Causes and risk factors for deaths in young infants in South Asia: the ANISA prospective population-based observational cohort study

IntroductionStrategies for reducing infant mortality require accurate, local, population-level data. We conducted a population-based observational study in three countries in South Asia to describe risk factors, causes and rates of mortality in young infants.MethodsPregnancies, births and pregnancy...

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Veröffentlicht in:BMJ global health Jg. 10; H. 11; S. e018433
Hauptverfasser: Darmstadt, Gary L, Abdalla, Safa, Islam, Mohammad Shahidul, El Arifeen, Shams, Arvay, Melissa L., Baqui, Abdullah H, Bhutta, Zulfiqar A, Bose, Anuradha, Connor, Nicholas E, Hossain, Belal, Isaac, Rita, Mahmud, Arif, Mitra, Dipak K., Mullany, Luke C, Nisar, Imran, Panigrahi, Kalpana, Panigrahi, Pinaki, Rahman, Qazi Sadeq-ur, Saha, Senjuti, Soofi, Sajid B., Solomon, Nardos, Santosham, Mathuram, Schrag, Stephanie J, Qazi, Shamim A., Saha, Samir K
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England BMJ Publishing Group Ltd 03.11.2025
BMJ Publishing Group LTD
BMJ Publishing Group
Schlagworte:
Adult
Age groups
Antibiotics
Asia - epidemiology
Asia, Southern
Autopsies
Babies
Bacterial infections
Birth weight
Breast feeding
Cause of Death
Child health
Childbirth & labor
Cohort analysis
Community health care
Congenital defects
Environmental factors
Epidemiology
Estimates
Etiology
Female
Global Health
Households
Humans
Infant
Infant Mortality
Infant, Newborn
Infants
Male
Mortality
Newborn babies
Observational studies
Original research
Paediatrics
Postpartum period
Pregnancy
Pregnancy Outcome - epidemiology
Premature birth
Prospective Studies
Public Health
Risk Factors
Sepsis
Stillbirth
Stillbirth - epidemiology
Surveillance
Trainers
Viral infections
Young Adult
Asia
Asia, Southern
Bangladesh
Pakistan
Africa
India
South Asia
Public Health
Global Health
Epidemiology
Paediatrics
Child health
ISSN:2059-7908, 2059-7908
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Zusammenfassung:IntroductionStrategies for reducing infant mortality require accurate, local, population-level data. We conducted a population-based observational study in three countries in South Asia to describe risk factors, causes and rates of mortality in young infants.MethodsPregnancies, births and pregnancy outcomes were determined through household surveillance, and cause of deaths was ascertained by verbal autopsy. Cox regression was used to identify risk factors for deaths during days 0–<3, 3–<7 and 7–<60.ResultsAmong 73 622 pregnancy outcomes, 4638 deaths were identified, including 1669 stillbirths (36.0%), 1347 (29.0%) deaths among non-registered liveborn infants who died before the first home visit by community health workers (CHWs), and 1622 (35.0%) deaths that occurred during days 0–<60 among liveborn registered infants. Most deaths among liveborn infants (59.3%, 1757 of 2965) took place within 3 days of birth. The most common causes of death over the young infant period were infections/sepsis (32.5%, n=963 of 2,965), birth asphyxia (29.0%, n=859) and preterm birth/low birth weight (14.1%, n=418). Risk factors for mortality included early morbidity (need for resuscitation, intrapartum infection/antibiotics, multiple gestation, congenital anomalies), environmental factors (smoke exposure, maternal betel chewing) and poor maternal access to quality care (history of a prior neonatal death, lack of care seeking for labour complications). Protective factors included biology (female sex, higher birth weight), essential newborn care (immediate breastfeeding, clean cord care) and access to quality maternal and newborn care (antenatal care, facility birth, skilled birth attendant, maternal education, household wealth).ConclusionsOur population-based data highlight the importance of addressing deaths due to birth asphyxia and infections, while recognising that the relative burden of deaths due to preterm birth and congenital anomalies is increasing globally. Access to quality community-based and facility-based maternal and newborn care is critical to efforts to reduce mortality in young infants in high-mortality settings such as rural South Asia.
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ISSN:2059-7908
2059-7908
DOI:10.1136/bmjgh-2024-018433