US Infant Mortality Rates ~ ranked 29th globally for 2004

Released in October 2008, a new data brief from the Centers for Disease Control and Prevention’s National Center for Health Statistics ranks the United States 29th globally in infant mortality in 2004, the latest year such data were available for all countries. The U.S. ranking, which has risen from 12th in 1960 to 23rd in 1990, currently ties the United States with Poland and Slovakia. Authors of the brief, “Recent Trends in Infant Mortality in the United States,” noted that while such global comparisons can be affected by reporting differences, “it appears unlikely that differences in reporting are the primary explanation for the United States’ relatively low international ranking.” According to the brief, the U.S. infant mortality rate in 2005 was 6.86 infant deaths per 1,000 live births, not much different than the 6.89 rate in 2000 — a lack of decline that has “generated concern among researchers and policy-makers.” In fact, the level rate from 2000-2005 represents the first period of ongoing lack of decline in the U.S. infant mortality rate since the 1950s, the brief stated. The Healthy People 2010 target for infant mortality is 4.5 infant deaths per 1,000 live births.
“Our lack of progress really is related to more and more babies being born too small,” said Joann Petrini, PhD, MPH, director of the March of Dimes’ Perinatal Data Center. “Because of amazing high-tech care, thankfully, we see miraculous outcomes for very, very small babies…but it can make it difficult to communicate that prematurity is still a problem.”

Forty weeks is the normal length for pregnancy, but even babies born between 34 weeks and 36 weeks — known as late preterm — have a death rate three times that of full-term babies, said Petrini, adding that “40 weeks is 40 weeks for a reason.” Petrini said an increase in late preterm births has been driving up the overall preterm birth rate, which NCHS reported in January rose to 12.8 percent in 2006, up 36 percent since the early 1980s. Babies born premature can later suffer a number of problems, including developmental disabilities, hearing loss, blindness and chronic diseases such as asthma. Though many behavioral factors, such as smoking, lack of breastfeeding and a rise in medically unnecessary Caesarean sections, are known to contribute to the U.S. infant mortality and prematurity rates, much is unknown.

Nations Health.  2009;39(1) ©2009 American Public Health Association