Antenatal and perinatal predictors of infant mortality in rural Malawi
BACKGROUND The slow pace in the reduction of infant mortality in sub-Saharan Africa has partially been attributed to the epidemic of human immunodeficiency virus (HIV) infection. To facilitate early interventions, antenatal and perinatal predictors of 1st year mortality were identified in a rural co...
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| Veröffentlicht in: | Archives of disease in childhood. Fetal and neonatal edition 2000-05, Vol.82 (3), p.F200-F204 |
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| container_title | Archives of disease in childhood. Fetal and neonatal edition |
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| creator | Vaahtera, Merimaaria Kulmala, Teija Ndekha, MacDonald Koivisto, Anna-Maija Cullinan, Timothy Salin, Marja-Leena Ashorn, Per |
| description | BACKGROUND The slow pace in the reduction of infant mortality in sub-Saharan Africa has partially been attributed to the epidemic of human immunodeficiency virus (HIV) infection. To facilitate early interventions, antenatal and perinatal predictors of 1st year mortality were identified in a rural community in southern Malawi. METHODS A cohort of 733 live born infants was studied prospectively from approximately 24 gestation weeks onwards. Univariate analysis was used to determine relative risks for infant mortality after selected antenatal and perinatal exposures. Multivariate modelling was used to control for potential confounders. FINDINGS The infant mortality rate was 136 deaths/1000 live births. Among singleton newborns, the strongest antenatal and perinatal predictors of mortality were birth between May and July, maternal primiparity, birth before 38th gestation week, and maternal HIV infection. Theoretically, exposure to these variables accounted for 22%, 22%, 17%, and 15% of the population attributable risk for infant mortality, respectively. INTERPRETATION The HIV epidemic was an important but not the main determinant of infant mortality. Interventions targetting the offspring of primiparous women or infants born between May and July or prevention of prematurity would all have considerable impact on infant survival. |
| doi_str_mv | 10.1136/fn.82.3.F200 |
| format | Article |
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To facilitate early interventions, antenatal and perinatal predictors of 1st year mortality were identified in a rural community in southern Malawi. METHODS A cohort of 733 live born infants was studied prospectively from approximately 24 gestation weeks onwards. Univariate analysis was used to determine relative risks for infant mortality after selected antenatal and perinatal exposures. Multivariate modelling was used to control for potential confounders. FINDINGS The infant mortality rate was 136 deaths/1000 live births. Among singleton newborns, the strongest antenatal and perinatal predictors of mortality were birth between May and July, maternal primiparity, birth before 38th gestation week, and maternal HIV infection. Theoretically, exposure to these variables accounted for 22%, 22%, 17%, and 15% of the population attributable risk for infant mortality, respectively. INTERPRETATION The HIV epidemic was an important but not the main determinant of infant mortality. Interventions targetting the offspring of primiparous women or infants born between May and July or prevention of prematurity would all have considerable impact on infant survival.</description><identifier>ISSN: 1359-2998</identifier><identifier>EISSN: 1468-2052</identifier><identifier>DOI: 10.1136/fn.82.3.F200</identifier><identifier>PMID: 10794786</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</publisher><subject>AIDS/HIV ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; antenatal predictors ; Babies ; Biological and medical sciences ; Children & youth ; Emergency and intensive care: neonates and children. Prematurity. Sudden death ; Epidemics ; Female ; Gestational Age ; GNP ; Gross National Product ; HIV ; HIV Infections - mortality ; Hospitals ; Human immunodeficiency virus ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Infants ; Intensive care medicine ; Malawi - epidemiology ; Malnutrition ; Maternal Age ; Medical sciences ; Multivariate Analysis ; Offspring ; Original ; Parity ; Pregnancy ; Premature birth ; Prospective Studies ; Risk Factors ; Rural areas ; Rural Health - statistics & numerical data ; Seasons ; Socioeconomic Factors ; sub-Saharan Africa ; Womens health</subject><ispartof>Archives of disease in childhood. Fetal and neonatal edition, 2000-05, Vol.82 (3), p.F200-F204</ispartof><rights>Royal College of Paediatrics and Child Health</rights><rights>2000 INIST-CNRS</rights><rights>Copyright: 2000 Royal College of Paediatrics and Child Health</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b507t-2d468ca374b3be451ae36a9b1f79a51c40f945bb3e40e81fdc7181c04bbf2a843</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1721093/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1721093/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1436550$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10794786$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vaahtera, Merimaaria</creatorcontrib><creatorcontrib>Kulmala, Teija</creatorcontrib><creatorcontrib>Ndekha, MacDonald</creatorcontrib><creatorcontrib>Koivisto, Anna-Maija</creatorcontrib><creatorcontrib>Cullinan, Timothy</creatorcontrib><creatorcontrib>Salin, Marja-Leena</creatorcontrib><creatorcontrib>Ashorn, Per</creatorcontrib><title>Antenatal and perinatal predictors of infant mortality in rural Malawi</title><title>Archives of disease in childhood. Fetal and neonatal edition</title><addtitle>Arch Dis Child Fetal Neonatal Ed</addtitle><description>BACKGROUND The slow pace in the reduction of infant mortality in sub-Saharan Africa has partially been attributed to the epidemic of human immunodeficiency virus (HIV) infection. To facilitate early interventions, antenatal and perinatal predictors of 1st year mortality were identified in a rural community in southern Malawi. METHODS A cohort of 733 live born infants was studied prospectively from approximately 24 gestation weeks onwards. Univariate analysis was used to determine relative risks for infant mortality after selected antenatal and perinatal exposures. Multivariate modelling was used to control for potential confounders. FINDINGS The infant mortality rate was 136 deaths/1000 live births. Among singleton newborns, the strongest antenatal and perinatal predictors of mortality were birth between May and July, maternal primiparity, birth before 38th gestation week, and maternal HIV infection. Theoretically, exposure to these variables accounted for 22%, 22%, 17%, and 15% of the population attributable risk for infant mortality, respectively. INTERPRETATION The HIV epidemic was an important but not the main determinant of infant mortality. Interventions targetting the offspring of primiparous women or infants born between May and July or prevention of prematurity would all have considerable impact on infant survival.</description><subject>AIDS/HIV</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>antenatal predictors</subject><subject>Babies</subject><subject>Biological and medical sciences</subject><subject>Children & youth</subject><subject>Emergency and intensive care: neonates and children. Prematurity. Sudden death</subject><subject>Epidemics</subject><subject>Female</subject><subject>Gestational Age</subject><subject>GNP</subject><subject>Gross National Product</subject><subject>HIV</subject><subject>HIV Infections - mortality</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant Mortality</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Intensive care medicine</subject><subject>Malawi - epidemiology</subject><subject>Malnutrition</subject><subject>Maternal Age</subject><subject>Medical sciences</subject><subject>Multivariate Analysis</subject><subject>Offspring</subject><subject>Original</subject><subject>Parity</subject><subject>Pregnancy</subject><subject>Premature birth</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Rural areas</subject><subject>Rural Health - statistics & numerical data</subject><subject>Seasons</subject><subject>Socioeconomic Factors</subject><subject>sub-Saharan Africa</subject><subject>Womens health</subject><issn>1359-2998</issn><issn>1468-2052</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp90Utv1DAUBeAIUdFS2LFGkUCwaQY_Y2dTqRp1oKWFLqAsrWvHBg-JM9hJof8ejzIqhQUrx7mfjo51i-IZRguMaf3GhYUkC7pYEYQeFAeY1bIiiJOH-ZvypiJNI_eLxymtEUJYCPGo2MdINEzI-qBYnYTRBhihKyG05cZGP9820bbejENM5eBKHxyEseyHmGd-vM0_yjjF7C6hg5_-SbHnoEv26e48LD6vTj8t31UXH9-eLU8uKs2RGCvS5nYGqGCaass4BktraDR2ogGODUOuYVxrahmyErvWCCyxQUxrR0Ayelgcz7mbSfe2NTaMuYTaRN9DvFUDePX3JPhv6utwo7AgGDU0B7zaBcThx2TTqHqfjO06CHaYkhIYyVpIkeGLf-B6mGLIj8tZEgnRcIKzOpqViUNK0bq7Khip7XqUC0oSRdV2PZk_v1__Hp73kcHLHYBkoHMRgvHpj2O05nybU83Mp9H-uhtD_K5qQQVXH66XCl_SL1dX76_VefavZ6_79f8b_gbs47Qc</recordid><startdate>20000501</startdate><enddate>20000501</enddate><creator>Vaahtera, Merimaaria</creator><creator>Kulmala, Teija</creator><creator>Ndekha, MacDonald</creator><creator>Koivisto, Anna-Maija</creator><creator>Cullinan, Timothy</creator><creator>Salin, Marja-Leena</creator><creator>Ashorn, Per</creator><general>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><general>BMJ Group</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20000501</creationdate><title>Antenatal and perinatal predictors of infant mortality in rural Malawi</title><author>Vaahtera, Merimaaria ; Kulmala, Teija ; Ndekha, MacDonald ; Koivisto, Anna-Maija ; Cullinan, Timothy ; Salin, Marja-Leena ; Ashorn, Per</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b507t-2d468ca374b3be451ae36a9b1f79a51c40f945bb3e40e81fdc7181c04bbf2a843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>AIDS/HIV</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>antenatal predictors</topic><topic>Babies</topic><topic>Biological and medical sciences</topic><topic>Children & youth</topic><topic>Emergency and intensive care: neonates and children. Prematurity. Sudden death</topic><topic>Epidemics</topic><topic>Female</topic><topic>Gestational Age</topic><topic>GNP</topic><topic>Gross National Product</topic><topic>HIV</topic><topic>HIV Infections - mortality</topic><topic>Hospitals</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant Mortality</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Intensive care medicine</topic><topic>Malawi - epidemiology</topic><topic>Malnutrition</topic><topic>Maternal Age</topic><topic>Medical sciences</topic><topic>Multivariate Analysis</topic><topic>Offspring</topic><topic>Original</topic><topic>Parity</topic><topic>Pregnancy</topic><topic>Premature birth</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Rural areas</topic><topic>Rural Health - statistics & numerical data</topic><topic>Seasons</topic><topic>Socioeconomic Factors</topic><topic>sub-Saharan Africa</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vaahtera, Merimaaria</creatorcontrib><creatorcontrib>Kulmala, Teija</creatorcontrib><creatorcontrib>Ndekha, MacDonald</creatorcontrib><creatorcontrib>Koivisto, Anna-Maija</creatorcontrib><creatorcontrib>Cullinan, Timothy</creatorcontrib><creatorcontrib>Salin, Marja-Leena</creatorcontrib><creatorcontrib>Ashorn, Per</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of disease in childhood. Fetal and neonatal edition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vaahtera, Merimaaria</au><au>Kulmala, Teija</au><au>Ndekha, MacDonald</au><au>Koivisto, Anna-Maija</au><au>Cullinan, Timothy</au><au>Salin, Marja-Leena</au><au>Ashorn, Per</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antenatal and perinatal predictors of infant mortality in rural Malawi</atitle><jtitle>Archives of disease in childhood. Fetal and neonatal edition</jtitle><addtitle>Arch Dis Child Fetal Neonatal Ed</addtitle><date>2000-05-01</date><risdate>2000</risdate><volume>82</volume><issue>3</issue><spage>F200</spage><epage>F204</epage><pages>F200-F204</pages><issn>1359-2998</issn><eissn>1468-2052</eissn><abstract>BACKGROUND The slow pace in the reduction of infant mortality in sub-Saharan Africa has partially been attributed to the epidemic of human immunodeficiency virus (HIV) infection. To facilitate early interventions, antenatal and perinatal predictors of 1st year mortality were identified in a rural community in southern Malawi. METHODS A cohort of 733 live born infants was studied prospectively from approximately 24 gestation weeks onwards. Univariate analysis was used to determine relative risks for infant mortality after selected antenatal and perinatal exposures. Multivariate modelling was used to control for potential confounders. FINDINGS The infant mortality rate was 136 deaths/1000 live births. Among singleton newborns, the strongest antenatal and perinatal predictors of mortality were birth between May and July, maternal primiparity, birth before 38th gestation week, and maternal HIV infection. Theoretically, exposure to these variables accounted for 22%, 22%, 17%, and 15% of the population attributable risk for infant mortality, respectively. INTERPRETATION The HIV epidemic was an important but not the main determinant of infant mortality. Interventions targetting the offspring of primiparous women or infants born between May and July or prevention of prematurity would all have considerable impact on infant survival.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</pub><pmid>10794786</pmid><doi>10.1136/fn.82.3.F200</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | AIDS/HIV Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy antenatal predictors Babies Biological and medical sciences Children & youth Emergency and intensive care: neonates and children. Prematurity. Sudden death Epidemics Female Gestational Age GNP Gross National Product HIV HIV Infections - mortality Hospitals Human immunodeficiency virus Humans Infant Infant Mortality Infant, Newborn Infants Intensive care medicine Malawi - epidemiology Malnutrition Maternal Age Medical sciences Multivariate Analysis Offspring Original Parity Pregnancy Premature birth Prospective Studies Risk Factors Rural areas Rural Health - statistics & numerical data Seasons Socioeconomic Factors sub-Saharan Africa Womens health |
| title | Antenatal and perinatal predictors of infant mortality in rural Malawi |
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