Neonatal infection-associated mortality in China, a population-based study, 2003–2008

Abstract

Objective: To examine trends in the major causes and rates of neonatal infection-associated mortality (NIMRs) in different geographical regions in China from 2003 to 2008. Methods: Neonatal mortality data collected from the Chinese National Women and Children’s Health Surveillance Network were analyzed. Results: The NIMRs declined. Pneumonia, sepsis and diarrhea were the top three infections that caused neonatal deaths. Compared to the coastal region, the relative risk (RR) of NIMRs in the remote and inland regions declined from 5.52 (95% CI: 4.05–7.52) and 2.37 (95% CI: 1.72–3.25) during 2003–2005 to 3.45 (95% CI: 2.58–4.61) and 1.72 (95% CI: 1.28–2.31) during 2006–2008, respectively. Once again, compared to the coastal region, the risk of pneumonia-specific mortality had significant regional disparities during 2006–2008 with a RR of 3.82 (95% CI: 2.74–5.32) in the remote region and 2.01 (95% CI: 1.44–2.80) in the inland region. The NIMRs in the remote region was characterized by more home deliveries and non-healthcare seeking behavior prior to death than the coastal region. Conclusions: Infection is still one of the main causes of neonatal mortality in China. Although the NIMRs have been declining, disparities concerning neonatal infection-associated and pneumonia-specific neonatal morality still exist. Approaches for reducing mortality of neonatal infections will efficiently decrease total neonatal mortality.

Keywords::

• Cause-specific mortality
• China
• infection
• neonatal mortality rate
• relative risk
• surveillance

Acknowledgements

The authors would like to thank all health workers in this surveillance system for providing the data and investigating the cause of death.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. This work was supported by the Chinese Ministry of Health (grants QT2003-009 and 05wsb-02), UNICEF (grant YH601-11-1141) and Program for Changjiang Scholars and Innovative Research Team in University (IRT0935).