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IJE Advance Access published online on March 23, 2006

International Journal of Epidemiology, doi:10.1093/ije/dyl047
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2006; all rights reserved.
Accepted March 2, 2006

Original paper

Post-neonatal mortality in Norway 1969-95: a cause-specific analysis

Annett Arntzen 1 *, Sven Ove Samuelsen 2, Anne Kjersti Daltveit 3, and Camilla Stoltenberg 4

1 Faculty of Social Science, Vestfold University College, PO Box 2243, N-3103 Tønsberg, Norway
2 Department of Mathematics, University of Oslo, PO Box 1053 Blindern, N-0316 Oslo, Norway
3 Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway; Division of Epidemiology, Norwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, Norway
4 Division of Epidemiology, Norwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, Norway

* To whom correspondence should be addressed.
Annett Arntzen, E-mail: Annett.Arntzen{at}hive.no


   Abstract

Background We recently reported increased social inequality for post-neonatal death. The aim of the present study was to investigate the association between socioeconomic status and cause-specific post-neonatal death.

Methods All 1 483 857 live births recorded in the Medical Birth Registry of Norway from 1969-95 with information on parents' education were included. During the post-neonatal period (from 28 to 364 days of life) 4464 infants died. Differences between education groups were estimated as risk differences, relative risks, population attributable fractions, and relative index of inequality.

Results The major causes of death were congenital conditions, sudden infant death syndrome (SIDS), and infections. Post-neonatal mortality declined from 3.2/1000 in the 1970s to 1.9/1000 in the 1990s, mainly due to reduced mortality from congenital conditions. The absolute risk for SIDS increased by 0.51/1000 in the same period among infants whose mothers had low education, while it decreased by 0.56/1000 for those whose mothers had high education. The relative risk for SIDS among infants whose mothers had low education increased from 1.02 in the 1970s to 2.39 in the 1980s and 5.63 in the 1990s. Among infants whose fathers were not recorded in the Birth Registry, the absolute risk of SIDS increased by 0.79/1000 from the 1970s to the 1990s.

Conclusions Increased social inequality for post-neonatal death was primarily due to increases in the absolute and relative risks of SIDS among infants whose mothers have low education. Social inequality widened during the study period for SIDS and deaths caused by infections.

Keywords: Post-neonatal mortality; causes of death; socioeconomic factors; trend.
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