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Preventing and postponing death: trends in Tennessee infant mortality.

Infants born in Tennessee between 1984 and 1988 experienced reduced mortality compared with those born in the 5 years previous. For all birthweight singleton infants, the reduction from 10.2 to 8.4 deaths per 1000 live births represents an 18% decline in mortality. The most impressive gain made was for very low birthweight (less than 1500 g) infants in the neonatal period, where mortality was reduced 24%. However, for these infants there was nearly a sixfold increase in the postneonatal mortality associated with prematurity-related causes.

Birth Weight↗

Infant mortality and infant care: cultural and economic constraints on nurturing in northeast Brazil.

The Brazilian 'Economic Miracle' has had an adverse effect on infant and childhood mortality which has been steadily rising throughout Brazil since the late 1960s. An analysis of the reproductive histories of 72 marginally employed residents of a Northeast Brazilian rural shantytown explores the economic and cultural context that inhibits these mother's abilities to rear healthy, living children and which forces them to devise 'ethnoeugenic' childrearing strategies that prejudice the life chances of those offspring judged 'less fit' for survival under the pernicious conditions of life on the Alto. it is suggested that the selective neglect of children is a direct consequence of the selective neglect of their mothers who have been excluded from participating in the national economy. The links between economic exploitation and maternal deprivation are further discussed with reference to the social causes of the 'insufficient breastmilk syndrome' and the commercial powdered milk dependency of these women.

Adult↗

Life table analysis of infant mortality and feto-infant mortality distributed on causes of death in Denmark 1983-1987.

The survival function of 263,322 singletons of the 1983-1987 Danish birth cohorts (262,159 liveborn and 1163 stillborn babies) with mortality distributed on functional groups of underlying causes of death is presented in two graphic forms on the basis of Kaplan-Meier estimates. About half of all first-day deaths in liveborn babies occurred during the first 4 hours. More than half of all first-week deaths happened during the first day. More than half of all deaths from 31 weeks to 76 weeks after the first day of the last menstrual period (LMP) were either fetal deaths prior to the onset of labour unexplained by fetal factors or unexplained sudden infant death syndrome (SIDS) deaths. Graphic presentation of feto-infant mortality distributed on functional cause-of-death groups improved the expression of the relative contribution and timing of the different causes of deaths. Despite a high autopsy rate and a uniform coding practice the distribution on causes of deaths from register data should be interpreted with caution. Full use of the feto-infant approach is only achieved with data which include late abortions. Thus the feto-infant approach is of special interest in countries which have registers of live births and fetal deaths from week 22 of gestation or earlier. The integration of the life table approach and analysis of underlying causes of deaths should be further explored as a way of utilizing vital statistic databases for the evaluation of perinatal care.

Cause of Death↗

[Monitoring and intervention of infant mortality rate and fetal and infant mortality rate in Beijing, 1992-2000].

OBJECTIVE: To monitor the changing trend of infant mortality rate (IMR) and fetal and infant mortality rate (FIM) in Beijing and to develop proper measures to decrease these two rates. METHODS: Dynamic series analysis was used to analyze the monitoring data of 590,833 cases of live birth, 5,835 cases of infant death, and 10,499 cases of stillbirth in Beijing during 1992-2000. The interventional measures in different phases were analyzed too. RESULTS: The IMR and FIMR in Beijing were 12.42% and 19.43% respectively in 1992 and were reduced to 6.84% and 15.79% respectively in 2000. The IMR and FIMR were declining significantly during the periods of 1992-1994, 1995-1997, and 1998-2001 (P < 0.01). The decrease of IMR by 48% was more remarkable than that of FIMR by 19%. The IMR I rural areas was higher than that in urban area. Pneumonia dropped from the position of the first death cause for infants to the fourth cause and congenital heart disease became the first cause. CONCLUSION: FIMR helps more comprehensively evaluate the effect of maternal and child health care. Monitoring and intervention of congenital heart diseases is very important.

Cause of Death↗