Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
Indian Pediatr. 2012 Apr;49(4):291-4. doi: 10.1007/s13312-012-0044-2. Epub 2011 Aug 15.
To identify the determinants of neonatal mortality.
Nested case-control study.
28 villages under the intensive field practice area of Comprehensive Rural Health Services Project, Ballabgarh, Haryana serving a population of 87,016, as on 31st December 2009. The study period was from 2005 to 2009.
The data were obtained from Health Management Information System and analyzed using multivariate logistic regression analysis. A hierarchical approach was used to analyze the factors associated with neonatal deaths, using community level factors, socio-economic status and biological determinants. The population attributable fractions were estimated for significant variables.
The total live births during the study period were 10392 and neonatal deaths were 248. The infant and neonatal mortality rates during the study period were 45.6 and 23.8 per 1000 live births, respectively. Socio-economic determinants (Low educational status of parents [OR 2.1, 95% CI; 1.4, 3.3]; fathers occupation [OR 1.8, 95% CI; 1.0, 3.0]; Rajput caste [OR 2.0, 95% CI; 1.2, 3.4] appeared to explain a major fraction (45.7%) of neonatal deaths. Community level factors (villages with no health facility [OR 1.5, 95% CI; 1.0, 2.1]; villages with population >6000 [OR 1.7, 95% CI; 1.2, 2.5]) were associated with 27.3% of all neonatal deaths. Proximate determinants (early childbearing age of mother (<20 years) [OR 2.0, 95% CI; 1.2, 3.2]) were least important. All the three level of variables seemed to act independently with little mediation among them.
Neonatal mortality is affected by socioeconomic, community level and proximate biological determinants.
确定新生儿死亡的决定因素。
嵌套病例对照研究。
哈里亚纳邦巴拉尔加赫综合农村卫生服务项目强化实地工作区的 28 个村庄，服务人口 87016 人，截至 2009 年 12 月 31 日。研究期为 2005 年至 2009 年。
数据来自健康管理信息系统，使用多变量逻辑回归分析进行分析。采用层次分析法分析与新生儿死亡相关的因素，包括社区水平因素、社会经济地位和生物学决定因素。对有意义的变量进行人群归因分数估计。
研究期间总活产数为 10392 例，新生儿死亡数为 248 例。研究期间婴儿和新生儿死亡率分别为每 1000 例活产 45.6 和 23.8。社会经济决定因素（父母文化程度低[比值比 2.1，95%可信区间；1.4，3.3]；父亲职业[比值比 1.8，95%可信区间；1.0，3.0]；拉杰普特种姓[比值比 2.0，95%可信区间；1.2，3.4]）似乎可以解释新生儿死亡的大部分（45.7%）。社区水平因素（无卫生设施的村庄[比值比 1.5，95%可信区间；1.0，2.1]；人口>6000 的村庄[比值比 1.7，95%可信区间；1.2，2.5]）与所有新生儿死亡的 27.3%有关。直接决定因素（母亲生育年龄早（<20 岁）[比值比 2.0，95%可信区间；1.2，3.2]）的重要性最低。所有三个层次的变量似乎都独立起作用，彼此之间很少有中介作用。
新生儿死亡受社会经济、社区水平和近期生物学决定因素的影响。
