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Gender variations in neonatal and early infant mortality in India and Pakistan: a secondary analysis from the Global Network Maternal Newborn Health Registry


The risk of mortality and morbidity has been found to be higher in male subjects compared to females during the perinatal period, infancy and childhood. The risk of prematurity, intrauterine growth restriction and respiratory morbidities are also higher in male infants. Male infants are also at an increased risk for respiratory and gastrointestinal infections likely due to high testosterone levels that suppress the immune system. In high-income nations, boys are at a greater risk of neonatal and infant mortality than girls. However, several recent studies have reported higher neonatal and infant mortality in females compared to males in south Asia. A few studies from south Asia also reported that girls experience a higher risk of late neonatal mortality (between 8 and 28 days). Gender preference and differential health care-seeking behavior can contribute to higher late neonatal and infant mortality in south Asian girls. The information on gender difference in stillbirths and mortality in different periods of infancy is important for developing strategies and identifying measures directed at reducing sex-specific mortality. The objective of the current study was to determine the gender differences in stillbirths, early and late neonatal mortality, and 29–42 day mortality in south Asia using Global Network data from the Maternal Newborn Health Registry (MNHR). We hypothesize that gender differences exist in fetal and neonatal survival with sex-specific trends in stillbirths, early and late neonatal mortality, and 29–42 day mortality. Understanding the variation in sex-specific differences in stillbirth and neonatal mortality will help to develop strategies to address them.

By: Aghai ZH, Goudar SS, Patel A, Saleem S, Dhaded SM, Kavi A et al.

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