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Predictors for neonatal death in the rural areas of Shaanxi Province of Northwestern China: a cross-sectional study.

Li C, Yan H, Zeng L, Dibley MJ, Wang D - BMC Public Health (2015)

Bottom Line: In the multiple logistic regression, the odds of neonatal death was significantly higher for multiparous women (OR = 2.77; 95% CI: 1.34, 5.70) and women who did not receive antennal health care in the first trimester of pregnancy (OR = 2.49; 95% CI: 1.41, 4.40).Women who gave birth in a county-level hospital (OR = 0.18; 95% CI: 0.04, 0.86) and had junior high school or higher education level (OR = 0.20; 95% CI: 0.05, 0.84) were significantly protected from neonatal death.Multipara, low educational level of the women, availability of prenatal visits in the first trimester of pregnancy and hospital delivery should be considered when planning the interventions to reduce the neonatal mortality in rural areas.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Health Statistics, Xi'an Jiaotong University Health Science Center, Xi'an, PR China. lichao.xjtu1985@stu.xjtu.edu.cn.

ABSTRACT

Background: Almost all (99%) neonatal deaths arise in low-income and middle-income countries. Approximately 450 new-born children die every hour, which is mainly from preventable causes. There has been increased recognition of the need for these countries to implement public health interventions that specifically target neonatal deaths. The purpose of this paper is to identify the predictors of neonatal death in Type 4 rural (poorest) counties in Shaanxi Province of northwestern China.

Methods: A cross-sectional study was conducted in Shaanxi Province, China. A single-stage survey design was identified to estimate standard errors. Because of concern about the complex sample design, the data were analysed using multivariate logistic regression analysis. Socioeconomic and maternal health service utilization factors were added into the model.

Results: During the study period, a total of 4750 women who delivered in the past three years were randomly selected for interview in the five counties. There were 4880 live births and 54 neonatal deaths identified. In the multiple logistic regression, the odds of neonatal death was significantly higher for multiparous women (OR = 2.77; 95% CI: 1.34, 5.70) and women who did not receive antennal health care in the first trimester of pregnancy (OR = 2.49; 95% CI: 1.41, 4.40). Women who gave birth in a county-level hospital (OR = 0.18; 95% CI: 0.04, 0.86) and had junior high school or higher education level (OR = 0.20; 95% CI: 0.05, 0.84) were significantly protected from neonatal death.

Conclusions: Public health interventions directed at reducing neonatal death should address the socioeconomic factors and maternal health service utilization, which significantly influence neonatal mortality in rural China. Multipara, low educational level of the women, availability of prenatal visits in the first trimester of pregnancy and hospital delivery should be considered when planning the interventions to reduce the neonatal mortality in rural areas.

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Permillage of neonatal mortality rate, early neonatal mortality and late neonatal mortality among five counties.
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Fig1: Permillage of neonatal mortality rate, early neonatal mortality and late neonatal mortality among five counties.

Mentions: A total of 54 out of 4800 new-borns (96 women delivered more than one baby in the past three years) had died by Day 28. Thirty-eight of these deaths occurred during the first week of life. The point estimation of NMR in Shaanxi Province is 11.3%; the early NMR is 7.9%, accounting for 69.9% of neonatal deaths. Bing and Lin You counties had the highest NMR among the five counties. The numbers of neonatal deaths in Bing and Lin You counties were 17 and 14, and more than 13 allowed defects (FigureĀ 1).Figure 1


Predictors for neonatal death in the rural areas of Shaanxi Province of Northwestern China: a cross-sectional study.

Li C, Yan H, Zeng L, Dibley MJ, Wang D - BMC Public Health (2015)

Permillage of neonatal mortality rate, early neonatal mortality and late neonatal mortality among five counties.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4403673&req=5

Fig1: Permillage of neonatal mortality rate, early neonatal mortality and late neonatal mortality among five counties.
Mentions: A total of 54 out of 4800 new-borns (96 women delivered more than one baby in the past three years) had died by Day 28. Thirty-eight of these deaths occurred during the first week of life. The point estimation of NMR in Shaanxi Province is 11.3%; the early NMR is 7.9%, accounting for 69.9% of neonatal deaths. Bing and Lin You counties had the highest NMR among the five counties. The numbers of neonatal deaths in Bing and Lin You counties were 17 and 14, and more than 13 allowed defects (FigureĀ 1).Figure 1

Bottom Line: In the multiple logistic regression, the odds of neonatal death was significantly higher for multiparous women (OR = 2.77; 95% CI: 1.34, 5.70) and women who did not receive antennal health care in the first trimester of pregnancy (OR = 2.49; 95% CI: 1.41, 4.40).Women who gave birth in a county-level hospital (OR = 0.18; 95% CI: 0.04, 0.86) and had junior high school or higher education level (OR = 0.20; 95% CI: 0.05, 0.84) were significantly protected from neonatal death.Multipara, low educational level of the women, availability of prenatal visits in the first trimester of pregnancy and hospital delivery should be considered when planning the interventions to reduce the neonatal mortality in rural areas.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Health Statistics, Xi'an Jiaotong University Health Science Center, Xi'an, PR China. lichao.xjtu1985@stu.xjtu.edu.cn.

ABSTRACT

Background: Almost all (99%) neonatal deaths arise in low-income and middle-income countries. Approximately 450 new-born children die every hour, which is mainly from preventable causes. There has been increased recognition of the need for these countries to implement public health interventions that specifically target neonatal deaths. The purpose of this paper is to identify the predictors of neonatal death in Type 4 rural (poorest) counties in Shaanxi Province of northwestern China.

Methods: A cross-sectional study was conducted in Shaanxi Province, China. A single-stage survey design was identified to estimate standard errors. Because of concern about the complex sample design, the data were analysed using multivariate logistic regression analysis. Socioeconomic and maternal health service utilization factors were added into the model.

Results: During the study period, a total of 4750 women who delivered in the past three years were randomly selected for interview in the five counties. There were 4880 live births and 54 neonatal deaths identified. In the multiple logistic regression, the odds of neonatal death was significantly higher for multiparous women (OR = 2.77; 95% CI: 1.34, 5.70) and women who did not receive antennal health care in the first trimester of pregnancy (OR = 2.49; 95% CI: 1.41, 4.40). Women who gave birth in a county-level hospital (OR = 0.18; 95% CI: 0.04, 0.86) and had junior high school or higher education level (OR = 0.20; 95% CI: 0.05, 0.84) were significantly protected from neonatal death.

Conclusions: Public health interventions directed at reducing neonatal death should address the socioeconomic factors and maternal health service utilization, which significantly influence neonatal mortality in rural China. Multipara, low educational level of the women, availability of prenatal visits in the first trimester of pregnancy and hospital delivery should be considered when planning the interventions to reduce the neonatal mortality in rural areas.

Show MeSH
Related in: MedlinePlus