Neonatal Mortality
Causes of Death Data
While great strides have been made to reduce the number of neonatal deaths globally, they still account for 47% of all child deaths under the age of 6 with highest burden in Sub-Saharan Africa and southern and central Asia. As of 2022 Sub-Saharan Africa had the highest rate of neonatal mortality with 27 deaths per 1000 live births with central and southern Asian having 21 deaths per 1000 live births. 75% of neonatal deaths occur within the first week of life; leading causes of death include premature birth, birth complications such as birth asphyxia/trauma, infections, and congenital abnormalities. At the current rate of reduction 64 countries will still fall short of meeting the 2030 Sustainable Development Goals target to reduce neonatal mortality.
NEONATAL MORTALITY
Quick Facts
Neonatal mortality, including stillbirths, remains a devastating global issue, with nearly 2 million babies lost in 2021. CHAMPS is addressing this crisis by working in high-risk regions like sub-Saharan Africa and Southern Asia, using data-driven solutions to prevent these tragedies and save lives.
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Stillbirths in Sub-Saharan Africa & Southern Asia
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Total stillbirths in Sub-Saharan Africa
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Total stillbirths in Southern Asia
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Global stillbirth rate estimate in 2021
The CHAMPS Network collects cause of death data for stillbirths and children under 5 years of age across seven countries in sub-Saharan Africa and South Asia; Mozambique began enrollment in 2016, South Africa, Kenya, Mali, and Bangladesh began in 2017, and Sierra Leone and Ethiopia began in 2019. Between December 2016 and December 2021 CHAMPS conducted minimally invasive autopsies (MITS) on 1,673 neonates with 1,458 having cause of death determined by a determination of cause of death (DeCoDe) panel. (See Fig. 1)
Among the deaths 41% occurred in the first 24 hours, 41% occurred in the next 6 days, and 18% occurred in the subsequent 21 days.
Fig. 1 Percentage of Neonatal deaths per site
The underlying cause of death for neonatal mortality were categorized as the following: congenital malformations, disorders related to fetal growth, birth trauma, complications of intrapartum events, convulsion and disorder of cerebral status, infections, respiratory and cardiovascular disorders, and low birth weight/prematurity complications. The underlying cause of death could not be determined for 21 deaths . (See Fig. 2)
Fig. 2 Underlying Causes of death for newborn deaths enrolled in CHAMPS [2]
Among the category of intrapartum events intrauterine hypoxia (233/1458)) and birth asphyxia (207/1458) accounted for the majority of deaths. Congential malformations of the nervous system and (21/1458) congenital malformations and deformations of the musculoskeletal system (29/1458) were the top two conditions found for congential malformations. The majority of infectious causes found included infections related to the perinatal period (166/1458), congenital pneumonia (33/1458), and bacterial and viral pneumonia (28/1458). Low birth weight accounted for 353 (out of 1458) deaths. Respiratory distress syndrome of newborn accounted for 125 (out of 1458) deaths [2] .
To further understand neonatal mortality, it is imperative to understand the maternal condition at the time of death. CHAMPS founds that 60% or 873 deaths (out of 1458) were related to a maternal condition. Maternal conditions that occurred during the neonatal period included complications of placenta, cord, and membranes, pregnancy complications, complications of labor and delivery, and maternal medical and surgical conditions. (See Table 3) Overall neonatal deaths that occurred close to birth more frequently had a maternal condition identified as contributing to the death than deaths that occurred later [2] .