Maternal and Child Health Library

MCH Alert: Focus on Infant Mortality is developed by the Maternal and Child Health Library in collaboration with the National Sudden and Unexpected Infant/Child and Pregnancy Loss Resource Center at Georgetown University. This and past issues are available online at http://www.mchlibrary.info/alert/archives.html and http://www.sidscenter.org/alert/archives.html.

May 28, 2010

Multimedia Featured Resource: The National Sudden Unexpected Infant-Child Death and Pregnancy Loss Resource Center's Web site contains archived and resource materials from the May 20, 2010, Webinar titled New Research into Sudden Infant Death: Unraveling the Mystery of SIDS. The Webinar was the second in a series of quarterly Webinars co-sponsored by the Association of SIDS and Infant Mortality Professionals and the Association of Maternal and Child Health Programs. Topics included the role of the postmortem evaluation in research into SIDS and seratonergic deficiencies in SIDS. The Webinar archive and resources are available at http://www.sidscenter.org/podcasts/2010/asip_amchp/2_webinar.html

1. REPORT PRESENTS INFANT MORTALITY DATA

Infant Mortality Statistics from the 2006 Period Linked Birth/Infant Death Data Set provides descriptive tabulations of infant mortality data by a variety of maternal and infant characteristics. The report, published in National Vital Statistics Reports on April 30, 2010, contains data based on birth and infant death certificates registered in all states, the District of Columbia, Puerto Rico, the Virgin Islands, and Guam. Content includes methods, results, and discussion about trends in infant mortality. Discussion and tables address infant mortality by race and Hispanic origin of mother, state, sex of infant, multiple births, age at death, period of gestation, birthweight, prenatal care, maternal age, maternal education, live birth order, marital status, nativity, maternal smoking, leading causes of infant death, and preterm-related causes of death. The information is useful for understanding the basic relationships between risk factors and infant mortality, unadjusted for possible effects of other variables. The report is available at http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_17.pdf

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• The Ohio infant mortality rate for all births regardless of gestational age for the study period was 7.3 per 1,000 live births. Unadjusted, gestational-age-specific infant mortality rates increased progressively from 2.2 per 1,000 live births at 39 or 40 weeks' gestational age to 16.3 per 1,000 live births at 32 weeks.
• In adjusted analyses, the odds ratio for infant death increased progressively as gestational age decreased from 38 to 32 weeks.
• For infants born at 32 to 33 weeks, the adjusted infant mortality rate was approximately 12 deaths for every 1,000 live births. For those born at 34, 35, 36-37, and 38 weeks, the rate was approximately 9, 6, 4, and 3 deaths for every 1,000 live births, respectively, compared with 2 infant deaths for every 1,000 live births at 39-40 weeks.
• As a percentage of all death causes at each gestational age, sudden infant death syndrome and intentional injury appeared to increase, whereas perinatal asphyxia or cerebral palsy and congenital malformations appeared to decrease as gestational age increased from 32 to 41 weeks.

• Of 7,770 pregnancies, 6,409 (82 percent) ended in live births, 1,225 (16 percent) in miscarriages, and 136 (2 percent) in stillbirths.
• Compared with women with live births, women with fetal losses were significantly more likely to have higher household incomes and to be cohabitating rather than married. White women and women with higher educational attainment were more likely to have a miscarriage, whereas black women and women with lower educational attainment were more likely to have a stillbirth. Women with losses also tended to be slightly older than women with live births at the time that their current relationship ended.
• Even when controlling for known risk factors for relationship dissolution (lower maternal age, cohabitation, previous live birth, black race, and shorter duration of relationship), women with miscarriages and stillbirths had higher risks of their relationships ending, compared with women whose pregnancies ended in live births.
• Most of the effect after miscarriages occurred between 1.5 and 3 years after the loss. In contrast, the effect for stillbirths persisted for up to 9 years after the loss.

• Approximately 32 percent (N=205,887) of the total 633,849 singleton births analyzed were to adolescents.
• The overall prevalence of smoking was 31.2 percent, with the lowest prevalence (14.1 percent) among younger adolescents and the highest (31.7 percent) among older adolescents.
• The prevalence of anemia, eclampsia, and pre-eclampsia was highest among adolescents ages 14 and under.
• The risk of intrapartum stillbirth among smokers decreased as maternal age increased.