Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000

Liu, Li; Johnson, Hope L.; Cousens, Simon; Perin, Jamie; Scott, Susana; Lawn, Joy E; Rudan, Igor; Campbell, Harry; Cibulskis, Richard; Li, Mengying; Mathers, Colin; Black, Robert E.

doi:10.1016/s0140-6736(12)60560-1

Cited by 3,321 publications

(2,654 citation statements)

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“…Birth spacing covers a reproductive continuum, including conception, pregnancy, birth, breastfeeding, and family planning. The risk of neonatal mortality and preterm birth linked to short intervals is small, but this finding is important because preterm birth is predicted to become the leading proportional cause of child deaths 9, 15. The rising rates with length of IPI of pre‐eclampsia, the second most common cause of maternal mortality worldwide,16 underscores the importance of the persistence needed for improving coverage of obstetric care.…”

Section: Discussionmentioning

confidence: 99%

“…Secondary maternal outcomes were the main causes of death, postpartum haemorrhage, pre‐eclampsia, eclampsia, and puerperal infection, classified in our database according to the International Classification of Diseases, 10th revision (ICD‐10) 5. Secondary offspring outcomes were the main causes of neonatal death,9 low birthweight (live baby weighing less than 2.5 kg at birth), and preterm birth (live baby delivered before 37 weeks of gestation, defined as the time between the date of the mother's last menstrual period and the infant's birth date).…”

Section: Methodsmentioning

confidence: 99%

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Interpregnancy interval and perinatal outcomes across Latin America from 1990 to 2009: a large multi‐country study

Mignini

Carroli

Betrán

et al. 2015

BJOG

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ObjectiveTo determine the relationship of interpregnancy interval with maternal and offspring outcomes.DesignRetrospective study with data from the Perinatal Information System database of the Latin American Centre for Perinatology and Human Development, Uruguay.SettingLatin America, 1990–2009.PopulationA cohort of 894 476 women delivering singleton infants.MethodsDuring 1990–2009 the Perinatal Information System database of the Latin American Centre for Perinatology identified 894 476 women with defined interpregnancy intervals: i.e. the time elapsed between the date of the previous delivery and the first day of the last normal menstrual period for the index pregnancy. Using the interval 12–23 months as the reference category, multiple logistic regression estimated adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) of the association between various interval lengths and maternal and offspring outcomes.Main outcome measuresMaternal death, pre‐eclampsia, eclampsia, puerperal infection, fetal death, neonatal death, preterm birth, and low birthweight.ResultsIn the reference interval there was 0.05% maternal death, 1.00% postpartum haemorrhage, 2.80% pre‐eclampsia, 0.15% eclampsia, 0.28% puerperal infection, 3.45% fetal death, 0.68% neonatal death, 12.33% preterm birth, and 9.73% low birthweight. Longer intervals had increased odds of pre‐eclampsia (>72 months), fetal death (>108–119 months), and low birthweight (96–107 months). Short intervals of <12 months had increased odds of pre‐eclampsia (aOR 0.80; 95% CI 0.76–0.85), neonatal death (aOR 1.18; 95% CI 1.08–1.28), and preterm birth (aOR 1.16; 95% CI 1.11–1.21). Statistically, the interval had no relationship with maternal death, eclampsia, and puerperal infection.ConclusionsA short interpregnancy interval of <12 months is associated with pre‐eclampsia, neonatal mortality, and preterm birth, but not with other maternal or offspring outcomes. Longer intervals of >72 months are associated with pre‐eclampsia, fetal death, and low birthweight, but not with other maternal or offspring outcomes.Tweetable abstractA short interpregnancy interval of <12 months is associated with neonatal mortality and preterm birth.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Interpregnancy interval and perinatal outcomes across Latin America from 1990 to 2009: a large multi‐country study

Mignini

Carroli

Betrán

et al. 2015

BJOG

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“…1 However, very preterm infants have a high risk of severe short‐term complications such as intracranial hemorrhage (ICH), periventricular leukomalacia (PVL), retinopathy of prematurity (ROP), and long‐term neurodevelopmental disorders such as cerebral palsy, intellectual disabilities, and hearing and vision impairment,2, 3 and prematurity is still a leading cause of neonatal death. Although active perinatal care has improved neurodevelopmental outcomes in extremely preterm infants, the most extremely preterm infants continue to have high rates of neurological disabilities 3, 4.…”

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confidence: 99%

Recombinant human erythropoietin improves neurological outcomes in very preterm infants

Shi

Sun

et al. 2016

Annals of Neurology

114

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ObjectiveTo evaluate the efficacy and safety of repeated low‐dose human recombinant erythropoietin (rhEPO) in the improvement of neurological outcomes in very preterm infants.MethodsA total of 800 infants of ≤32‐week gestational age who had been in an intensive care unit within 72 hours after birth were included in the trial between January 2009 and June 2013. Preterm infants were randomly assigned to receive rhEPO (500IU/kg; n = 366) or placebo (n = 377) intravenously within 72 hours after birth and then once every other day for 2 weeks. The primary outcome was death or moderate to severe neurological disability assessed at 18 months of corrected age.ResultsDeath and moderate/severe neurological disability occurred in 91 of 338 very preterm infants (26.9%) in the placebo group and in 43 of 330 very preterm infants (13.0%) in the rhEPO treatment group (relative risk [RR] = 0.40, 95% confidence interval [CI] = 0.27–0.59, p < 0.001) at 18 months of corrected age. The rate of moderate/severe neurological disability in the rhEPO group (22 of 309, 7.1%) was significantly lower compared to the placebo group (57 of 304, 18.8%; RR = 0.32, 95% CI = 0.19–0.55, p < 0.001), and no excess adverse events were observed.InterpretationRepeated low‐dose rhEPO treatment reduced the risk of long‐term neurological disability in very preterm infants with no obvious adverse effects. Ann Neurol 2016;80:24–34

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“…Annual assessments of trends in child mortality have been produced by the GBD and the UN Inter-agency Group for Child Mortality Estimation (IGME) using distinct methods [2,4,9,13–16], both of which are frequently used for understanding child mortality estimates and are highly correlated (0.983) [7]. In this study, we used the data published by Liu and colleagues [1] because the average annual changes of cause-specific child mortality have been examined using their dataset and method, although previous analyses were carried out at the global and regional levels.…”

Section: Methodsmentioning

confidence: 99%

“…When estimating child deaths, they updated the database to include new VR data up to July 2015 and new VA data up to February 2015. The details of the estimation approaches developed by Liu and colleagues have been described elsewhere [1,4,9,19]. …”

Section: Methodsmentioning

confidence: 99%

Cause-specific child mortality performance and contributions to all-cause child mortality, and number of child lives saved during the Millennium Development Goals era: a country-level analysis

Jin

Mankadi

Rigotti

et al. 2018

Global Health Action

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Background: During the Millennium Development Goal (MDG) era, impressive reductions in the under-5 mortality rate (U5MR) have been observed, although the MDG 4 target was not met. So far, cause-specific progress in child mortality has been analyzed and discussed mainly at the global and regional levels. Objectives: We aimed to explore annual changes in cause-specific mortality at the country level, assess which causes contributed the most to child mortality reduction in 2000–2015, and estimate how many child lives were saved. Methods: We used the cause-specific child mortality estimates published by Liu and colleagues. We derived average annual changes in cause-specific child mortality rates and cause-specific contribution to overall child mortality in 2000–2015. We estimated the number of cause-specific child deaths averted during the MDG era, assuming that cause-specific child mortality remained the same as in 2000. We targeted the 75 Countdown countries where 95% of maternal and child deaths occurred during the MDG era. Results: Wide disparities existed across causes within countries, both in neonatal and post-neonatal mortality reduction, except for a few countries such as China, Rwanda, and Cambodia. In 20 of the 45 sub-Saharan African countries, malaria was the main contributor to post-neonatal mortality reduction, and pneumonia was the main contributor in only six countries. A single disease often contributed to a substantial proportion of the child mortality reduction, particularly in west and central African countries. Diarrhea-specific post-neonatal child mortality reduction accounted for 7.1 million averted child deaths (24.5%), while pneumonia accounted for another 6.7 million averted child deaths (23%). Conclusions: This study demonstrates country-specific characteristics with regards to cause-wise child mortality that could not be identified by global or regional analyses. These findings provide the global community with evidence for formulating national policies and strategies to achieve the Sustainable Development Goals in child mortality reduction.

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Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000

Cited by 3,321 publications

References 25 publications

Interpregnancy interval and perinatal outcomes across Latin America from 1990 to 2009: a large multi‐country study

Interpregnancy interval and perinatal outcomes across Latin America from 1990 to 2009: a large multi‐country study

Recombinant human erythropoietin improves neurological outcomes in very preterm infants

Cause-specific child mortality performance and contributions to all-cause child mortality, and number of child lives saved during the Millennium Development Goals era: a country-level analysis

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