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Login with Facebook. Why register? What children die from in the first few days or weeks of life is very different to the months and years that follow. So, too, are the interventions to prevent these deaths. In the visualization we see the total number of child deaths by life stage. More than one-third — 1. This is a devastatingly large number: it means that, on average, 5, children younger than one week die every day. While child mortality has fallen across all age groups, the rate of reduction has not been even.
The world has been much more successfully in preventing deaths of older children than young infants. Since , mortality has fallen by:. Older children tend to die from diseases such as diarrhea , pneumonia , measles , and meningitis. These can now be prevented through vaccination. Over the last decades, the world has made rapid progress in the fight against these vaccine-preventable diseases. But the causes of death in the youngest children are very different.
Pre- and post- birth complications — which are the major cause of death in the early days of life — cannot be directly prevented by these types of interventions. This means that as child mortality rates decline across the world, our attention must turn increasingly towards saving babies in the first days of life. We need to make much faster progress in addressing neonatal causes of death.
Neonatal deaths can be prevented by provision of basic care for mothers and newborns. Over the past decades the coverage of many of these interventions has increased: more women receive antenatal care , more births are attended by a skilled healthcare worker , more newborns are exclusively breastfed. But the coverage of these and other interventions is still far from sufficient.
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More than , neonates died in due to complications arising as a result of preterm birth. Premature birth is common globally, around 1 in 10 newborns is born prematurely every year.
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Close to half a million newborns died due to this condition in In the map you see child mortality rates due to complications arising as a result of preterm birth. Globally, preterm birth mortality rates have been falling since In that number has halved to 0. Some countries have made impressive progress in recent decades: Brazil, Peru and Egypt, for example, now see close to five times fewer deaths from premature births compared to almost 30 years ago.
But huge disparities between countries still exist. The highest mortality rate due to preterm birth complications is in Sudan, where out of , preterm babies die.
There are two ways to reduce preterm mortality rates: trying to reduce the prevalence of preterm births and providing better care for babies who are born prematurely. A recent systemic review of the literature by the Cochrane Library has identified four interventions that had a positive effect on reducing preterm births: We should note that zinc supplementation was found to be effective in studies based on low-income populations.
Therefore, the study authors suggest that this may be a consequence of a general maternal undernutrition. Indeed, multiple observational studies have indicated that maternal nutrition may have an impact on the length of pregnancies. In the right settings, most premature babies can be taken care of with simple interventions. The key care required for preterms is provision of thermal insulation and feeding, both of which can usually be provided by the mother through kangaroo care. Kangaroo care involves early breastfeeding and hour skin-to-skin contact between the mother and newborn. From life expectancy to mental health ; substance use to cancer rates ; there are important differences in health outcomes between the sexes.
Here we focus on the youngest, asking, why do young boys die more often than girls?
Child mortality measures the share of newborns who die before reaching their 5th birthday. In the chart below we see the comparison of child mortality by sex. Here, the mortality rate for boys is shown on the y-axis, and the mortality rate for girls on the x-axis. The grey line running diagonally across the chart marks where the mortality rate for both sexes is equal. In countries which lie above the grey line, the rate for boys is higher than for girls. This is also true for infant mortality , which is the share of newborns who die within their 1st year of life. We study why India and Tonga are outliers here.
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Over the past half-century in particular, child mortality has been falling rapidly across the world. This has been true for boys and girls alike. It has been known for a long time that the mortality of boys is higher. Why is it the case that boys die more often than girls? In this chart we see global mortality rates in infants across different causes in Just like the charts above, causes which lie above the grey line are more common in boys.
The chart shows that for all major causes of death, mortality is higher in boys. The sex differences in the causes of infant deaths were already documented almost a century ago: in an impressive paper published in , Bawkin explores the mortality sex ratio of specific diseases from countries across the world. But overall, infant boys are more likely to die in childhood than girls. Boys are more vulnerable in two key ways: they are at higher risk of birth complications, and infectious disease. We explore the possible reasons for this below.
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From comparison of mortality rates in infant boys and girls, it becomes clear that boys are at higher risk of complications in the first few days of life: preterm births, asphyxia, birth defects and heart anomalies. But why? First of all, boys are more likely to be born prematurely : the share of boys born before full-term pregnancy is higher than for girls. Boys tend to have a higher birthweight than girls — which can increase the risk of waiting to term to deliver — meaning that more boys are induced before the end of the pregnancy term.
The fact that preterm births are more common for boys contributes to this. Although boys are, on average, heavier than girls at birth, they are less physiologically mature at birth. This means they are at higher risk of having delayed physiological function such as lung function and adverse neurological outcomes. The reason for this difference has been an important question for decades — the answer is still not clear. But there are some leading hypotheses: surfactant production for lung function has been observed earlier in female fetuses, leading to improved airway flow in the lungs; estrogen has been shown to affect lung development positively in females; males, on average, have a higher birthweight meaning they may trade-off increased size for functional development; and the uterus may be less hospitable to male fetuses — the introduction of a Y chromosome in females can create and immunoreactive response to the central nervous system.
This, combined with a higher risk of premature birth may explain why boys have higher rates of asphyxia, respiratory infections and birth defects. Boys are also at higher risk of infectious diseases such as syphilis, malaria , respiratory infections, tetanus and diarrheal diseases. This is more generally true for a broad range of infections, spanning person-to-person, vector-borne, blood-borne, and food and water borne diseases. We see this clearly when we compare mortality rates for boys and girls in the earlier chart. But why are boys more susceptible to infection?
Overall, boys have weaker immune systems. There are two key hypotheses for why. The Y-chromosome in boys increases their vulnerability. Biologically, males and females are differentiated by chromosomes: females have two X chromosomes XX and males one X and one Y chromosome XY.
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Having two X chromosomes means that the newborn has a stronger immune system because X chromosomes contain a larger number of immune-related genes. This makes males more vulnerable to many infectious diseases. They are also more susceptible to specific genetic diseases where the defective genes are carried on either the X or Y chromosomes; this is because boys have only one X chromosome so a single recessive gene on that X chromosome results in the disease.
But the stronger immune response of females comes with a cost. Sex hormones may be another key reason for weaker immune systems in males. Males have much higher amounts of testosterone which seem to inhibit two major parts of the immune system — B and T-lymphocytes.
Estrogen, on the other hand, acts as an effective regulator of this. Overall, male hormones weaken the immune system relative to females. This is not restricted to childhood: the female advantage carries into adulthood. More specifically, differences in maturity, sex chromosomes, and hormones. In circumstances where both sexes are treated equally, we would therefore expect infant and child mortality rates to be slightly higher for boys. As one would expect, income level of the country is extremely correlated with child mortality rate.