Infant mortality by cause of death
Authors: Milankovic Jasna 
Published: April 2020

Infant mortality is still a major problem in our country as its level has
remained relatively high by European standards. This points to the need for
better preventive measures particularly as regards infant mortality and
other adverse consequences of pregnancy, as key indicators of health and
health care for mother and child. Namely, the analysis of movement in infant
mortality in low mortality countries shows that it can be decreased
relatively easily if certain social and health care measures are undertaken.
For that reason, it is necessary to engage in permanent organized research
to explain and measure both the relative impact of individual factors or
groups of factors in our country which are significant in terms of infant
mortality and their mutual relationships. We should also try to gain from
the experiences of other countries which had already made progress in this
respect. One of the elements of prevention is certainly the analysis of
causes of infant morbidity and mortality primarily during the pre-natal
period with the aim of specifying the most frequent causes of death to
enable their elimination and to induce a subsequent decline in infant
mortality. Besides showing the efficiency of health service activities, data
on causes of infant death also point to the specific measures that should be
undertaken and may be used as a base for planning and programming the
development of health services, i.e. implementation of health policy as part
of the population policy. With the decline in infant mortality in our
country there has also been registered a change in the composition of
diseases as the most frequent cause of death. During the initial observation
period when the general level of infant mortality was exceptionally high,
the share of infectious diseases and those of the respiratory system was
very large. These deaths were mainly induced by exogenous factors, that is
the diseases which the society in general and health services in particular
could most easily have checked both by measures to improve the general
living conditions and by preventive and curative health care measures. The
period from 1989 to 1996 is characterized by endogenous causes of infant
mortality primarily during the neonatal period and have to do with the
constitutional features of the live-born children, congenital anomalies,
premature birth, respiratory distress, etc. Thus, from the socio-medical
point of view, the primary causes of infant mortality in this period are
genetically induced or can be attributed to the mother in labour birth which
modern men and modern medicine cannot influence to a larger extent. The
analysis of infant death frequency by group of causes of death points that
there still exist possibilities of eliminating the exogenous causes of death
(as the same causes prevail in the socio-economically least developed
regions of the country). Besides, some improvement can also be expected in
the area of endogenous mortality (improvement in pre-natal diagnostics and
other measures of health care for pregnant women and those who have just
given birth, better conditions for child delivery and application of modern
techniques to care for the prematurely born children. The semanatal
mortality is probably the major socio-medical problem in our country both
because it accounts for the highest percentage in neo-natal mortality and
because it displays an almost negligible downward tendency. This justifies
another request - for a more extensive and comprehensive analysis of this
problem as well as for participation of other scientific disciplines besides
medicine. Among the leading causes of semanatal mortality in the most recent
observation period are premature birth, congenital anomalies, respiratory
distress syndrome and intrauterine hypoxia and asphyxia at birth.