by
Olga Deshchenko, DOTmed News Reporter | May 24, 2011
From the May 2011 issue of HealthCare Business News magazine
“But having said that, [our infant mortality rate] is embarrassing for us, given how affluent we are as a country. It would certainly be great to see us doing better,” she says.
So what accounts for America’s high IMR when compared to other industrialized nations? Contributing factors often intertwine, making it difficult to pinpoint problems, but the major issues are known, and fortunately, so are some strategies for improvement.
Before the due date
The leading causes of infant death in America are congenital defects, preterm birth and low birth weight and sudden infant death syndrome.
According to a 2009 report by the National Center for Health Statistics, compared to Europe, America has a higher percentage of preterm births, likely the main cause of its higher IMR. (Preterm is defined as birth before 37 completed weeks of gestation.)
According to the study, in 2005, in Sweden, 6.3 percent of babies were born prematurely, while 12.4 percent were born early in America. Per 1,000 births, the U.S. lost 6.9 infants before their first birthdays, while Sweden lost 2.4. If America could match Sweden’s prematurity rate, “nearly 8,000 infant deaths would be averted each year and the U.S. infant mortality rate would be one-third lower,” the study’s authors wrote.
About one in eight babies in the U.S. is born prematurely, a total of more than 500,000 babies a year, says Dr. Scott Berns, a pediatrician and a senior vice president with the March of Dimes Foundation.
Premature babies are at risk for a slew of health and developmental problems. In 2005, 68.6 percent of all infant deaths “occurred to preterm infants,” according to a NCHS data brief on U.S. trends in infant mortality.
But reducing preterm births is a complicated matter, as the baby’s arrival before the due date can have many causes.
Around 25 percent of the time, the baby’s premature birth can be explained, according to Berns. Maternal distress or a sign of fetal distress often require an early delivery for medical reasons. But then there are times when the baby comes early for reasons that are unknown. “About half the time, there’s no specific risk factor or cause. A woman can do everything right and still have a baby born prematurely,” says Berns.
Why us?
It’s well known that women who smoke, are obese, suffer from chronic medical conditions or have certain uterine problems are at a higher risk of having a premature baby. But if European countries and the U.S. are on par in understanding contributing risk factors, why are more babies born prematurely in the U.S.?
What we do know is that American women tend to have babies at a more advanced age, which heightens the risk for early delivery. American parents also commonly employ the aid of fertility treatments. The number of women who used assistive reproductive technologies doubled from 1996 to 2002, according to a 2006 Institute of Medicine report. Researchers found at least half of the women who used ART became pregnant with two or more babies, and multiple births are a high risk for preterm delivery.
