A systematic review and meta-analysis of 32 Indian studies covering 14,681 neonatal deaths found 75% occurred on days 1-7 and 36% on day one. Prematurity/low birth weight accounted for 31%; over 90% of asphyxia- and prematurity-related deaths occurred in week one, while sepsis was distributed into the late period. Evidence spans heterogeneous observational studies.
Key findings
- Across 32 studies and 14,681 deaths, pooled early mortality was 75% (95% CI 68-81) and late mortality 25% (20-30); 36% occurred on day one and 18% on days two-three. Prematurity/low birth weight contributed 31%. Over 90% of asphyxia and prematurity deaths occurred in week one; sepsis was 45% early and 52% late.
Why this matters globally
Findings support investment in safe delivery, neonatal resuscitation and immediate preterm/low-birth-weight care, alongside continued sepsis surveillance beyond the first critical days.
Thai researcher contribution
Anuj Kumar Pandey is affiliated with Mahidol University's Institute for Population and Social Research alongside Indian institutions and the University of Huddersfield. All mortality data concern India, not Thailand.
Limitations to consider
Source studies vary by period, geography, facility/community setting, cause definition and death certification, creating heterogeneity and possible publication bias. Shares among deaths are not live-birth risks, and cross-study time patterns are not a national longitudinal series.