Contribution of birth defects to infant mortality - United States, 1986

Article Abstract:

A decrease in the rate of infant mortality has been recorded in this century, but at the same time a rise in the number of birth defects has also been observed. Fifty-two percent of all deaths are attributed to either birth defects, premature births, or SIDS (Sudden Infant Death Syndrome). Birth defects comprise the greater portion of this number and are also a contributing cause of death before age 65. An evaluation based upon data reported in 1986 and compiled by the Center for Disease Control's (CDC) National Center of Health was performed. Birth defects were defined as stated in 'Congenital Anomalies' for the 'Internal Classification of Diseases', 9th edition. From a group of 38,957 reported infant deaths, 8,005 (20.5 percent) were attributed to birth defects. In an additional 1,088 instances, birth defects were considered to be a contributing cause of mortality. An overall total of 23.3 percent (9,093) of the deaths were related to birth defects. A breakdown of the group of 8,005 revealed three major categories of congenital problems. In descending order, they were: cardiovascular defects, which represented 3,057 cases (38.2 percent), central nervous system defects, which accounted for 1,191 (14.9 percent), and respiratory failure, which accounted for 870 cases (10.9 percent). In the 1970s a decrease in the rate of infant mortality was observed. This has been attributed not to a decrease in the frequency of birth defects, but to technological improvements in the area of neonatal care. The 1980s have shown a slowdown in the decline of infant mortality, which reflects the lack of progress in prevention of congenital defects leading to death. A national health objective currently being formulated is an overall reduction of the infant mortality rate to only nine deaths per every 1,000 births. It is unlikely that this goal will be met. Further research to investigate and understand the causes of birth defects is recommended.

Birth defects, Infants (Newborn), Newborn infants

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Black-white comparisons of premature mortality for public health program planning - District of Columbia

Article Abstract:

Much recent data has demonstrated that there is a significant difference in health status for various racial groups within the US. These data are important in public health planning and for the correct provision of health care to both minority and nonminority segments of the US population. Without including the effects of significant risk factors (such as alcohol and drug abuse) in the estimates, assessments based solely on race can be misleading. The District of Columbia Commission of Public health has examined mortality data according to several different estimates: age-adjusted mortality; premature deaths (deaths occurring before age 70); and years of potential life lost before age 65 (YPLL). During the period of 1980 to 1986, there were 47,694 deaths of Washington, DC residents; the average age-adjusted mortality rate was l,973 per 100,000 population. The value for blacks was 1,092 per 100,000 population; for whites, it was 692 per 100,000 population, a difference of 37 percent. Black males had a higher mortality for sudden infant death syndrome, suicide and homicide, chronic liver diseases and unintentional injuries. Black females had higher mortality rates for diabetes, premature birth, chronic liver diseases, pneumonia and flu. Blacks had lower mortality rates than whites for birth defects and chronic obstructive lung disease (asthma and emphysema). Black males in general have the highest level of YPLL, followed in order by white males, black females and white females. Total premature deaths and YPLL of blacks were twice those expected if both races had the same mortality rate. Although blacks compose only 46 percent of the Washington, DC population, they accounted for 66 percent of excess or premature deaths.

Infants (Premature), Premature infants, Infant mortality, Washington, D.C., Washington, D.C. Commission of Public Health

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Maternal mortality in developing countries: an ongoing but neglected 'epidemic.'

Article Abstract:

Maternal death is one of the great neglected health problems of developing countries. The World Health Organization estimates that 500,000 women die each year from pregnancy-related causes; more than 98 percent of these deaths occur in developing countries where maternal death rates are as much as 100 times those of industrialized countries. Common causes of death include obstructions to the baby's exit from the womb, hemorrhages after birth, convulsions and coma associated with pregnancy, infections after birth, and complications of illegal abortions. Reorientation of priorities and allocation of needed resources would be sufficient to alleviate these problems. Dealing with them at the village level is more complicated, although antibiotics, ergonovine maleate and sedatives might be used after suitable training. Networks of maternity care facilities, trained personnel, and transportation are necessary to provide emergency maternity care services.

Health aspects, Developing countries, Pregnant women, Pregnancy, Complications of, Pregnancy complications, World Health Organization

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