| Trends of infant mortality in Hong Kong (1956-90) and evaluation of preventable infant deaths. | |
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MedLine Citation:
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PMID: 9259297 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: This study describes the time trends for infant mortality in Hong Kong and aims to develop statistical models that can be used to predict changes of infant mortality in places already having low levels of infant mortality. METHODOLOGY: Data on births and deaths of infants in Hong Kong during the years 1956-90 were analysed annually as well as by aggregating the data into seven consecutive quinquennia. To assess the contribution of preventable infant deaths, causes for infant deaths were classified into two broad categories: (i) congenital anomalies; and (ii) preventable diseases. A simple linear regression model was used to analyse the time trend of the mortality rate of the preventable diseases (PIMR) over the seven quinquennia. RESULTS: During the period 1956-90, the infant mortality rate fell from 60.9 in 1956-5.9 per 1000 in 1990 and the neonatal mortality rate fell from 24.2-3.8 per 1000. There was no clear time trend observed for infant mortality of congenital anomalies. However, the time trend for PIMR (log scale) was very close to a straight line and simple linear regression modelling showed a R2 of 0.9970. CONCLUSION: As the infant mortality rate (IMR) falls to below 30 per 1000, the further rate of decrease becomes less predictable from the regression model of the IMR. By removing the portion of deaths attributable to congenital anomalies, the further decrease in infant mortality became more predictable down to very low levels of IMR. This study determines the pattern of reliability of infant mortality reports in Hong Kong. Data are obtained from annual reports of the director of Medical and Health Services during 1956-88 and the director of Health during 1989-90. Deaths were grouped in 5-year age periods during 1956-90. Infant deaths were registered according to cause based on 3 different versions of the International Classification of Disease into 4 major groups: congenital anomalies, conditions originating in the perinatal period, pneumonia, and all other causes. Preventable infant deaths were grouped into 2 categories based on Bourgeois-Pichat's classification: congenital causes and preventable ones. These 2 causes were plotted on a line chart by quinquennial period. Infant mortality rates (IMR) declined from 60.9/1000 in 1956 to 5.9/1000 in 1990. The neonatal mortality rate declined from 24.2 to 3.8/1000 in the same period. Postneonatal mortality rates declined the most from 36.7 to 2.2/1000. The 3 mortality trends were mostly linear. All 3 rates were highly correlated with each other. Major decreases occurred for pneumonia and other. The other group of infectious diseases that included tuberculosis, tetanus, gastroenteritis, and other diarrheal diseases declined the most rapidly by as much as 66 times. Mortality rates by congenital causes increased during the early period and declined slowly during the 1980s, while proportional mortality continued to increase. 84.6% of all infant deaths during 1986-90 were congenital deaths and deaths occurring in the perinatal period. The authors suggest reducing congenital deaths by imposing public health measures, raising the medical knowledge of the public, and improving the use of modern technology. Conditions originating in the perinatal period could be reduced by addressing intrauterine hypoxia, birth asphyxia, and other respiratory conditions. |
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Authors:
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S L Wong; I T Yu; T W Wong; O L Lloyd |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of paediatrics and child health Volume: 33 ISSN: 1034-4810 ISO Abbreviation: J Paediatr Child Health Publication Date: 1997 Jun |
Date Detail:
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Created Date: 1997-09-25 Completed Date: 1997-09-25 Revised Date: 2007-09-24 |
Medline Journal Info:
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Nlm Unique ID: 9005421 Medline TA: J Paediatr Child Health Country: AUSTRALIA |
Other Details:
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Languages: eng Pagination: 226-9 Citation Subset: IM; J |
Affiliation:
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Department of Community and Family Medicine, Chinese University of Hong Kong, Shatin, New Territories. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Cause of Death* Hong Kong / epidemiology Humans Infant Mortality / trends* Infant, Newborn Linear Models Preventive Medicine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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