Decreasing Trends of Neonatal and Infant Mortality Rates in Korea: Compared with Japan, USA, and OECD Nations

Abstract

Neonatal mortality rate (NMR) and infant mortality rate (IMR) are two of the most important indices reflecting the level of public health of a country. In this review, we investigated changes in NMR and IMR in Korea and compared the results with those of Japan, USA, and OECD nations. During the past 20 yr, NMR and IMR have lowered remarkably from 6.6 and 9.9 in 1993 to 1.7 and 3.2 in 2009, respectively, in Korea. It is an impressive finding that Korean IMR (3.2 in 2009) is lower than the average of OECD nations (4.7 in 2008), and USA (6.3 in 2009), although higher than Japanese IMR (2.8 in 2009). The proportion of NMR among the IMR calculation decreased from 66.7% in 1993 to 53.1% in 2009. The reason the value of Korea was higher than Japan but lower than USA was speculated to be an aspect of the health care service system. Several suggestions in perinatal, neonatal and infantile health care such as establishment of perinatal care center, research network system, regionalization, and new policies for care of pre-term and high risk pregnancy, are elucidated to achieve further improvement on NMR and IMR in Korea.

Changes in the neonatal and infant mortality rate and the causes of death in Korea

“…1. A remarkable reduction in IMR was observed: 9.9 in 1993, 7.7 in 1996, 6.2 in 1999, 5.3 in 2002, 4.7 in 2005, 4.1 in 2006, 3.5 in 2007, 3.4 in 2008 and 3.2 in 20098).…”

“…Despite the recent high risk of neonatal morbidity due to increasing premature birth rates, the remarkable advances in NMR were partly influenced by highly advanced neonatal intensive care technique during the last 30 years11). In addition, the reduced perinatal mortality rate during the last 20 years (6.0 in 1996, 5.2 in 1999, 4.6 in 2002, 4.2 in 2005, 3.6 in 2006, 3.7 in 2007, 3.6 in 2008, and 3.4 in 2009) influenced the lowered NMR as well12). With decreasing NMR, the proportion of early NMR was 79% in 1993 and 68% in 2009, but the proportion was still over two-thirds the entire NMR, emphasizing the importance of early period neonatal management.…”

Recognizing global disparities in health and in health transitions in the 21st century: what can nurses do?

“…The IM declined from 350 per 1,000 before 1920 to, to 100 per 1,000 during the Korean War, and to 30-40 per 1000 in the 1970s (Chang et al, 2011). It is a surprising finding that IM actually declined during the Korean war when there was no established health care system.…”

Deaths in the Neonatal Intensive Care Unit between 2002 and 2014

“…Although advanced medical care over recent decades has resulted in significantly improved neonatal outcomes [1][2][3][4] , neonatal mortality still represents a large proportion of overall infant and childhood mortality. Under standing the causes and trends of deaths in neonatal intensive care units (NICUs) is important because the proportion of postneonatal deaths has a major impact on infant mortality 5,6) .…”