Cent Eur J Public Health 2015, 23(1):14-19

Territorial Differences in Infant Mortality in Latvia in the First Decade of the Third Millennium

Inguna Ebela1, Irisa Zīle2, Nadīne Muciņa1, Danute Ražuka-Ebela1, Ingrīda Rumba-Rozenfelde1
1 Department of Paediatrics, Faculty of Medicine, University of Latvia, Riga, Latvia
2 Department of Research, Statistics and Health Promotion, Centre for disease prevention and control of Latvia, Riga, Latvia

Objective: Infant and child mortality are some of the most substantial indicators of country welfare. Infant mortality (IM) in Latvia is constantly the highest among 25 Member States of the European Union. Since the regaining of independence in 1991, IM has decreased by almost 50%, however, it is still high enough to cause concern that the country will not be able to meet the UN Millennium Development Goals to decrease IM in Latvia by 2015. The Medical Faculty at the University of Latvia has conducted several studies identifying correlations between IM and GDP, total expenditure on health, unemployment and GINI coefficient. It is necessary to identify all IM causes and relationships which have not been studied, including the effect of social factors causing inequality between inhabitants of urban and rural areas. The aim of the study was to determine the IM rate and the main death causes and their differences between rural and urban areas in Latvia (2000-2010).

Materials: This is a register-based study. The data of 1994 deceased infants was analyzed over the time period from 2000-2010. The studied population was divided into two groups - urban and rural areas by mothers' area of residence. Descriptive and analytical methods were used for analysis - frequency distribution, correlation and regression analysis.

Results: IM by maternal residence as well as IM indicators in the most common diagnostic subgroups have been higher in rural areas in the entire studied period (2000-2010). The decrease proportion of IM was more rapid in rural regions with a period average of 6.2% in comparison to urban regions - 2.6%. Annual decrease of IM from perinatal period conditions was 50% lower in rural than urban areas; annual decrease of IM from congenital malformations, deformations and chromosomal abnormalities was 20% lower in urban than rural areas; annual decrease in other diagnostic groups was 40% lower in urban than rural areas. During the study period, differences in infant mortality based on maternal sociodemographic factors, maternal health as well as pregnancy and obstetric history have been found, but the results of statistical analysis cannot be used to define these relationships as statistically significant in either areas.

Conclusions: Infant mortality in Latvia due to various conditions prevailing during perinatal period, external causes and sudden infant death syndrome can be substantially decreased - by improving the theoretical and technical capacity of obstetric departments in rural areas as well as educating society on preventable causes of death.

Keywords: infant mortality, perinatal mortality, Latvia, regional differences, urban, rural

Received: December 1, 2013; Revised: November 30, 2014; Accepted: November 30, 2014; Published: March 1, 2015  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Ebela I, Zīle I, Muciņa N, Ražuka-Ebela D, Rumba-Rozenfelde I. Territorial Differences in Infant Mortality in Latvia in the First Decade of the Third Millennium. Cent Eur J Public Health. 2015;23(1):14-19. PubMed PMID: 26036093.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Ebela I, Biķis E, Rumba-Rozenfelde I. Under-five child mortality in Latvia: causal relationships and reduction possibilities in an international context. Scientific Papers University of Latvia. Medicine. 2009;750:8-27. (In Latvian.)
    2. Phumaphi J, Evans T, Van Lerberghe W, editors. The World health report 2005: make every mother and child count [Internet]. Geneva: WHO; 2005 [cited 2013 Jun 3]. Available from: http://www.who.int/whr/2005/whr2005_en.pdf.
    3. The Millennium Development Goals report 2013 [Internet]. New York: United Nations; 2013 [cited 2013 Sep 30]. Available from: http://www.un.org/millenniumgoals/pdf/report-2013/mdg-report-2013-english.pdf.
    4. United Nations Development Programme. What will it take to achieve the Millennium Development Goals?An InternationalAssessment [Internet]. New York: UNDP; 2010 [cited 2013 Nov 23]. Available from: http://content.undp.org/go/cms-service/stream/asset/?asset_id=2620072.
    5. World Health Organization. European health for all database (HFA-DB) [Internet]. Copenhagen: WHO Regional Office for Europe [cited 2013 Mar 5]. Available from: http://data.euro.who.int/hfadb/.
    6. Zeitlin J, Mohangoo A, Delnord M, editors. European perinatal health report: health and care of pregnant women and babies in Europe in 2010 *Source: United Nations demographic yearbook, 2000-2012 [Internet]. EURO-PERISTAT; 2013 [cited 2013 Sep 9]. Available from: http://www.europeristat.com/images/doc/Peristat%202013%20V2.pdf.
    7. Van de Poel E, O'Donnell O, Van Doorslaer E. What explains the ruralurban gap in infant mortality: household or community characteristics? Demography. 2009 Nov;46(4):827-50. Go to original source... Go to PubMed...
    8. Guildea ZE, Fone DL, Dunstan FD, Cartlidge PH. Differences in risk of mortality under 1 year of age between rural and urban areas: an ecological study. Public Health. 2005 May;119(5):442-7. Go to original source... Go to PubMed...
    9. Guildea ZE, Fone DL, Dunstan FD, Sibert JR, Cartlidge PH. Social deprivation and the causes of stillbirth and infant mortality. Arch Dis Child. 2001 Apr;84(4):307-10. Go to original source...
    10. Latvian health and health care indicator database [Internet]. Riga: The Centre for Disease Prevention and Control of Latvia [cited 2013 Mar 5]. Available from: http://www.spkc.gov.lv/index.php?id=5. (In Latvian.)
    11. Ebela I, Rumba - Rozenfelde I, Karaškēvica J, Biķis E, Braclavska O, Daugule I, et al. Child mortality: risk factors, causal relationships, possibilities of prevention. In: Rumba- Rozenfelde I, editor. Pediatric diseases and their risk factors. Rīga: LU Akadēmiskais Apgāds; 2009. p. 144-79. (In Latvian.)
    12. Ebela I, Zile I, Zakis A, Folkmanis V, Rumba-Rozenfelde I. Mortality of children under five and prevalence of newborn congenital anomalies in relation to macroeconomic and socioeconomic factors in Latvia. Medicina (Kaunas). 2011;47(12):667-74. Go to original source... Go to PubMed...
    13. Aleshina N, Redmond G. How high is infant mortality in Central and Eastern Europe and the CIS. Innocenti working papers, no. 95 [Internet]. Florence: UNICEF Innocenti Research Centre; 2003 [cited 2013 Sept 9]. Available from: http://www.unicef-irc.org/publications/355/#pdf.
    14. Villerusa A, Zile I, Petersons A. Registration of congenital anomalies in Latvia. RSU Collection of Scientific Papers 2009. Research Articles in Medicine and Phermacy. 2010:103-6.
    15. Gigele I, Rozentāle G, Skrule J, Štāle M. Justice and solidarity in health field: report on attainment of 2nd objective of public health strategy [Internet]. Rīga: Sabiedrības Veselības Aģentūra; 2008 [cited 2013 Jun
    16. 15]. Available from: http://vec.gov.lv/uploads/files/4d00dfb53bac1.pdf. (In Latvian.)
    17. Karaškēvica J. Latvian healthcare system reform and inhabitant health from 1993 to 2003 [dissertation]. Riga: Rīgas Stradiņa Universitāte; 2004. (In Latvian.)
    18. Skrule J, Štāle M, Upmale S. Maternal and child health in perinatal period [Internet]. Rīga: Sabiedrības Veselības Aģentūra; 2009 [cited 2013 Jun 15].Available from: http://kastanis.org/uploads/0000/0186/SVA-Matesun-berna-veseliba-perinatalaja-perioda_2009.11.16-04.pdf. (In Latvian.)
    19. Eurostat. Health statistics - Atlas on mortality in the European Union [Internet]. Luxembourg: Office for Official Publications of the European Communities; 2009 [cited 2013 Jun 15]. Available from: http://www.eurosfaire.prd.fr/7pc/doc/1252488295_atlas_mortalite_ue_2009.pdf.
    20. Ebela I, Karaškēvica J, Ražuka-Ebela D, Rumba-Rozenfelde I. Child healthcare and health situation in Latvia - analysis of several relationships. Proceedings of the University of Latvia 69th Scientific Conference, Medical Section; 2011 Feb 3; Riga, Latvia. Riga: University of Latvia; 2011. p. 33. (In Latvian.)
    21. Kliegman RM, Marcdante KJ, Jenson HB, Behrman RE. Nelson essentials of pediatrics. 5th ed. Philadephia: Elsevier Saunders; 2006.
    22. Prüss-ÜstünA, Bos R, Gore F, Bartram J. Safer water, better health: costs, benefits and sustainability of interventions to protect and promote health [Internet]. Geneva: WHO; 2008 [cited 2013 Sep 9].Available from: http://whqlibdoc.who.int/publications/2008/9789241596435_eng.pdf.
    23. Mathews TJ, MacDorman MF. Infant mortality statistics from the 2005 period linked birth/infant death data set. Natl Vital Stat Rep. 2008 Jul 30;57(2):1-32.
    24. Zeitlin J, Mohangoo A, editors. European perinatal health report: data from 2004 [Internet]. EURO-PERISTAT; 2008 [cited 2013 Jun 15]. Available from: http://www.europeristat.com/reports/european-perinatalhealth-report2004.html.
    25. Office for National Statistics. Gestation-specific infant mortality in England and Wales, 2009. Statistical Bulletin [Internet]. London: Office for National Statistics; 2011 [cited 2013 Aug 13]. Available from: http://www.ons.gov.uk/ons/dcp171778_237668.pdf.
    26. The Millennium Development Goals report 2011 [Internet]. New York: United Nations; 2011 [cited 2013 Sep 9]. Available from: http://www.un.org/millenniumgoals/pdf/%282011_E%29%20MDG%20Report%202011_Book%20LR.pdf.

    Return to the content