HANOI -- About 4 million babies die in their first month of life -- about half of those in the first 24 hours, according to a global report on newborn mortality.
Simple measures such as knit caps to keep babies warm could help save many of those lives, according to the report released yesterday by Save the Children, a group based in the United States.
Expectant mothers also fare poorly in undeveloped countries, with half a million women dying annually from complications during pregnancy or birth often because they have no care before, during, or after their babies are born, the report said. A huge number of women give birth at home alone or with no skilled attendant.
''In most of the developing world, childbirth is a dance with death for both mother and baby, even though 70 percent of those deaths could be prevented," said Anne Tinker, a coauthor and director of the organization's Saving Newborn Lives Initiative. ''The secret is really knowledge."
The 50-page report compiles data from the world's nations as well as the World Health Organization and UNICEF. It presents a bleak look at the challenges pregnant women and newborns face in impoverished countries, where up to 99 percent of deaths occur -- illustrating the wide gap between rich and poor nations.
For instance, 1 in every 5 women in sub-Saharan Africa has lost a baby in the first month of life, along with 1 in every 7 women in South Asia.
Out of 78 low- and middle-income countries examined, Liberia had the highest newborn mortality rate with 65 out of 1,000 babies dying in a country where forced teen marriages are common and many women die during pregnancy or childbirth.
Liberia was closely followed by Afghanistan, Sierra Leone, Iraq, Pakistan, and Ivory Coast.
The Save the Children report acknowledges the challenges of cultural and traditional practices. In some countries there are rituals such as immediately bathing newborns and letting them dry in the cold.
The report highlights the need for better education and nutrition among expectant mothers, along with the importance of breast-feeding. It offers cost-effective options to protect mothers and babies against infection, especially from dirty instruments that may be used during birth.
The study found that most newborn deaths result from some type of infection, such as pneumonia or diarrhea, or complications related to premature births. Low birth weight and lack of proper care also contribute.
In the developing world, Vietnam and Colombia were most highly rated, with both countries boasting high percentages of prenatal care, births assistance with a skilled attendant, and higher levels of education. The two countries tied for the lowest newborn mortality rates with 12 out of 1,000 babies dying in the first month of life.
In the industrialized world, Japan had the lowest newborn mortality rate of 1.8 per 1,000, followed by the Czech Republic, Finland, Iceland, and Norway.
The United States had one of the highest newborn death rates -- 5 in 1,000 -- in the developed world. It tied with Hungary, Malta, Poland, and Slovakia.
The US rate was largely affected by deaths among minorities and poor, rural, uneducated women. Many of the deaths were linked to low birth weight and premature birth.