Infant Mortality Increases in Missouri in 2002

Missouri’s infant death rate increased by 15 percent in 2002 from 7.4 per 1,000 live births in 2001 to 8.5 in 2002, according to an official with the Missouri Department of Health and Senior Services. According to Joseph Stockbauer, Chief of the Bureau of Health Data Analysis, the 8.5 rate is the highest state infant death rate in ten years.

Missouri infant mortality increased throughout the state, and in both neonatal (under 28 days of age) and post-neonatal (aged 1-11 months) mortality.

According to Stockbauer, the Missouri increase was much larger among white infants than among African-American infants. The white infant death rate increased by 22 percent from 5.8 in 2001 to 7.1 per 1,000 live births in 2002, while the African-American rate increased just 2 percent from 16.8 to 17.2. Despite these changes, the African-American infant death rate was still 2.4 times higher than the white rate in 2002.

Stockbauer said that nationally, the infant death rate increased very slightly for January-September 2002 (the latest available data) from 6.8 to 6.9 per 1,000 live births.

Stockbauer said the higher infant mortality represents both an increase in babies being born too small and an increase in death rates for these small babies. The number of very low birth weight (VLBW, under 3 pounds 5 ounces) infants increased by 11 percent from 1,069 in 2001 to 1,188 in 2002. The low birth weight (under 5 pounds 8 ounces) increased from 7.6 percent to 8.1 percent, the highest rate since the 1960s. When adjusted for these changes in birth weight distribution, the infant death rate still increased (by 8 percent as opposed to the 15 percent unadjusted infant mortality increase).

“While we are, of course, concerned about the increase in the infant mortality rate, we want to emphasize that one year does not necessarily indicate a trend,” Stockbauer said. “We will be watching these numbers very closely over the remainder of the year.”

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Stockbauer noted that there are many possible reasons for the increase in the infant mortality rate, including:

· Greater efforts are being made to resuscitate VLBW infants at borderline viability. These efforts lead to more VLBW births and possibly eventual infant deaths.

Infant Mortality – first add

· More twins and triplets are being born, many as a result of infertility treatments (e.g. in-vitro fertilization, artificial insemination, medications). The number of multiple births increased by about 10 percent in 2002 and by 40 percent since 1992. The infant death rate for multiple births was 6 times the rate for singleton births in 2002.

· More C-Sections and induced terminations of labor are being performed at earlier gestational ages, which also leads to more very low birth weight births.

· More infants with congenital anomalies were born.

· There was a large increase in three potentially preventable post-neonatal causes of death: SIDS, infectious diseases, and unintentional injuries.

Stockbauer said the department recently has increased efforts to identify and report all infant deaths, and that staff in the department’s vital records section have worked closely with the Child Death Review Project to improve reporting. He also emphasized that the number of infant deaths in any given year is subject to random fluctuation.

Other maternal and child health statistics from 2002 reported by the department include:

· Teen births decreased by 4.9 percent from 9,426 in 2001 to 8,964 in 2002. This is a continuation of a decade-long trend, as teen births have decreased by 19 percent since 1992.

· Smoking during pregnancy decreased slightly from 18.3 percent in 2001 to 18.1 percent in 2002. It has dropped from 23.3 percent in 1992.

· Short birth spacing (less than 18 months between births) decreased from 11.0 percent in 2001 to 10.7 percent in 2002.

· Births on Medicaid, WIC and Food Stamps all increased in 2002 with the continued economic slowdown.

· The rate of inadequate prenatal care stayed the same in 2001 and 2002, (10.8 percent).

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