Trends and Causes of Neonatal Mortality in Serbia, 1997-2016

Abstract

Background: Regardless of the notable reduction in infant deathsworldwide over the last 30 years, the proportion of neonatal mortalityin total child mortality is increasing.Aims: To perform a trend analysis of neonatal mortality in Serbia.Study Design: Descriptive observational study.Methods: Joinpoint regression was used to analyze neonatal mortalitydata for the years 1997 to 2016 that were obtained from the StatisticalOffice of Serbia.Results: The trend in the neonatal mortality rate decreasedsignificantly by -5.6% (95% CI: -6.5 to -4.6) per year from 1997to 2007, and by -2.6% (95% CI: -3.7 to -1.5) per year from 2007 to2016. The neonatal mortality rate for certain conditions originatingin the perinatal period decreased by -6.2% (95% CI: -7.5 to -4.9) peryear during the years from 1997 to 2006, and by -1.9% (95% CI:-3.1 to -0.7) per year from 2006 to 2016. Among these conditions,disorders related to short gestation and low birth weight, notelsewhere classified, showed an upward trend by 8.5% (95% CI: 6.2to 10.8) per year during the entire study period. From 1997 to 2016,a significant decrease in the neonatal mortality rate was detected incases of congenital malformations, deformations, and chromosomalabnormalities, by -5.0% (95% CI: -6.1 to -4.0) per year. The neonatalmortality rate for cases of symptoms, signs, and abnormal clinicaland laboratory findings, not elsewhere classified, decreased by -8.1%(95% CI: -11.0 to -5.2) yearly.Conclusion: The neonatal mortality rate in Serbia decreased between1997 and 2016, excluding deaths due to short gestation and low birthweight. Therefore, prevention of short gestation and low birth weightshould be the highest public priority.