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      Early neonatal death: A challenge worldwide.

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          Abstract

          Early neonatal death (ENND), defined as the death of a newborn between zero and seven days after birth, represents 73% of all postnatal deaths worldwide. Despite a 50% reduction in childhood mortality, reduction of ENND has significantly lagged behind other Millennium Developmental Goal achievements and is a growing contributor to overall mortality in children aged <5 years. The etiology of ENND is closely related to the level of a country's industrialization. Hence, prematurity and congenital anomalies are the leading causes in high-income countries. Furthermore, sudden unexpected early neonatal deaths (SUEND) and collapse have only recently been identified as relevant and often preventable causes of death. Concomitantly, perinatal-related events such as asphyxia and infections are extremely relevant in Africa, South East Asia, and Latin America and, together with prematurity, are the principal contributors to ENND. In high-income countries, according to current research evidence, survival may be improved by applying antenatal and perinatal therapies and immediate newborn resuscitation, as well as by centralizing at-risk deliveries to centers with appropriate expertise available around the clock. In addition, resources should be allocated to the close surveillance of newborn infants, especially during the first hours of life. Many of the conditions leading to ENND in low-income countries are preventable with relatively easy and cost-effective interventions such as contraception, vaccination of pregnant women, hygienic delivery at a hospital, training health care workers in resuscitation practices, simplified algorithms that allow for early detection of perinatal infections, and early initiation of breastfeeding and skin-to-skin care. The future is promising. As initiatives undertaken in previous decades have led to substantial reduction in childhood mortality, it is expected that new initiatives targeting the perinatal/neonatal periods are bound to reduce ENND and provide these babies with a better future.

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          Author and article information

          Journal
          Semin Fetal Neonatal Med
          Seminars in fetal & neonatal medicine
          Elsevier BV
          1878-0946
          1744-165X
          June 2017
          : 22
          : 3
          Affiliations
          [1 ] Division of Neonatology, Turku University Hospital, Turku, Finland; University of Turku, Turku, Finland.
          [2 ] Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain.
          [3 ] Health Research Institute La Fe, Valencia, Spain.
          [4 ] Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain; Health Research Institute La Fe, Valencia, Spain. Electronic address: maximo.vento@uv.es.
          Article
          S1744-165X(17)30021-5
          10.1016/j.siny.2017.02.006
          28238633
          f1774eb1-8801-45f9-8e9d-56d30f37cfac
          History

          Morbidity,Early death,Mortality,Newborn
          Morbidity, Early death, Mortality, Newborn

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