Regional Contribution of Previable Infant Deaths to Infant Mortality Rates in the United States

2019 ◽  
Author(s):  
MacKenzie Lee ◽  
Eric S. Hall ◽  
Meredith Taylor ◽  
Emily A. DeFranco
Keyword(s):  
United States ◽  
Infant Mortality ◽  
Infant Death ◽  
The United States ◽  
Mortality Rates ◽  
Population Based ◽  
Infant Mortality Rate ◽  
Infant Deaths ◽  
Live Births ◽  
Healthy People 2020

Objective Lack of standardization of infant mortality rate (IMR) calculation between regions in the United States makes comparisons potentially biased. This study aimed to quantify differences in the contribution of early previable live births (<20 weeks) to U.S. regional IMR. Study Design Population-based cohort study of all U.S. live births and infant deaths recorded between 2007 and 2014 using Centers for Disease Control and Prevention's (CDC's) WONDER database linked birth/infant death records (births from 17–47 weeks). Proportion of infant deaths attributable to births <20 vs. 20 to 47 weeks, and difference (ΔIMR) between reported and modified (births ≥20 weeks) IMRs were compared across four U.S. census regions (North, South, Midwest, and West). Results Percentages of infant deaths attributable to birth <20 weeks were 6.3, 6.3, 5.3, and 4.1% of total deaths for Northeast, Midwest, South, and West, respectively, p < 0.001. Contribution of < 20-week deaths to each region's IMR was 0.34, 0.42, 0.37, and 0.2 per 1,000 live births. Modified IMR yielded less regional variation with IMRs of 5.1, 6.2, 6.6, and 4.9 per 1,000 live births. Conclusion Live births at <20 weeks contribute significantly to IMR as all result in infant death. Standardization of gestational age cut-off results in more consistent IMRs among U.S. regions and would result in U.S. IMR rates exceeding the healthy people 2020 goal of 6.0 per 1,000 live births.

scholarly journals State-level trends in sudden unexpected infant death and immunization in the United States: an ecological study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacqueline Müller-Nordhorn ◽  
Konrad Neumann ◽  
Thomas Keil ◽  
Stefan N. Willich ◽  
Sylvia Binting
Keyword(s):  
United States ◽  
Infant Mortality ◽  
Infant Death ◽  
Immunization Coverage ◽  
The United States ◽  
Mortality Rates ◽  
Sleep Position ◽  
Live Births ◽  
Unexpected Infant Death ◽  
Rate Ratios

Abstract Background Sudden unexpected infant death (SUID) continues to be a major contributor to infant mortality in the United States. The objective was to analyze time trends in SUID and their association with immunization coverage. Methods The number of deaths and live births per year and per state (1992–2015) was obtained from the Centers for Disease Control and Prevention (CDC). We calculated infant mortality rates (i.e., deaths below one year of age) per 1000 live births for SUID. We obtained data on immunization in children aged 19–35 months with three doses or more of diphtheria-tetanus-pertussis (3+ DTP), polio (3+ Polio), and Haemophilus influenzae type b (3+ Hib) as well as four doses or more of DTP (4+ DTP) from the National Immunization Survey, and data on infant sleep position from the Pregnancy Risk Assessment Monitoring System (PRAMS) Study. Data on poverty and race were derived from the Current Population and American Community Surveys of the U.S. Census Bureau. We calculated mean SUID mortality rates with 95% confidence interval (CI) as well as the annual percentage change using breakpoint analysis. We used Poisson regression with random effects to examine the dependence of SUID rates on immunization coverage, adjusting for sleep position and poverty (1996–2015). In a second model, we additionally adjusted for race (2000–2015). Results Overall, SUID mortality decreased in the United States. The mean annual percent change was − 9.6 (95% CI = − 10.5, − 8.6) between 1992 and 1996, and − 0.3 (95% CI = − 0.4, − 0.1) from 1996 onwards. The adjusted rate ratios for SUID mortality were 0.91 (95% CI = 0.80, 1.03) per 10% increase for 3+ DTP, 0.88 (95% CI = 0.83, 0.95) for 4+ DTP, 1.00 (95% CI = 0.90, 1.10) for 3+ polio, and 0.95 (95% CI = 0.89, 1.02) for 3+ Hib. After additionally adjusting for race, the rate ratios were 0.76 (95% CI = 0.67, 0.85) for 3+ DTP, 0.83 (95% CI = 0.78, 0.89) for 4+ DTP, 0.81 (95% CI = 0.73, 0.90) for 3+ polio, and 0.94 (95% CI = 0.88, 1.00) for 3+ Hib. Conclusions SUID mortality is decreasing, and inversely related to immunization coverage. However, since 1996, the decline has slowed down.

PUBLIC HEALTH, NURSING AND MEDICAL SOCIAL WORK

PEDIATRICS ◽  
1949 ◽  
Vol 3 (5) ◽  
pp. 722-728
Keyword(s):  
Public Health ◽  
United States ◽  
Infant Mortality ◽  
Relative Frequency ◽  
The United States ◽  
Mortality Rates ◽  
Infant Mortality Rate ◽  
First Year ◽  
Infant Deaths ◽  
One Year

THE infant mortality rate in 1947 was the lowest on record, according to figures released by the National Office of Vital Statistics of the Public Health Service, Federal Security Agency. The number of deaths under one year recorded in the United States during 1947 was 119,173, or 8,110 more than the number (111,063) reported in 1946. However, this increase reflects the tremendous increase in the number of births during 1947 and not a rise in infant mortality. The relative frequency of infant deaths as [SEE TABLE 1,2 and 3 IN SOURCE PDF] measured by the infant mortality rate decreased from 33.8 per 1,000 live births in 1946 to 32.2 in 1947. Provisional figures indicate a further decline in 1948 to an estimated rate of 31.8. The five leading causes of infant deaths in 1947 and the infant mortality rates for each are: premature birth, 11.1 ; congenital malformations, 4.6; pneumonia and influenza, 3.6; injury at birth, 3,5; and asphyxia and atelectasis, 1.6. These leading causes accounted for 75.7% of all the infant deaths in 1947. This was the first year that asphyxia and atelectasis ranked among the five leading causes of infant deaths and that diarrhea, enteritis and ulceration of the intestines has not been in this group. The number of deaths [See Table 4 in source pdf] under one you and infant mortality rates for selected causes in the United States during 1946 and 1947 are presented in Table 2. The relative frequency of deaths under one year is greatest for the under one day age group and decreases steadily with age. Mortality is higher among nonwhite than white infants deaths and among male than female infants. The number of infants deaths and infant mortality rates in the United States for 1947 by subdivisions of the first year of life, race, and sex, are shown in Table 1.

Infant Mortality Among Singletons and Twins in Japan During 1999–2008 on the Basis of Risk Factors

2013 ◽  
Vol 16 (2) ◽  
pp. 639-644 ◽  
Author(s):  
Yoko Imaizumi ◽  
Kazuo Hayakawa
Keyword(s):  
Infant Mortality ◽  
Maternal Age ◽  
Survival Rates ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Infant Mortality Rate ◽  
Age Group ◽  
Neonatal Deaths ◽  
Infant Deaths ◽  
Live Births

The infant mortality rate (IMR) among single and twin births from 1999 to 2008 was analyzed using Japanese Vital Statistics. The IMR was 5.3-fold higher in twins than in singletons in 1999 and decreased to 3.9-fold in 2008. The reduced risk of infant mortality in twins relative to singletons may be related, partially, to survival rates, which improved after fetoscopic laser photocoagulation for twin — twin transfusion syndrome. The proportion of neonatal deaths among total infant deaths was 54% for singletons and 74% for twins. Thus, intensive care of single and twin births may be very important during the first month of life to reduce the IMR. The IMR decreased as gestational age (GA) rose in singletons, whereas the IMR in twins decreased as GA rose until 37 weeks and increased thereafter. The IMR was significantly higher in twins than in singletons from the shortest GA (<24 weeks) to 28 weeks as well as ≥38 weeks, whereas the IMR was significantly higher in singletons than in twins from 30 to 36 weeks. As for maternal age, the early neonatal and neonatal mortality rates as well as the IMR in singletons were significantly higher in the youngest maternal age group than in the oldest one, whereas the opposite result was obtained in twins. The lowest IMR in singletons was 1.1 per 1,000 live births for ≥38 weeks of gestation and heaviest birth weight (≥2,000 g), while the lowest IMR in twins was 1.8 at 37 weeks and ≥2,000 g.

scholarly journals A new record linkage for assessing infant mortality rates in Ontario, Canada

2019 ◽  
Vol 111 (2) ◽  
pp. 278-285 ◽  
Author(s):  
Deshayne B. Fell ◽  
Alison L. Park ◽  
Ann E. Sprague ◽  
Nehal Islam ◽  
Joel G. Ray
Keyword(s):  
Infant Mortality ◽  
Live Birth ◽  
Infant Death ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Infant Mortality Rate ◽  
Income Quintile ◽  
Alternative Source ◽  
Live Births ◽  
Birth Records

Abstract Objective Infant mortality statistics for Canada have routinely omitted Ontario—Canada’s most populous province—as a high proportion of Vital Statistics infant death registrations could not be linked with their corresponding Vital Statistics live birth registrations. We assessed the feasibility of linking an alternative source of live birth information with infant death registrations. Methods All infant deaths occurring before 365 days of age registered in Ontario’s Vital Statistics in 2010–2011 were linked with birth records in the Canadian Institute for Health Information’s hospitalization database. Crude birthweight-specific and gestational age-specific infant mortality rates were calculated, and rates examined according to maternal and infant characteristics. Results Of 1311 infant death registrations, only 47 (3.6%) could not be linked to a hospital birth record. The overall crude infant mortality rate was 4.7 deaths per 1000 live births (95% CI, 4.4 to 4.9), the same as previously reported for the rest of Canada in 2011. Infant mortality was higher in women < 20 years (5.8 per 1000 live births) and ≥ 40 years (5.9 per 1000 live births), and lowest among those aged 25–29 years (3.9 per 1000 live births). Infant mortality was notably higher in the lowest (5.1 per 1000 live births) residential income quintile than the highest (3.4 per 1000 live births). Conclusion Use of birth hospitalization records resulted in near-complete linkage of all Vital Statistics infant death registrations. This approach could enhance the conduct of representative surveillance and research on infant mortality when direct linkage of live birth and infant death registrations is not achievable.

Letter To The Editor

PEDIATRICS ◽  
1970 ◽  
Vol 45 (6) ◽  
pp. 1044-1044
Author(s):  
Alfred Yankauer
Keyword(s):  
United States ◽  
Infant Mortality ◽  
Infant Death ◽  
The United States ◽  
Mortality Rates ◽  
European Countries ◽  
Death Rates ◽  
Letter To The Editor

Second, Dr. Yankauer: "Disgraceful and totally unacceptable" are inflammatory adjectives. They stir up uncomfortable feelings of personal guilt and blame. It would be reassuring if the differences between infant mortality rates in the United States and those of several small European countries with relatively homogenous populations and stable traditions could be explained away as statistical artefacts. Unfortunately the differences cannot be explained away. Clear evidence for their substance is the fact that infant death rates after the first month of life are three times as high in the United States as in Sweden.

ANNUAL SUMMARY OF VITAL STATISTICS—1967

PEDIATRICS ◽  
1968 ◽  
Vol 42 (6) ◽  
pp. 1005-1008
Author(s):  
Myron E. Wegman
Keyword(s):  
United States ◽  
Infant Mortality ◽  
The United States ◽  
Vital Statistics ◽  
Downward Trend ◽  
Vital Rates ◽  
Population Groups ◽  
Infant Deaths ◽  
Live Births ◽  
Second Year

0nmany occasions previously this annual article has included serious criticism of the record of the United States as to infant mortality. It is satisfying, therefore, to report that 1967 marked a second year of a downward trend and that early tentative reports for 1968 are encouraging that the trend has continued. Nevertheless, as will be seen later, there is still a long way to go, and there are too many unacceptably high rates in particular population groups. Each year at this time a report is presented of the national situation in respect of the most significant vital rates, that is live births and infant deaths.

scholarly journals The Challenge of Infant Mortality: Have We Reached a Plateau?

2009 ◽  
Vol 124 (5) ◽  
pp. 670-681 ◽  
Author(s):  
Marian F. MacDorman ◽  
T.J. Mathews
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Infant Death ◽  
Low Birthweight ◽  
Ethnic Disparities ◽  
Mortality Rates ◽  
Infant Mortality Rate ◽  
Racial And Ethnic Disparities ◽  
Live Births ◽  
The U.S

Objectives. Infant mortality is a major indicator of the health of a nation. We analyzed recent patterns and trends in U.S. infant mortality, with an emphasis on two of the greatest challenges: ( 1) persistent racial and ethnic disparities and ( 2) the impact of preterm and low birthweight delivery. Methods. Data from the national linked birth/infant death datasets were used to compute infant mortality rates per 100,000 live births by cause of death (COD), and per 1,000 live births for all other variables. Infant mortality rates and other measures of infant health were analyzed and compared. Leading and preterm-related CODs, and international comparisons of infant mortality rates were also examined. Results. Despite the rapid decline in infant mortality during the 20th century, the U.S. infant mortality rate did not decline from 2000 to 2005, and declined only marginally in 2006. Racial and ethnic disparities in infant mortality have persisted and increased, as have the percentages of preterm and low birthweight deliveries. After decades of improvement, the infant mortality rate for very low birthweight infants remained unchanged from 2000 to 2005. Infant mortality rates from congenital malformations and sudden infant death syndrome declined; however, rates for preterm-related CODs increased. The U.S. international ranking in infant mortality fell from 12th place in 1960 to 30th place in 2005. Conclusions. Infant mortality is a complex and multifactorial problem that has proved resistant to intervention efforts. Continued increases in preterm and low birthweight delivery present major challenges to further improvement in the infant mortality rate.

scholarly journals Evolution and current state of global research on paediatric resuscitation: a systematic scientometric analysis

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Sean S. Scholz ◽  
Rainer Borgstedt ◽  
Leoni C. Menzel ◽  
Sebastian Rehberg ◽  
Gerrit Jansen
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Research Performance ◽  
The United States ◽  
Mortality Rates ◽  
Infant Mortality Rate ◽  
Hirsch Index ◽  
Current State ◽  
High Infant Mortality

Abstract Background Paediatric resuscitation is rare but potentially associated with maximal lifetime reduction. Notably, several nations experience high infant mortality rates even today. To improve clinical outcomes and promote research, detailed analyses on evolution and current state of research on paediatric resuscitation are necessary. Methods Research on paediatric resuscitation published in-between 1900 and 2019 were searched using Web of Science. Metadata were extracted and analyzed based on the science performance evaluation (SciPE) protocol. Research performance was evaluated regarding quality and quantity over time, including comparisons to adult resuscitation. National research performance was related to population, financial capacities, infant mortality rate, collaborations, and authors’ gender. Results Similar to adult resuscitation, research performance on paediatric resuscitation grew exponentially with most original articles being published during the last decade (1106/1896). The absolute number, however, is only 14% compared to adults. The United States dominate global research by contributing the highest number of articles (777), Hirsch-Index (70), and citations (18,863). The most productive collaboration was between the United States and Canada (52). When considering nation’s population and gross domestic product (GDP) rate, Norway is leading regarding population per article (62,467), per Hirsch-Index (223,841), per citation (2226), and per GDP (2.3E-04). Regarding publications per infant mortality rate, efforts of India and Brazil are remarkable. Out of the 100 most frequently publishing researchers, 25% were female. Conclusion Research efforts on paediatric resuscitation have increased but remain underrepresented. Specifically, nations with high infant mortality rates should be integrated by collaborations. Additional efforts are required to overcome gender disparities.

Letter To The Editor

PEDIATRICS ◽  
1970 ◽  
Vol 45 (6) ◽  
pp. 1042-1044
Author(s):  
I. M. Moriyama
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Infant Mortality ◽  
The Netherlands ◽  
High Mortality ◽  
The United States ◽  
Infant Mortality Rate ◽  
Live Births ◽  
Letter To The Editor ◽  
Nonwhite Population

We are grateful to two authorities for the following replies to Dr. Nickey. First, Dr. Moriyama: Is the differential between the infant mortality rate for the United States (22.4 per 1,000 live births in 1967) and the corresponding rate for Sweden (13.7), the Netherlands (13.4), Norway (14.8), and other countries of low mortality real?1, 2 One possible reason for the large differential is the contribution that the nonwhite population makes to the relatively high mortality rate for the United States.

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