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Preterm neonatal mortality in China during 2009-2018: A retrospective study
Xue Yu1, Chunhua He1, Yanping Wang1
1National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Plos One
|December 8, 2021
Summary
Neonatal mortality from preterm birth significantly declined from 2009-2018, but regional disparities persist. Preterm infants born before 32 weeks require targeted interventions, especially in western China.
Area of Science:
- Neonatal Health
- Public Health
- Epidemiology
Background:
- Preterm birth is a leading cause of neonatal mortality globally.
- Regional variations in healthcare resources impact neonatal outcomes.
- Understanding epidemic characteristics is crucial for targeted interventions.
Purpose of the Study:
- To analyze the epidemic characteristics of neonatal mortality due to preterm birth (28-36 weeks gestation) in China from 2009-2018.
- To identify regional disparities in preterm birth mortality and its causes.
- To evaluate trends and risk factors associated with preterm neonatal mortality.
Main Methods:
- Retrospective analysis of data from China's Under-5 Child Mortality Surveillance System (U5CMSS).
- Utilized statistical methods including the χ2 trend test, Poisson regression, and the Cochran-Mantel-Haenszel method.
- Examined mortality rates, annual decline rates, and relative risks across eastern, central, and western China.
Main Results:
- Preterm infants accounted for 42.0%-51.3% of neonatal deaths, with immaturity as the primary cause (60.1%-69.5%).
- Preterm neonatal mortality rates due to immaturity declined significantly across all regions, but remained higher in western China.
- The relative risk of mortality increased over time, particularly in central and western regions. Higher proportions of deaths occurred in infants <32 weeks gestation, and fewer were delivered in medical institutions in the western region.
Conclusions:
- Despite overall declines, significant regional disparities in preterm birth mortality persist in China.
- Infants born preterm, especially before 32 weeks gestation, require focused attention and enhanced survival programs.
- Region-specific interventions, considering economic and healthcare resource availability, are essential for improving child survival rates.
