Fatal discrimination | Nepali Times

A new study in Nepal has found that more female babies die after the third week of birth than male ones. 

Even though more male babies die in the first week after birth, the survey points to how gender discrimination may be disproportionately claiming the lives of girl children.

The findings have larger implications for Nepal’s target to reduce the Neonatal Mortality Rate (NMR) to 12 deaths per 1,000 live births by 2030 as per the Sustainable Development Goals (SDGs). At present, the figure stands at 21. 

Neonatal mortality is the death of a child between 0- 28 days of birth. It can be categorised into early (0-7 days) and late neonatal death (7-28 days). NMR is an important indicator of maternal and newborn health, which shows a country’s quality of life. 

Generally, male children are at an approximately 20% greater risk of succumbing to neonatal mortality than girls. Several factors associated with higher neonatal mortality among male children include intrauterine growth restriction, respiratory distress syndrome, prematurity and birth asphyxia. 

Animal model studies have shown that testosterone suppresses the immune system, while oestradiol and progesterone in females improve immune responses which means they are better able to fight infections. Data from high-income countries reveal that it is true not only during the neonatal period, but later on in life as well. 

In low and middle-income countries males are at a higher risk of mortality in the early neonatal period but more females die in the late neonatal stage. But the specific age (days) where this reversal takes place was not previously known.

Which is why we conducted a study to examine sex differentials in neonatal mortality by detailed ages (0-1, 1-3, 3-7, 7-14,14-21 and 21-28 days). This is the first study to look at the sex differentials by such granular ages.

We looked into data from three sequential, community-based randomised controlled trials (RCTs) in Sarlahi district of the southern plains of Nepal. The studies provide pregnancy cohorts from 1999 through 2017.

Neonatal mortality was 41.9 (44.2 vs 39.7 in boys and girls), 30 (30.5 vs 29.6 in boys and girls) and 31.4 (33.4 vs 29.4 in boys and girls) in 1999, 2002 and 2010 studies respectively. A common finding in all three studies was that male mortality was higher in the early neonatal period (0-7days), but there was a reversal after the third week of life (21-28 days), where female mortality was higher.

Leave a Reply

Your email address will not be published. Required fields are marked *