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[Infant mortality from congenital malformations in Chile: temporal and spatial analysis, 1997-2011]
José Edgardo Dipierri1, Nieves Elena Acevedo2, Rubén Adrian Bronberg3
1Instituto de Biología de la Altura, San Salvador, Jujuy, Argentina.
Insights
Infant mortality from congenital malformations (CM) in Chile decreased from 1997-2011, but deaths from CM increased as a percentage. Regional disparities in infant mortality persist, especially in southern Chile.
Area of Science:
- Public Health
- Epidemiology
- Demography
Background:
- Infant mortality remains a key public health indicator.
- Congenital malformations (CM) are a significant cause of infant death globally.
- Understanding the spatial and temporal trends of CM-related infant mortality is crucial for targeted interventions.
Purpose of the Study:
- To analyze the spatial and temporal distribution of infant mortality due to congenital malformations (CM) in Chile between 1997 and 2011.
- To identify trends in infant mortality rates from CM (IMR-CM) and the percentage of deaths from CM (PD-CM) across different regions and by affected systems.
- To assess the secular trends and regional variations in infant mortality from CM in Chile.
Main Methods:
- Utilized national birth and death data (ICD-10 coded) from Chile's National Statistics Institute.
- Calculated IMR-CM and PD-CM for three periods (1997-2001, 2002-2009, 2007-2011) across administrative and natural regions.
- Employed Poisson regression models to estimate secular trends and risk variations in infant mortality from CM.
Main Results:
- Observed a negative secular trend for IMR-CM and a positive secular trend for PD-CM nationwide (P < 0.01).
- Found mild spatial heterogeneity in IMR-CM and PD-CM across all regions, with the Central region mirroring national patterns.
- Noted negative secular trends for IMR-CM associated with nervous and cardiovascular systems, and specific CMs like anencephaly and spina bifida.
Conclusions:
- Chile appears to be in the later stages of the epidemiological transition regarding infant mortality causes.
- Significant regional disparities in infant mortality from CM were identified, particularly in the southern regions.
- Further investigation into regional variations is warranted to address persistent health inequities.
Objective:
To analyze the spatial and temporal distribution (1997-2011) of infant mortality resulting from congenital malformations (CM) in Chile.
Methods:
Data on births and deaths among infants aged less than one year using ICD-10 coding were obtained from the National Statistics Institute. The percentage of deaths from CM (PD-CM) and the infant mortality rate from CM (IMR-CM) during three different periods (1997-2001, 2002-2009, 2007-2011) were estimated for Chile's administrative and natural regions (Norte Grande, Norte Chico, Central, Austral, and Sur), broken down by systems (nervous, cardiovascular, digestive, genitourinary, musculoskeletal, and chromosomal abnormalities) and by 28 specific malformations. The secular trend and the variation in the risk of death were estimated using a Poisson regression model.
Results:
For the whole of Chile, the secular trend for the IMR-CM was negative, and the secular trend for the PD-CM was positive (P < 0,01). The IMR-CM and the PD-CM both showed mild spatial heterogeneity in all administrative and natural regions. The Central region was the natural region that came closest to showing the pattern observed nationwide. The IMR-CM involving the nervous and cardiovascular systems and specific types of CM (anencephaly, spina bifida, and atrial and ventricular septal defects) showed a negative secular trend. For Chile as a whole, the pattern of infant mortality from CM is marked by a drop in the IMR-CM and by an increase in the PD-CM over the period from 1997 to 2011.
Conclusion:
The findings suggest that Chile is in the latter stages of the epidemiological transition with respect to the causes of infant mortality. However, these indicators show disparities between regions, more pronounced in the south of the country.
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