WHICH BABIES DIE DURING THE FIRST WEEK - A CASE-CONTROL STUDY IN A NICARAGUAN HOSPITAL

In a hospital-based case control study (108 and 285 infants) on risk f actors for early neonatal death in Nicaragua, an analysis was performe d on the possible association with characteristics of the mother and h er environment, her reproductive history and contact with antenatal se rvices as well as characteristics of the child. Antenatal medical supe rvision was associated with a lower risk for neonatal death, even when adjusting for parents' literacy. This association disappeared if birt h weight or gestational age was entered into the analysis. There was a n interaction between mortality and the mother's versus the father's l iteracy, showing the highest risk if the mother was illiterate and the fater was literate (odds ratio, OR 7.0, CI 2.6-19.3), while illiterac y of both parents was associated to a lower risk (OR 4.2, CI 1.0-18.3) . The strong association between maternal literacy and early neonatal death is striking. Is maternal empowerment the important factor?