Leading causes of global neonatal death identified
MedWire News: Preterm birth and intrapartum complications, and sepsis and meningitis, are the leading causes of neonatal death globally, say researchers in The Lancet.
Although there have been major reductions in mortality among children, few countries will achieve the Millennium Development Goal (MDG) 4, which is to reduce global child mortality by two‑thirds by 2015.
"In the past decade, the country-specific under-5 mortality rate reduced at an average rate of 2.6% per year, which is less than 4.4% of the annual rate of decrease needed to reach MDG4," commented lead author Robert Black (John Hopkins Bloomberg School of Public Health, Maryland, USA) in a press statement.
"The attainment of MDG4 is possible only if life-saving maternal, newborn, and child health interventions are rapidly scaled up in high-burden regions and countries and across major causes in the next few years."
For their study, Black and team applied the updated total numbers of deaths in children aged 0‑27 days and 1‑59 months to the corresponding country-specific distribution of deaths by cause.
To derive the number of deaths in children aged 1‑59 months, the researchers used vital registration data for countries with an adequate registration system. They applied a multinomial logistic regression model to registration data for low-mortality countries without adequate registration.
Of 7.6 million deaths in children younger than 5 in 2012, 4.879 million (64.0%) were attributed to infectious causes and 3.072 million (40.3%) overall occurred in neonates.
Preterm birth complications, intrapartum-related complications, and sepsis or meningitis were the leading causes of neonatal death, at 14.1%, 9.4%, and 5.2%, respectively.
Injury and congenital abnormalities were also important causes of neonatal mortality, and were responsible for 4.6% and 3.5% of neonatal deaths, respectively.
Overall, the decreases in under 5-mortality rates were greater in children aged 1‑59 months than they were in neonates, at 2.9% per year versus 2.1% per year, which meant that the neonatal fraction of deaths increased from 38.2% to 40.3% from 2000 to 2010.
"Two-fifths of deaths in children younger than 5 years occurred in the first 28 days of their life, indicating the crucial importance of the reduction of neonatal deaths if countries are to achieve MDG4," write the authors.
"More rapid decreases from 2010‑2015 will need accelerated reduction for the most common causes of death, notably pneumonia and preterm birth complications. Continued efforts to gather high-quality data and enhance estimation methods are essential for the improvement of future estimates," they conclude.
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By Piriya Mahendra