Correlations between infant mortality and recommended immunization schedules against vaccine–preventable diseases in Slovenia

M. Zemljič, B. Pejković, Ivan Kranjc, A. Kraigher
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Abstract

Purpose: The infant mortality rate (IMR) is among the most important indicators of a nation's health and well–being. In Slovenia, over the last 55 years, infant mortality (IM) has decreased rapidly and vaccinations are undoubtedly the major contributing factor. In Slovenia, infant immunization is initiated at the age of 3 months. The vaccination schedule includes several doses of combined vaccines that should be administered according to the yearly program on immunization. Methods: In this retrospective study, 279 infants were divided into subgroups in accordance with the vaccination program. The structure of the study design used the data of the National Institute of Public Health of Slovenia regarding the causes of IM for the years 2007–2011 Results: Direct and indirect leading causes of death were infant respiratory distress syndrome (n = 22), extreme immaturity (n = 19), necrotizing enterocolitis (n = 18), extremely low birth weight (n = 14), and hypoplastic left heart syndrome (n = 14). The maximum IMR (85.30%) occurred before the recommended vaccination period. During the prescribed program of vaccination, the IMR was 14.70%. Conclusion: Genetic alterations, congenital abnormalities, and preterm birth complications are the major and leading causes of IM. Most instances of IM occur within the first two months of life, before the recommended vaccinations. During the recommended vaccination period, IM is low and causes of death are largely congenital and genetic diseases. The results of the comparative study during the recommended vaccination schedule by the end of the first year of life from 2007 to 2011 substantiates that the vaccines are not a major cause of IM.
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斯洛文尼亚婴儿死亡率与针对疫苗可预防疾病的推荐免疫时间表之间的相关性
目的:婴儿死亡率是一个国家健康和福祉的最重要指标之一。在斯洛文尼亚,过去55年来,婴儿死亡率迅速下降,接种疫苗无疑是主要因素。在斯洛文尼亚,婴儿免疫接种在3个月大时开始。疫苗接种计划包括几剂联合疫苗,应根据年度免疫计划进行管理。方法:采用回顾性研究方法,将279例婴儿按照疫苗接种方案分为亚组。研究设计的结构使用了斯洛文尼亚国家公共卫生研究所2007-2011年关于IM原因的数据。结果:直接和间接的主要死亡原因是婴儿呼吸窘迫综合征(n = 22)、极度不成熟(n = 19)、坏死性小肠结肠炎(n = 18)、极低出生体重(n = 14)和左心发育不良综合征(n = 14)。最大IMR(85.30%)发生在推荐接种期之前。在规定的接种方案中,IMR为14.70%。结论:遗传改变、先天性异常和早产并发症是导致IM的主要原因。大多数IM病例发生在生命的头两个月内,在推荐的疫苗接种之前。在建议的疫苗接种期间,死亡率很低,死亡原因主要是先天性和遗传性疾病。在2007年至2011年这一出生第一年结束前推荐的疫苗接种计划期间进行的比较研究结果证实,疫苗不是IM的主要原因。
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