Trends and Causes of Neonatal Mortality in Serbia, 1997-2016

Background: Regardless to notable reduction of child deaths worldwide over the last 30 years, the proportion of neonatal mortality in total child mortality is increasing. Aims: Trends analysis of neonatal mortality in Serbia. Study design: Observational descriptive surveillance system evaluation study. Methods: Join-point regression was used to analyze neonatal mortality data for the 1997-2016 period, obtained from the Statistical Office of Serbia. Results: Trend in neonatal mortality rate (NMR) decreased significantly, by -5.6% (95% CI: -6.5 to -4.6) per year from 1997 to 2007, and by -2.6% (95% CI: -3.7 to -1.5) per year from 2007 to 2016. NMR from certain conditions originating in the perinatal period decreased by -6.2% (95% CI: -7.5 to -4.9) per year in the 1997-2006 period and by -1.9% (95% CI: -3.1 to -0.7) per year yearly in the 2006-2016 period. Among these conditions, disorders related to short gestation and low birth weight, not elsewhere classified, showed an upward trend by 8.5% (95% CI: 6.2 to 10.8) per year during the entire study period. From 1997 to 2016, a significant decrease in NMR was detected in cases of congenital malformations, deformations and chromosomal abnormalities, by -5.0% (95% CI: -6.1 to -4.0) per year. NMR for cases of symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified, decreased by -8.1% (95% CI: -11.0 to -5.2) yearly. Conclusions: In the 1997-2016 period, neonatal mortality in Serbia decreased, with the exception of disorders related to short gestation and low birth weight, whose prevention should be therefore given the highest public health priority.