Published online April 10, 2006
PEDIATRICS Vol. 117 No. 5 May 2006, pp. e949-e954 (doi:10.1542/peds.2005-2354)
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Reduction in Neonatal Mortality in Chile Between 1990 and 2000

Rogelio Gonzalez, MDa, Mario Merialdi, MD, PhD, MPHb, Ornella Lincetto, MD, MPHc, Jeremy Lauer, MA, MScd, Carlos Becerra, MDe, René Castro, MDe, Pedro García, MDe, Ola D. Saugstad, MD, PhDf and José Villar, MD, MPH, FRCOGb

a Department of Obstetrics and Gynecology, Sotero del Rio Hospital, Center for Perinatal Diagnosis, Catholic University of Chile, Santiago, Chile
b Departments of Reproductive Health and Research
c Making Pregnancy Safer
d Health Systems Financing, World Health Organization, Geneva, Switzerland
e Ministry of Health, Santiago, Chile
f Department of Pediatric Research, Rikshospitalet University Hospital, University of Oslo, Oslo, Norway

OBJECTIVE. Our objective with this article was to describe the declining trend in neonatal mortality in Chile between 1990 and 2000 and examine potential causal factors.

METHODS. Descriptive analysis of data that were provided by the Chilean Ministry of Health on all ~2900000 births occurred in Chile between 1990 and 2000. Total neonatal mortality rates (<28 days), and birth weight–specific and gestational age–specific mortality rates from 1990 to 2000 were analyzed by year. Public health interventions that were implemented during the 1990s were reviewed to assess their potential influence on the observed trends in neonatal mortality.

RESULTS. The neonatal mortality rate between 1990 and 2000 decreased from 8.3 to 5.7 per 1000 live births. This decline was not associated with decreases in the proportion of low birth weight and preterm infants but rather with declines in birth weight–specific and gestational age–specific mortality rates. Examination of the trends in birth weight–specific and gestational age–specific mortality rates showed that a marked proportional decrease in mortality rates was achieved among infants who weighed <1500 g and were delivered before 32 weeks. It is plausible, both biologically and temporally, that the observed trends in the reduction in birth weight–specific and gestational age–specific mortality rates are associated with the introduction of specific sector-wide interventions that aim to improve newborn care in very preterm and low birth weight infants.

CONCLUSIONS. Important reductions in newborn mortality in developing countries are possible with the implementation of effective neonatal care interventions.

Key Words: health policy • public health • neonatal mortality • international child health • health services

Abbreviations: LBW—low birth weight • VLBW—very low birth weight

Accepted Nov 28, 2005.




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