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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Repeated neonatal deaths in families with special reference to causes of death
1Health and Demographic Surveillance Programme, International Centre for Diarrhoeal Disease Research, Bangladesh.
Insights
A prior infant death from non-infectious causes increases the risk of a subsequent sibling dying from similar causes. Maternal and child health programs reduced infectious disease deaths but not non-infectious ones.
Area of Science:
- Perinatal and neonatal health
- Epidemiology of infant mortality
- Public health interventions
Background:
- Infant mortality risk is elevated following a sibling's death.
- Understanding specific causes and timing of sibling mortality is crucial for targeted interventions.
Purpose of the Study:
- To investigate the relationship between the cause of an older sibling's death and the mortality risk of a younger sibling.
- To determine the timing of this increased risk for neonatal and post-neonatal periods.
- To evaluate the impact of the maternal and child health and family planning (MCH-FP) project on mortality from different causes.
Main Methods:
- Utilized longitudinal vital events data from Matlab, Bangladesh (1989-92).
- Analyzed causes of death (infectious vs. non-infectious) for 18,865 singleton live births and their immediate elder siblings.
- Employed multinomial logistic regression to assess risks, controlling for biosocial factors.
Main Results:
- A neonatal death due to non-infectious causes was associated with a twofold increased risk of a subsequent neonatal death from similar causes.
- This increased risk was specific to the same age period (neonatal).
- The MCH-FP project effectively reduced mortality from infectious diseases but showed no significant impact on non-infectious causes of death.
Conclusions:
- Non-infectious causes of infant death pose a familial risk, particularly within the neonatal period.
- Public health interventions need to address non-infectious causes of infant mortality more effectively.
- The MCH-FP project's success in reducing infectious disease mortality highlights the need for tailored strategies for non-infectious causes.
Abstract:
It is recognized that one infant death in a family indicates an increased risk of death of a subsequent sibling. This study examines which cause of death of a sibling is related to the mortality of the younger sibling and when. Longitudinal vital events data from the maternal and child health and family planning (MCH-FP) project and the comparison areas in Matlab, Bangladesh, were used. Primary causes of 868 neonatal deaths and 624 post-neonatal deaths resulting from 18,865 singleton live births in 1989-92 and those (967 as neonates and 708 as post-neonates) of their immediate elder siblings were categorised into infectious and non-infectious diseases. Multinomial logistic regression was used to estimate the risk of younger siblings dying in each age period from infectious and non-infectious diseases given the age and cause of deaths of older siblings and controlling for other biosocial correlates of infant mortality. A neonatal death of non-infectious causes in a family was twice as likely to be followed by another one occurring at the same age from similar causes compared with a surviving infant followed by a neonatal death from non-infectious causes. The MCH-FP project, though successful in reducing the risk of neonatal and post-neonatal mortality from infectious diseases, did not reduce the risk of dying from non-infectious diseases.
