Drop in infant mortality rate is good news but US still lags

The CDC released its annual “Mortality in the United States” report in December, and it offered some good news for infants. According to the report, the infant mortality rate decreased 2.3 percent in 2014 to a new historic low of 582.1 infant deaths per 100,000 babies. The top five causes of infant mortality in decreasing order are: congenital malformations, low birth weight, maternal complications, SIDS, and unintentional injury. To get the IMR, divide the number of infant deaths by the total live infant births over a specific period of time.

Of these deaths, preterm birth remains a major factor in the United States. Prematurity is birth before the estimated gestational age of 37 weeks, and each of the top five causes of infant mortality are impacted by it. According to the March of Dimes®, which both researches and works to decrease prematurity across the globe, there are 15 million babies born prematurely worldwide, and 1 million of those babies will die as the result of their premature birth.

In the US, the medical costs to care for a preterm baby are 12 times higher than the costs to care for a healthy, full-term baby. That is because preemies are not just small babies, but immature babies. They have a greater risk of infection, respiratory complications, feeding problems, and a whole host of other medical issues. The younger the baby, the more severe the complications, including permanent issues with the lungs, body, and brain. As a pediatrician, I often see these babies after months of time spent in the hospital’s neonatal intensive care unit (NICU).

The United States, with all our medical resources and technology, should be the world leader in the fight against prematurity, but we are not. With over 380,000 babies born before 37 weeks, we’ve earned a “C” grade from the March of Dimes® prematurity report card. What’s more, there are significant racial and ethnic disparities throughout our country that contribute to our poor score. Black, American Indian, and Hispanic women have a significantly higher rate of premature delivery than White and Asian women. That is terrible.

There are several simple ways to lower our country’s prematurity rate and improve our score. Access to family planning before conception and then to early and continuous prenatal care and education is key. To this end, health insurance is crucial. Encouraging women to get and remain healthy before conception (including smoking, drug, and alcohol cessation and the initiation of folic acid supplementation before becoming pregnant) is also important. If we work together, pediatricians, obstetricians, community organizations, and parents can decrease our country’s prematurity rate.