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Neonatal and postneonatal mortality in Germany since unification
E Nolte1, A Brand, I Koupilová
1European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine.
Journal of Epidemiology and Community Health
|March 15, 2000
Summary
Infant mortality rates in East and West Germany converged after unification, driven by improved perinatal care and survival of very low birth weight infants. Focus on preventive measures is recommended due to increasing numbers of low birth weight babies.
Area of Science:
- Public Health
- Perinatal Medicine
- Demography
Background:
- Post-unification Germany saw widening infant mortality gaps between East and West, with unclear causes.
- Trends in infant mortality rates (IMR) showed initial divergence followed by convergence.
Purpose of the Study:
- To analyze neonatal and postneonatal mortality trends in Eastern (new Länder) and Western (old Länder) Germany post-1990 unification.
- To identify factors influencing these trends and areas for further infant mortality reduction.
Main Methods:
- Analysis of vital statistics data from 1990-1997.
- Examination of trends in birth weights, birth weight-specific neonatal mortality, and cause-specific postneonatal mortality.
Main Results:
- Neonatal mortality decreased significantly in both East (33%) and West (17%), largely due to improved survival of very low birth weight infants.
- Postneonatal mortality initially worsened in the East but then declined, leading to comparable rates in both regions by 1997.
- While deaths from diseases decreased, deaths from accidents and injuries remained higher in the East.
Conclusions:
- Convergence in infant health indicators suggests improved perinatal care quality post-unification.
- Increasing proportions of very low birth weight infants necessitate a focus on preventive strategies to further reduce infant mortality in Germany.