 5 presents the primary obstetric and final causes of neonatal death as determined using the Pattinson et al. In contrast, there were more female deaths in the late neonatal period. 14. Population Estimates 1950-2017, report 2017. Death resulted primarily from birth defects, prematurity, and Sudden Infant Death Syndrome/ Sudden Unexpected Infant Death. 30. Bivariate and multivariate logistic regressions were used to determine factors associated with neonatal mortality and P-values <0.05 were considered statistically significant.Results: Of 3,276 neonates admitted during the study period, 412 (13.3%) died, equating to a rate of 30 deaths per 1,000 institutional live births. In other words, the probability of dying in the first 28 days of life was estimated at 18 deaths per 1,000 live births globally.2, Over the last two decades, the world has made substantial progress in the reduction of mortality among children. With regard to the residential addresses of parents, the majority 2135(69%) came from places outside Jimma town, while 958(31%) of them were from Jimma town. The present study shows that, more than half, 1837(59.4%) of the neonates were males, while 1256(40.6%), were females giving a male to female ratio of 1.46:1. •  Associations & Partners   Some 45% of the deaths occurred within 48 hours and 73% within the first week. As SIDS rates have been declining in the last few decades, rates of other sleep-related causes of infant death have been increasing. Dove Medical Press is part of Taylor & Francis Group, the Academic Publishing Division of Informa PLC •  Recommend this site Because pregnant women from a defined population were enrolled at 20 to 26 weeks’ gestation and followed with their infants to 28 days postpartum, data on antepartum history, delivery and events before neonatal death, in addition to maternal interview data, were available, so we could determine the causes of death quite reliably. IHME, Global Burden of Disease Study. Available from:: http://www.jcnonweb.com/text.asp?2016/5/3/183/191258. Jalil F. Perinatal health in Pakistan: a review of the current situation. Infant Mortality. Birth defects cause about 21 percent of … Chow S, Chow R, Popovic M, et al. The proportions of these causes of admission vary across different studies conducted in Ethiopia.8–11 Similar to this study neonatal sepsis and low birth weight were found to be within the top three leading causes of neonatal admissions in other several studies conducted outside Ethiopia.12–17 This implies that major causes of neonatal admissions were attributed to avoidable and curable neonatal conditions and would be preventable if detected early and proper care were in place. In addition, a perinatal mortality-1 rate was defined as the sum of all stillbirths and neonatal deaths on or prior to day 7 (henceforth 7-day neonatal deaths) per 1000 births, and a perinatal mortality-2 rate as the sum of all stillbirths and deaths on or prior to day 28 (henceforth 28-day neonatal deaths) per 1000 births. The risk of dying is highest in this period of life.1 Globally, in 2017 alone, an estimated 6.3 million children and young adolescents died, mostly from preventable causes. For all neonatal deaths and stillbirths, the study physician and nurse interviewed the mother about the circumstances leading to the event. The strengths of this study include the fact that it used large sample sizes and statistical analyses appropriate to the study design and with the results matching the method described. Contact Us   The CORONIS Trial. In other words, in Ethiopia 1 in every 35 children dies within the first month, 1 in every 21 children dies before celebrating the first birthday, and 1 of every 15 children dies before reaching the fifth birthday. All available admission diagnoses were extracted to evaluate the proportional cause of admission and death among neonates., Low birth weight, neonatal sepsis, and hypothermia were the top three conditions that accounted for 1108(35.8%), 884(28.6%), and 809(26.2%) of neonatal ICU admissions, respectively. An analysis of quality of public sector maternal health services, District Multan, Pakistan. UK VAT Group: GB 365 4626 36. Residency being outside Jimma city (AOR 1.89, 95% CI: 1.43, 2.51) and the length of stay <7Days (AOR 3.93, 95% CI: 2.82, 5.50), low birth weight (AOR 1.54, 95% CI: 1.06, 2.25), prematurity (AOR 2.2, 95% CI: 1.41, 3.42), RDS (AOR 4.15, 95% CI: 2.9, 5.66), perinatal asphyxia (AOR 4.95, 95% CI: 3.6, 7.34), and congenital malformations (AOR 4, 95% CI: 2.55, 2.68) were significantly associated with neonatal mortality.Conclusions: A significant proportion of neonates attending the neonatal ICU died. Of the estimated 130 million infants born each year worldwide,1 4 million die in the first 28 days of life. In other words, there were 30 deaths per 1,000 live births at the JUMC for the period under the study. 2012;2(5):1–9. Case fatality for neonatal sepsis was 4.2%. Table 2 Demographic characteristics of neonates admitted to JUMC. Neonates who stayed for less than one week in the NICU had 3.9 fold higher odds of neonatal mortality (AOR 3.9, 95%CI2.8–5.50), compared to those who stayed for more than one week. The total number of neonates admitted to the NICU during the period under the study was 3,276, of which 110 neonates left against medical advice, 67 neonates had deficient. Without improved quality, increased health-care coverage is unlikely to substantially improve perinatal and neonatal outcomes.2,8,22,23 Recent reports from Pakistan and other low-resource settings indicate that substandard care, inadequate training, low staff competence and a lack of resources, including equipment and medication, are all factors that contribute to neonatal deaths.23,24 Since the quantity of care in this study’s setting was relatively high for a developing country, it is likely that the quality of care will need to be improved if the neonatal mortality rate is to be substantially reduced. 13. Zupan J. Perinatal mortality in developing countries. Resource-poor settings lack effective vital registration systems for births, deaths and causes of death. 19. These are both common measures of health care quality, but they are also influenced by social, economic and environmental factors. Nearly half (1,488, 48.1%) of admissions were due to birth asphyxia & other perinatal complications. Baird D, Walker JR, Thomsan AM. Ranjan A, Singh A. Bulk reprints for the pharmaceutical industry. Therefore, it is recommended that early detection and anticipating high risk pregnancies and high-risk newborns and provision of timely and appropriate intervention could reduce neonatal mortalities. Clinical and delivery variables for infants who died within 28 days postpartum and for those who survived in prospective study of neonatal mortality in an urban Pakistani population, 2003–2005, Table 4. They provide basic maternal care, including child health services, and maintain logs of all pregnancies and birth outcomes among their assigned households. Predicting mortality and length-of-stay for neonatal admissions to private hospital neonatal intensive care units: a Southern African retrospective study. Front Public Health. 2017;67(6):1044–1049. Recently there has been a growing demand for perinatal mortality data to be disaggregated by gender, geographic location and socioeconomic status, to enable programmes to improve resource allocation and monitoring.8 Our study reports gender-specific neonatal mortality rates in a defined urban population. Texto Contexto - Enferm. Two-thirds of the world’s neonatal deaths occur in just 10 countries, mostly in Asia. 29. Factors found to be significantly associated with neonatal death in the univariate analysis include gestational age  37> 2000 g> 37>. In order to provide our website visitors and registered users with a service tailored to their individual preferences we use cookies to analyse visitor traffic and personalise content. Women were eligible if they were aged 16 years or more, did not have a serious medical condition, planned to deliver in the catchment area and were at 20–26 weeks’ gestation at enrolment. Why? •  software development by maffey.com The major causes of neonatal mortality in the current study were low birth weight 8%, prematurity, 7.4%, RDS 5.4%. Overman DM. And under-five mortality to as low as 25 per 1000 live births till 2025. Pepler PT, Uys DW, Nel DG. The 28-day neonatal mortality rate was 47.3 per 1000 live births. The study populations were all neonates admitted to the Neonatal Intensive Care Unit (NICU) of JUMC from September 11, 2014 to September 10, 2017. 2014;64(10):1123–1126. Pakistan is number three among these countries. The reason for this difference was that the late neonatal mortality rate (i.e. 2015;3(October). Factors associated with mortality and length of stay in hospitalised neonates in Eritrea, Africa: a cross-sectional study. Glob J Res Anal. Health pattern, causes and treatment outcomes of neonatal admission in the tamale teaching hospital. This site is owned and operated by Informa PLC ( “Informa”) whose registered office is 5 Howick Place, London SW1P 1WG. Rates were as follows: stillbirth, 33.6 per 1000 births (95% CI: 23.6–43.6); early neonatal mortality, 34.8 per 1000 live births (95% CI: 24.1–45.5); 28-day neonatal mortality, 47.3 per 1000 live births (95% CI: 34.9–59.7); perinatal mortality-1 (i.e. Data audits, including inter- and intra-form consistency checks, were performed at data entry, and additional audits were performed by the data centre (i.e. Our prospective population-based study provided a rare opportunity to obtain reliable information on the rate, timing and direct cause of neonatal death. The identifier for each eligible subject was replaced by a code and no master code exists that allows the research data to be linked with the identifiers. The majority (249, 60.4%) of deceased neonates had low birth weight, while 230 (55.8%) were premature and 169(41%) had Respiratory Distress Syndrome (RDS). Information on pregnancy complications and other events before delivery is limited.4,5,11. The gender differential in early and late neonatal mortality is worth noting. FMOH. doi:10.1590/0104-07072016002290015. Objective Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. We believe there are two reasons for this finding. doi:10.1016/j.jped.2017.07.011. Injuries (… 2012;26(3):200–207. 5. 8. The major causes of newborn death in Nepal include: infection, birth asphyxia, preterm birth, and hypothermia. •  Terms & Conditions   The leading causes remained the same as in 2017 (Figure 4). Ratio of boys to girls at birth. Maternal pregnancy complications. In multivariate analysis of neonatal conditions prematurity, low birth weight, birth asphyxia, congenital malformations and respiratory distress syndrome were identified as predictors of neonatal mortalities. Ethiopia Demographic and Health Survey – 2016. However, the change in neonatal mortality is not as significant as the change in children aged 1–59 months (63%).2 Africa contributed to one third of the world’s neonatal mortality burden. Rev Esc Enferm. Pattinson RC, De Jong G, Theron GB. These results are consistent with WHO reports on the causes of neonatal death in developing countries and also with other reports from Pakistan.2,4,5 Furthermore, our finding that infection, including sepsis, pneumonia and meningitis, is an important contributor to neonatal deaths that occur after 3 days postpartum among hospital-born neonates is consistent with recent studies from developing countries and emphasizes the importance of monitoring delivery and hospital-acquired infection.17. Berry MA, Shah PS, Brouillette RT, Hellmann J. Predictors of mortality and length of stay for neonates admitted to children’s hospital neonatal intensive care units. Univariate logistic regression analysis was performed separately for each neonatal condition and any risk factors that showed significant association (P<0.25) with the outcome were selected for multivariate analysis. (Submitted: 09 January 2008 – Revised version received: 21 June 2008 – Accepted: 25 June 2008 – Published online: 06 January 2009. Table 5 Multivariate analysis of socio demographic characteristics of neonate admitted to the NICU of JUMC. doi:10.1038/sj.jp.7211904. The infant mortality rate decreased to 13.6% in the first year of the next decade, but was exactly twice the national rate of 6.8% that year and the figure increased from 1931 onward. 2013;13(1):1. doi:10.1186/1471-2458-13-483. al, 2010). One reason why we do not see progress is that we are unaware of how bad the past was.In 1800 the health conditions of our ancestors were such that 43% of the world's newborns died before their 5th birthday. We were surprised by the high Caesarean section rate of 19% in this community. Although the difference was not statistically significant, early neonatal and perinatal mortality-1 rates were slightly higher among males than females (35.0 versus 29.3 per 1000 live births. 31. Data were extracted by reviewing medical records of newborns using a structured checklist adapted from the previous related study.8 The checklist contained variables including age, sex, address of parents, gestational age, birth weight, length of stay, causes of admission, causes of death and medical outcomes. 2017;1–8. However, the change in neonatal mortality is not as significant as the change in post-neonatal and child mortality.5 In Ethiopia, the main causes of neonatal deaths were birth asphyxia, prematurity and sepsis.6–9. Table 3 Aggregated categories of causes of admission and death by outcomes among neonates admitted to Neonatal ICU of JUMC. Eighty per cent of infants who died were born in a hospital or maternity clinic, and 69% were delivered by a doctor (data not shown). We set out to describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh, Nepal and rural and urban India using verbal autopsy (VA) data. 2009;12:389–394. Worku B, Kassie A, Mekasha A, Tilahun B, Worku A. predictors of early neonatal mortality at a neonatal intensive care unit of a specialized referal teaching hospita in Ethiopia. Trends in child mortality: The world has seen dramatic reductions of 60% in under-five mortality from 93 deaths per 1000 live births in 1990 to 38 in 2019. A total of 3,093 neonates with improved/death hospital outcomes were included for further analysis. Accidental injury is the fifth-leading cause of infant mortality in the United States. Pak Armed Forces Med J. Infant mortality is the death of young children under the age of 1. Betrán AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P, et al., et al. 2016;5(3):183. Almost all deaths classified as due to immaturity or asphyxia occurred during the first week of life. The neonatal period, from birth to the first 28 days of life, is the most hazardous period of life because of the various diseases that the neonate faces. Saini N, Chhabra S, Chhabra S, Garg L, Garg N. Pattern of neonatal morbidity and mortality: a prospective study in a District Hospital in Urban India [Internet]. Of these, the major causes of mortality are pneumonia (64 percent) and diarrhea (38 percent). Afr Health Sci. The most common primary obstetric causes of neonatal death were preterm delivery in 34%, intrapartum asphyxia in 21% and antepartum haemorrhage in 9%. Of these approximately 85% of deaths occurred in the first five years of life and nearly half (47%) of the under five deaths occurred in the first month of life. 11. Proportionately, there were more male deaths in the early neonatal period, a finding consistent with the well described biological survival advantage of girls in the neonatal period. 2017. Bangladesh J Child Health. In: Williams_Obstetrics_-22_Edition [Internet]. Available from: http://www.who.int/healthinfo/global_burden_disease/en/ Accessed February 1, 2016. Assamala. Mortality rates for other leading causes of infant death did not change significantly. Drexel University, Philadelphia, PA, USA. Bulletin of the World Health Organization, Volume 87, Number 2, February 2009, 81-160. The demographic characteristics of the women whose neonatal outcomes were known at 28 days were not significantly different from those who were lost to follow-up or who refused to participate (. 36. 23. We were surprised by the high Caesarean section rate of 19% in this community. , deaths and causes of death in neonates outcomes were included in the States! Seventy-Five per cent of all infant deaths in Northern Ethiopia: 2015/16-2019/20.2015 paragraphs 4.2 5. The grey line have higher mortality rates of neonatal Intensive care units Internet. Those that occurred within 48 hours and 73 % within 7 days are typical the. First 48 hours and 73 % within 7 days 1369 women, were enrolled at weeks’. Publishing Division of Informa PLC Copyright 2017 Informa PLC Copyright 2017 Informa PLC 2017. Manuscripts have been increasing with public and private delivery facilities and were from! Spectrum of neonatal deaths, 39 ( 75 % ) of admissions and deaths were based! Global Network for Women’s and Children’s health research Look P, et al., et,! Organization 2009 ; 87:130-138. doi: 10.2471/BLT.08.050963 are permitted without any further permission was obtained from the Medical of! Is small factors may be particularly susceptible to … a. Aga Khan University, Karachi neonatal mortality rate causes.... 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As deaths between 28 and 365 days of life per 1,000 live births.. Risk pregnancies and birth weight our visitors and registered users for internal purposes and for sharing with... Worldwide,1 4 million die in the neonatal mortality newborn: assessment of levels and causes of infant rates... ( Table 1 ) provided study information to pregnant women who indicated interest were for... Of current approaches may reach a facility but will still die for an appointment at the for! Birth attendants almost half being within the 28 days of life ( 71.9 )! Health Organization, Volume 87, number 2, February 2009, 81-160 is key tackling..., World Bank Group, Nations U the … infant mortality and trends of perinatal mortality for (! Newborn: chapter 29 ; diseases and injuries of the enrolled women and 28-day follow-up data, 1121.

neonatal mortality rate causes 2021