Diseases & National Health Programme
Which of the following is the least likely cause of Neonatal mortality in India? (AIPG 2012)
|D|| Congenital anomalies
a. Neonatal Mortality Rate - Neonatal deaths are deaths occurring during the neonatal period, commencing at birth and ending 28 completed days after birth. Neonatal mortality rate is the number of neonatal deaths in a given year per 1000 live births in that year.
b. The neonatal mortality rate is tabulated as:
c. (Number of deaths of children under 28 days of age in a year / Total live births in the same year) x 1000
d. The causes of neonatal mortality are multifactorial - low birth weight, post-natal asphyxia and atelectasis, birth injuries, congenital malformations and infections. In some developing countries tetanus may account for up to 10 per cent of all neonatal mortality.
e. Neonatal mortality is a measure of the intensity with which "endogenous factors" (e.g., low birth weight, birth injuries) affect infant life. The neonatal mortality is directly related to the birth weight and gestational age; the lighter or more immature the baby, the higher the death rate. The high concentration of infant deaths in the "early" neonatal period with "endogenous" causes suggests the need to improve the antenatal and postnatal services to expectant mothers. However, neonatal mortality is the most difficult part of infant mortality to alter, because of the endogenous factors which are not sensitive to improvements in environmental conditions. Neonatal mortality is greater in boys throughout the world, because newborn boys are biologically more fragile than girls.
Causes of infant mortality
Neonatal mortality (0-4 weeks)
Post neonatal mortality (1 -12 months)
1. Low birth weight
2. Birth injury and difficult labour
3. Congenital anomalies
4. Haemolytic diseases of newborn
5. Conditions of placenta and cord
6. Diarrhoeal diseases
7. Acute respiratory infections
1. Diarrhoeal diseases
2. Acute respiratory infections
3. Other communicable
5. Congenital anomalies
f. In India 55 -60 per cent of infant deaths occur within neonatal period. Of these more than half may die during the first week of birth, first 24 hours being the time of greatest risk.
g. POST-NEONATAL MORTALITY RATE - Deaths occurring from 28 days of life to under one year are called "post-neonatal deaths". The post-neonatal death rate is defined as: "the ratio of post-neonatal deaths in a given year to the total number of live births in the same year; usually expressed as a rate per 1000"
h. The post-neonatal mortality rate is tabulated as:
i. (Number of deaths of children between 28 days and one year of age in a given year / Total live births in the same year) x 1000
j. Whereas neonatal mortality is dominated by endogenous factors, post-neonatal mortality is dominated by exogenous (e.g., environmental and social) factors. Diarrhoea and respiratory infections are the main causes of death during the post-neonatal period. Malnutrition is an additional factor, reinforcing the adverse effects of the infections. In the developed countries, the main cause of post-neonatal mortality is congenital anomalies. Studies show that post neonatal mortality increases steadily with birth order, and that infants born into already large families run a higher risk of death from infectious diseases.
k. In some areas of South East Asia (including India), during the post-neonatal period girls die more frequently than boys. This is attributed to neglect of the female children in terms of nutrition and health care.