Rates and Causes of Neonatal Mortality In North-West of Iran

Background: The neonatal mortality rate (NMR) is a crucial indicator of a country's population health Objectives: This study aims to assess the rates and causes of NMR in West Azerbaijan. Methods: This population-based cross-sectional study utilizes data from the Child Mortality Surveillance System (CMSS) spanning from 2013 to 2022. The study population comprised all neonates (< 28 days old) with permanent residency in any of the 17 cities within the West Azerbaijan province who died within the stated period. Mortality rates, both all-cause and cause-specific, were determined per 1 000 live births for the years 2013, 2016, and 2022. Results: The investigation covered 3 689 reports of neonatal deaths (< 28 days old) from 2013 to 2022. Of these, 53% were males, with an average gestational age of 31.85 ± 5.56 weeks. Over 72% of the deaths occurred in preterm infants, and 69% were linked to cesarean section deliveries. Perinatal prematurity was the leading cause of death during the periods examined, with rates of 32.3%, 35.2%, and 36.8% in 2013, 2016, and 2022, respectively. The distribution of neonatal mortality across the province was uneven, with Poldasht city experiencing the highest mortality rates and Shot city the lowest (9.13 and 2.89 per 1 000 live births, respectively). Conclusions: West Azerbaijan province has achieved the Health-related Sustainable Development Goal (SDG-3) of reducing neonatal mortality to below 12 deaths per 1 000 live births by 2030. Nonetheless, significant disparities in NMR persist across the province. Further epidemiological research and the development of targeted health programs are essential to address areas with elevated mortality rates.