Infant, neonatal, and postneonatal mortality trends in a disaster region and in Japan, 2002–2012: a multi-attribute compositional study

Abstract

Background The reductions achieved in infant mortality in Japan are globally regarded as remarkable. However, no studies in Japan have classified infant mortality trends into neonatal and postneonatal or considered regional issues. This study aimed to explore trends in neonatal and postneonatal deaths, both overall for Japan and in a region affected by a natural disaster. Methods Drawing on national infant death data, we used a multi-attribute compositional study design to examine all infant deaths occurring in a region affected by a disaster (Tohoku, which consists of Iwate, Miyagi, and Fukushima) between 2002 and 2012. We used conjoint analysis to clarify the associations between infant and maternal characteristics and age of infant death. Results We obtained data of a total of 31,012 infant deaths between 2002 and 2012, which included 1450 from Tohoku. Infant mortality rates in Japan overall declined over the period but increased in 2011. There were more postneonatal (29–364 days post-birth) than neonatal (0–28 days post-birth) deaths. Infant deaths in Tohoku declined slightly overall, with a fluctuation in 2011. In Tohoku, the trends in postneonatal death rates were similar; the overall rates for males increased, but those for females decreased in 2011. We found that the cause and place of infant death differed by gender for neonatal and postneonatal deaths in both Japan in general and Tohoku. The conjoint analysis showed that most variables affected the age of postneonatal death. The factor with the largest influence on the variation in infant death age was gestational week (55.5%). A maternal gestational week ≤36 was linked to an average age at death of 43.4 days, and > 37 was linked to an average of 83.7 days. Conclusions In Japan, infant death rates have declined steadily over the past 10 years. The recent trends indicated that postneonatal death rates were higher than neonatal rates, especially in Tohoku. However, not much attention has been focused on postneonatal deaths in Japan. Our findings may help health planners to prioritise work on the factors that are linked to infant deaths in the neonatal and postneonatal periods. Trial registration Not applicable.

Neonatal mortality: the need for teaching strategies directed to the protection and promotion of children's health

“…In conclusion, the importance of this research is highlighted, since knowing the distribution of causes of death and risk factors in each place, as well as the socio-demographic aspects that influence them, corroborates a more comprehensive and consolidated understanding of these data, implementing policies aimed at combating inequalities in infant mortality, as well as providing valuable information to improve child health indicators (Dandona et al, 2020;Tashiro et al, 2019).…”

“…In the national scenario, the absence of a partner, maternal age ≥ 35 years, male gender, multiple gestation, inadequate and absent prenatal care, presence of intercurrences during pregnancy, congenital malformation, Apgar< 7 in the fifth minute, low and very low birth weight, gestational age ≤ 37 weeks, and cesarean delivery are presented as risk factors for neonatal mortality (Veloso et al, 2019). In Japan, in which the top five causes of death for neonates were congenital hypoplasia, trisomy, low birth weight, and severe neonatal asphyxia (Tashiro et al, 2019).…”

Early intervention to risk groups with the QR code system in disasters

“…Between 2002 and 2012, 31,012 babies died in Japan and 1450 in Tohoku. The Great East Japan Earthquake and Tsunami (GEJET) appears to have a greater impact on post neonatal deaths than neonatal deaths (Toshiro et al, 2019). Toshiro et al (2018) examined the deaths of children under the age of 10 years after 2008-2014 and after the 2011 great earthquake in Japan, and it was found that the mortality rate among children younger than 10 years old was 6.4 times higher than the rate before and after 2011 during the 2011 disaster period.…”

Nursing consultation with newborns in a capital city of the Legal Amazon: the need for teaching and learning about the theme

“…In recent years, several countries have shown a significant drop in infant and child morbidity and mortality rates (Dandona et al, 2020;Burstein et al, 2019;UNICEF, 2018;UNICEF, 2019). However, despite the advances in the protection of children's health on the world stage, research shows that mortality in this group is still high and its profile significantly influenced by socio-demographic inequalities (UNICEF, 2018;Tashiro et al, 2019). It is recorded that 58% of infant deaths that occurred between 2000 and 2017 could have been prevented in the absence of these differences (Burstein et al, 2019).…”