4 million neonatal deaths: when? Where? Why?

Publisher: Elsevier Country of Publication: England NLM ID: 2985213R Publication Model: Print Cited Medium: Internet ISSN: 1474-547X (Electronic) Linking ISSN: 01406736 NLM ISO Abbreviation: Lancet Subsets: MEDLINE

Publication: 2004- : London : Elsevier
Original Publication: London : J. Onwhyn

Infant Mortality*; Adolescent ; Adult ; Africa/epidemiology ; Asia/epidemiology ; Cause of Death ; Developing Countries/statistics & numerical data ; Female ; Healthy People Programs ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Insurance, Health ; Male ; Pregnancy ; Pregnancy Complications ; Risk Factors ; Socioeconomic Factors

The proportion of child deaths that occurs in the neonatal period (38% in 2000) is increasing, and the Millennium Development Goal for child survival cannot be met without substantial reductions in neonatal mortality. Every year an estimated 4 million babies die in the first 4 weeks of life (the neonatal period). A similar number are stillborn, and 0.5 million mothers die from pregnancy-related causes. Three-quarters of neonatal deaths happen in the first week--the highest risk of death is on the first day of life. Almost all (99%) neonatal deaths arise in low-income and middle-income countries, yet most epidemiological and other research focuses on the 1% of deaths in rich countries. The highest numbers of neonatal deaths are in south-central Asian countries and the highest rates are generally in sub-Saharan Africa. The countries in these regions (with some exceptions) have made little progress in reducing such deaths in the past 10-15 years. Globally, the main direct causes of neonatal death are estimated to be preterm birth (28%), severe infections (26%), and asphyxia (23%). Neonatal tetanus accounts for a smaller proportion of deaths (7%), but is easily preventable. Low birthweight is an important indirect cause of death. Maternal complications in labour carry a high risk of neonatal death, and poverty is strongly associated with an increased risk. Preventing deaths in newborn babies has not been a focus of child survival or safe motherhood programmes. While we neglect these challenges, 450 newborn children die every hour, mainly from preventable causes, which is unconscionable in the 21st century.

Comment in: Lancet. 2005 May 28-Jun 3;365(9474):1845. (PMID: 15924974)

Date Created: 20050309 Date Completed: 20050323 Latest Revision: 20220410

20221213

10.1016/S0140-6736(05)71048-5

15752534