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Background: Globally, 240,000 babies die in the neonatal period annually due to congenital anomalies (CA). Malta reports the highest neonatal mortality rate (NMR) among EU (European Union) Countries, constituting a public health concern. Objectives: This study describes the contribution of CA to NMR in Malta, investigating possible associations with known maternal risk factors of maternal age, nationality, and education. Additionally, it provides an update on the contribution of CA to neonatal deaths in Malta and other EU countries. Methods: Anonymous data for births and neonatal deaths were obtained for 2006–2020 from the National Obstetrics Information System (NOIS) in Malta. Regression analyses adjusting for maternal risk factors were run on this data to explore possible associations with NMR. NMRs published by EUROSTAT 2011–2020 were used to compare mortality by underlying cause of death (CA or non‐CA causes) for Malta and other EU countries. Results: Between 2006 and 2020, 63,890 live births with 283 neonatal deaths were registered in Malta, (NMR 4.4 per 1000 live births). CA accounted for 39.6% of neonatal deaths. No time trends were observed in either total NMR, NMR attributed to CA or mortality due to non‐CA causes. Adjusted variables revealed associations for women hailing from non‐EU, low‐income countries. Malta registered high NMRs compared to EU countries, most marked for deaths attributed to CA. Conclusions: Between 2006 and 2020, Malta's NMR remained stable. Maternal Nationality, from non‐EU low‐income countries, was associated with higher neonatal mortality. The influx of such migrants may play a partial role in the high NMRs experienced. Malta's high NMR was primarily driven by early neonatal deaths, which included high proportions of deaths due to CA and is linked to the fact that termination of pregnancy is illegal in Malta. [ABSTRACT FROM AUTHOR]

Abstract The long-term trends in maternal and child health (MCH) in China and the national-level factors that may be associated with these changes have been poorly explored. This study aimed to assess trends in MCH indicators nationally and separately in urban and rural areas and the impact of public policies over a 30‒year period. An ecological study was conducted using data on neonatal mortality rate (NMR), infant mortality rate (IMR), under-five mortality rate (U5MR), and maternal mortality ratio (MMR) nationally and separately in urban and rural areas in China from 1991 to 2020. Joinpoint regression models were used to estimate the annual percentage changes (APC), average annual percentage changes (AAPC) with 95% confidence intervals (CIs), and mortality differences between urban and rural areas. From 1991 to 2020, maternal and child mortalities in China gradually declined (national AAPC [95% CI]: NMRs − 7.7% [− 8.6%, − 6.8%], IMRs − 7.5% [− 8.4%, − 6.6%], U5MRs − 7.5% [− 8.5%, − 6.5%], MMRs − 5.0% [− 5.7%, − 4.4%]). However, the rate of decline nationally in child mortality slowed after 2005, and in maternal mortality after 2013. For all indicators, the decline in mortality was greater in rural areas than in urban areas. The AAPCs in rate differences between rural and urban areas were − 8.5% for NMRs, − 8.6% for IMRs, − 7.7% for U5MRs, and − 9.6% for MMRs. The AAPCs in rate ratios (rural vs. urban) were − 1.2 for NMRs, − 2.1 for IMRs, − 1.7 for U5MRs, and − 1.9 for MMRs. After 2010, urban‒rural disparity in MMR did not diminish and in NMR, IMR, and U5MR, it gradually narrowed but persisted. MCH indicators have declined at the national level as well as separately in urban and rural areas but may have reached a plateau. Urban‒rural disparities in MCH indicators have narrowed but still exist. Regular analyses of temporal trends in MCH are necessary to assess the effectiveness of measures for timely adjustments.

Objectives: This study compared the neonatal mortality rates (NMRs) and certification behaviors between New Taipei City (NTC) and other cities/counties in Taiwan. Methods: We first examined the NMR trends for days <28 and day 0 for each city or county for the years 2002 to 2022. Joinpoint regression was performed to identify significant changes in the trends. We then linked five population-based data sets to calculate the proportion of day-0 deaths for which the death certificate was issued by an obstetrician and to examine the related characteristics. Finally, we reviewed the charts for 50 day-0 deaths in NTC in 2021 and interviewed hospital managers regarding the regulation of certification behaviors. Results: Only the day 0 NMR trends for NTC and Kaohsiung City (KC) exhibited a decline-and-rise pattern. The annual percent change was 11.4% since 2012 for NTC and 8.1% since 2006 for KC. In total, 788 day-0 deaths occurred between 2018 and 2021, and the death certificates of 404 (52%) were issued by obstetricians. The percentage of day-0 deaths with obstetrician-issued death certificates was 72% in NTC, which was higher than those of other cities/counties (approximately 55%), and a rising trend was also identified (63% in 2018, 73% in 2019, 74% in 2020, and 78% in 2022). More than nine-tenths of these deaths involved a gestational age of <24 weeks, and most of them were the result of artificial abortions. The interviewed hospital managers indicated that various regulations for certification behaviors have been introduced. Conclusions: The higher NMRs and rising NMR trend in NTC compared with other cities/counties were partially due to certification-related behavioral artifacts. To properly interpret the regional variations in NMRs we should first remove this behavioral artifact. [ABSTRACT FROM AUTHOR]

IntroductionAddressing neonatal mortality is an important priority for improving the health and well-being of newborns. Almost two-thirds of infant deaths occur in the first month of life; among these, more than two-thirds die in their first week. Therefore, the aim of this study was to assess the mortality rate and predictors of mortality among neonates admitted to the neonatal intensive care unit (NICU) at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, in 2023.MethodsAn institutional-based retrospective follow-up study was conducted using 459 neonates who were admitted to the NICU at Tikur Anbessa Specialized Hospital from January 2020 to December 2022. The data were extracted from randomly selected charts using a pretested data extraction checklist. The Nelson Alan curve with log-rank test was used to compare the presence of differences in the mortality rate of different groups over different categorical variables. The cox proportional hazards analysis model was used to identify predictors of neonatal death. The presence and absence of statistical significance was considered at a p-value of less than 0.05 and the strength of association was measured using AHR.ResultsThe neonatal mortality rate was 3.1 (95% CI: 1.3–4.9) per 1,000 neonate-days. Low birth weight (AHR = 1.44: 95% CI: 1.06–3.13), exclusive breast-feeding (AHR = 0.74: 95% CI: 0.35–0.95), and time of exclusive breast-feeding (AHR = 0.92: 95% CI: 0.49–0.99) were the identified predictors of newborn mortality.ConclusionThe neonatal mortality rate was high. Low birth weight of the neonate, exclusive breast-feeding initiation, and time of exclusive breast-feeding were independent predictors of neonatal death. Therefore, empowering mothers to exclusively breastfeed their children, which is a cost-effective, safe, and realistic option, can significantly minimize infant mortality.

Background: Neonatal Mortality Rate (NMR) is a value which plays a vital role in gauging the effectiveness and advancement in healthcare pertaining to newborns. The alarmingly high rate promotes the need of further development of better medical facilities. One such facility is the Special Newborn Care Unit (SNCU). Objective: This study targets the analysis of factors contributing to the mortality of neonates and aims at coming up with solution to tackle the issue Methodology: A facility based retrospective study was carried out based on information from medical records of neonates admitted to the SNCU from a tertiary care hospital. Results: The 1038 neonates admitted it was found that nearly half of the neonates admitted had low birth weight (48.2%) contrary to maturity where 37.9 % were preterm. Most of the admissions were due to neonatal jaundice (46.6%) followed by low birth weight (15.2%) and respiratory distress syndrome (10.3%). Of the 85 neonates who expired, the leading causes were respiratory distress syndrome (21.2%), sepsis (14.9%), Hypoxic Ischemic Encephalopathy (12.9%), major congenital malformations (12.9%) and extreme low birth weight 11 (12.9%). Conclusion: The expansion of services and technology provided by SNCUs is of great importance in the development of healthcare for the nation. The growth of better antenatal health care, seamless referral systems along with identification of alarming conditions requiring admission to SNCUs immediately after birth form the pillars of confronting the goal of decreasing the NMR.

Introduction: Addressing neonatal mortality is an important priority for improving the health and well-being of newborns. Almost two-thirds of infant deaths occur in the first month of life; among these, more than two-thirds die in their first week. Therefore, the aim of this study was to assess the mortality rate and predictors of mortality among neonates admitted to the neonatal intensive care unit (NICU) at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, in 2023., Methods: An institutional-based retrospective follow-up study was conducted using 459 neonates who were admitted to the NICU at Tikur Anbessa Specialized Hospital from January 2020 to December 2022. The data were extracted from randomly selected charts using a pretested data extraction checklist. The Nelson Alan curve with log-rank test was used to compare the presence of differences in the mortality rate of different groups over different categorical variables. The cox proportional hazards analysis model was used to identify predictors of neonatal death. The presence and absence of statistical significance was considered at a p -value of less than 0.05 and the strength of association was measured using AHR., Results: The neonatal mortality rate was 3.1 (95% CI: 1.3-4.9) per 1,000 neonate-days. Low birth weight (AHR = 1.44: 95% CI: 1.06-3.13), exclusive breast-feeding (AHR = 0.74: 95% CI: 0.35-0.95), and time of exclusive breast-feeding (AHR = 0.92: 95% CI: 0.49-0.99) were the identified predictors of newborn mortality., Conclusion: The neonatal mortality rate was high. Low birth weight of the neonate, exclusive breast-feeding initiation, and time of exclusive breast-feeding were independent predictors of neonatal death. Therefore, empowering mothers to exclusively breastfeed their children, which is a cost-effective, safe, and realistic option, can significantly minimize infant mortality., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Getahun, Beyene, Afework, Desalegn, Jemberie and Shitemaw.)