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PLoS One. 2016 Jan 8;11(1):e0146669. doi: 10.1371/journal.pone.0146669. eCollection 2016.

Mortality in Children Aged 0-9 Years: A Nationwide Cohort Study from Three Nordic Countries.

Author information

1
Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
2
Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.
3
Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
4
Information Department, THL National Institute for Health and Welfare, Helsinki, Finland.
5
Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America.
6
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.

Abstract

BACKGROUND:

Mortality in children under five years has been widely studied, whereas mortality at 5-9 years has received little attention. Using unique data from national registers in three Nordic countries, we aimed to characterize mortality directionality in children aged 0 to 9 years.

METHODS AND FINDINGS:

The cohort study included all children born in Denmark from 1973 to 2008 (n = 2,433,758), Sweden from 1973 to 2006 (n = 3,400,212), and a random sample of 89.3% of children born in Finland from 1987 to 2007 (n = 1,272,083). Children were followed from 0 to 9 years, and cumulative mortality and mortality rates were compared by age, gender, cause of death, and calendar periods. Among the 7,105,962 children, there were 48,299 deaths during study period. From 1981-1985 to 2001-2005, all-cause mortality rates were reduced by between 34% and 62% at different ages. Overall mortality rate ratio between boys and girls decreased from 1.25 to 1.21 with the most prominent reduction in children aged 5-9 years (from 1.59 to 1.19). Neoplasms, diseases of the nervous system and transport accidents were the most frequent cause of death after the first year of life. These three leading causes of death declined by 42% (from 6.2 to 3.6 per 100,000 person years), 43% (from 3.7 to 2.1) and 62% (from 3.9 to 1.5) in boys, and 25% (from 4.1 to 3.1 per 100000 person years), 42% (from 3.4 to 1.9) and 63% (from 3.0 to 1.1) in girls, respectively. Mortality from neoplasms was the highest in each age except infants when comparing cause-specific mortality, and half of deaths from diseases of the nervous system occurred in infancy. Mortality rate due to transport accidents increased with age and was highest in boys aged 5-9 years.

CONCLUSIONS:

Mortality rate in children aged 0-9 years has been decreasing with diminished difference between genders over the past decades. Our results suggest the importance of further research on mortality by causes of neoplasms, and causes of transport accidents-especially in children aged 5-9 years.

PMID:
26744840
PMCID:
PMC4706349
DOI:
10.1371/journal.pone.0146669
[Indexed for MEDLINE]
Free PMC Article

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