Relationship between infant mortality and altitude in the Northwest region of Argentina.

INTRODUCTION Given its location on the Andes, the Northwest region of Argentina is geographically, socioeconomically, culturally, and biologically heterogeneous, and this is reflected on an infant mortality rate (IMR) that is higher than in any other Argentine region. OBJETIVE To estimate IMR, neonatal mortality rate (NMR), and post-neonatal mortality rate (PNMR), and to analyze their spatial and temporal variations using secular trends and the relative risk based on altitudinal zones. POPULATION AND METHOD This was a retrospective, descriptive, correlational study based on birth and death data recorded in the Northwest region of Argentina (1998-2010); IMR, NMR, PNMR, secular trends, and the relative risk of death were calculated by district and altitudinal zone (districts at < 2000 meters above sea level, lowlands; at > 2000 meters above sea level, highlands) by means of a cluster analysis. RESULTS AND CONCLUSIONS Rates were higher in the highlands; IMR was 29.8%o (versus 15.6%o in the lowlands); PNMR was 17.7% in the highlands (versus 5.2% in the lowlands). In the highlands, there was an annual average reduction of 3.9% in IMR and of 4.1% in PNMR; in the lowlands, such reduction was of 7.0% in IMR and of 9.3% in PNMR. The relative risk of IMR and PNMR was significantly higher at high-altitude zones. NMR, its secular trend, and the relative risk did not show statistically significant differences between both altitudinal zones.

[1]  M. Marrodán,et al.  Altitude effect on birth weight and prematurity in the Province of Catamarca (Argentina) , 2015, American journal of human biology : the official journal of the Human Biology Council.

[2]  M. Sammel,et al.  Preterm birth risk at high altitude in Peru. , 2015, American journal of obstetrics and gynecology.

[3]  Victoria Mazzeo La mortalidad infantil en Argentina. Análisis de sus cambios y de las diferencias regionales , 2015 .

[4]  E. Alfaro,et al.  Efecto de la altitud sobre el peso al nacer y eventos perinatales adversos en dos poblaciones argentinas , 2013 .

[5]  G. Gonzales Impacto de la altura en el embarazo y en el producto de la gestación , 2012 .

[6]  H. Behm Determinantes economicos y sociales de la mortalidad en America Latina , 2011 .

[7]  E. Alfaro,et al.  VARIABILIDAD INTERPOBLACIONAL Y DIFERENCIAS AMBIENTALES, MATERNAS Y PERINATALES DEL PESO AL NACIMIENTO , 2009 .

[8]  L. Huicho,et al.  Child health and living at high altitude , 2008, Archives of Disease in Childhood.

[9]  L. Huicho,et al.  National and sub-national under-five mortality profiles in Peru: a basis for informed policy decisions , 2006, BMC public health.

[10]  Horacio Cao,et al.  Desarrollo regional en la Argentina: la centenaria vigencia de un patrón de asimetría territorial , 2006 .

[11]  N. Grañana,et al.  Problemas respiratorios durante el sueño en lactantes nativos del altiplano argentino , 2005 .

[12]  Fernando Longhi,et al.  El Norte Grande Argentino entre el progreso y la pobreza , 2005 .

[13]  M. Serrano,et al.  Peso al nacimiento en comunidades de altura de la Puna Argentina: Antofagasta de la Sierra (Catamarca) , 2005 .

[14]  L. Moore,et al.  Intrauterine Growth Restriction, Preeclampsia, and Intrauterine Mortality at High Altitude in Bolivia , 2003, Pediatric Research.

[15]  M. Serrano,et al.  Peso al nacimiento en ecosistemas de altura: noroeste argentino, Susques , 2003 .

[16]  E. Alfaro,et al.  Variación altitudinal del peso al nacer en la provincia de Jujuy , 2002 .

[17]  D. Barker,et al.  Effects of Altitude versus Economic Status on Birth Weight and Body Shape at Birth , 2001, Pediatric Research.

[18]  S. Kiechl,et al.  Living at high altitude and risk of sudden infant death syndrome , 1998, Archives of disease in childhood.

[19]  A. Wiley Neonatal size and infant mortality at high altitude in the western Himalaya. , 1994, American journal of physical anthropology.

[20]  J. Reeves,et al.  Fetal growth retardation and increased infant mortality at high altitude. , 1977, Obstetrical & gynecological survey.

[21]  A. R. Frisancho,et al.  Secular trend in neonatal mortality in the moutain states. , 1970, American journal of physical anthropology.

[22]  R. Mazess Neonatal mortality and altitude in Peru. , 1965, American journal of physical anthropology.

[23]  J. A. Lichty,et al.  Studies of babies born at high altitudes. I. Relation of altitude to birth weight. , 1957, A.M.A. journal of diseases of children.