Patterns of infant mortality from 1993 to 2007 in Belgrade (Serbia)

The population of the Republic of Serbia has been exposed to radical changes in living standards and employment status and inequalities in utilization of health-care services. Given that infant mortality rates (IMR) reflect general community health, we evaluated the trends and mortality structure of Belgrade's infant population for a 15-year period (1993-2007). Data were collected from published and unpublished materials of the Municipal Institute of Statistics in Belgrade. Records were based on official notifications of live-born infants and death certificates. A linear regression equation was used to estimate mortality trends over time, while an F test was performed to assess the significance of the linear regression coefficient. The average IMR was 11.3 [95% confidence interval (CI) 9.4, 13.2] per 1,000 live births for both sexes with a higher average rate observed for male infants. Throughout the whole period, a statistically significant declining trend (y = 17.072 - 0.721x, p = 0.001) was noted. The most common causes of death were conditions occurring during the perinatal period, with an average annual mortality rate of 7.7 [95% CI 6.4, 8.9] per 1,000, arising mainly from respiratory distress of the newborns. Regarding congenital anomalies, deformations of the heart and aortic and mitral valves were most frequently found. A statistically significant inverse correlation was observed between average net salary and IMR for each sex separately (for males r = -0.727, p = 0.002, for females r = -0.721, p = 0.002) and for both sexes jointly (r = -0.759, p = 0.001). A decline in infant mortality in Belgrade has been observed. However, further promotion of health-related activities, as well as continuous surveillance of IMR, is required.