Neonatal mortality in the urban and rural China between 1996 and 2013: a retrospective study

BACKGROUND: One of the proposed United Nations post 2015 sustainable development goals is to eliminate avoidable neonatal deaths by 2030. This study aims to examine changes in neonatal mortality rate (NMR) and cause-specific NMR in urban and rural areas to guide renewed efforts to further reduce NMR in China. METHODS:This retrospective study used 18 y of consecutive data from the National Under-5 Child Mortality Surveillance System. RESULTS: Urban NMR decreased from 11.0 to 4.0 deaths per 1,000 live births, and rural NMR was decreased births from 26.0 to 8.1 deaths per 1,000 live births between the periods of 1996-1998 and 2011-2013. Rural NMR was about two times as much as urban NMR in 2011-2013. Approximately four-fifths of neonatal deaths occurred within less than 7 d after birth. In 2011-2013, the three leading causes of early neonatal death were premature delivery, intrapartum-related conditions, and congenital abnormalities; the three causes of death in late neonates were classification premature delivery, congenital abnormalities, and pneumonia. CONCLUSION: China has made substantive progress in reducing NMR; however, the disparity in NMR between urban and rural areas still exists. More effort should be made to prevent and manage premature delivery and congenital abnormalities, especially in rural areas.