High infant mortality rates have been a key public health issue in the United States over the last decades. Researchers have been focusing on learning about the causes, the risk factors and possible interventions in reducing infant mortality (IM). IM can be defined as the passing away of a newborn before their first birthday. IM rate is the ratio of infant death per one thousand live births. Infant mortality rate provides vital information regarding infant and maternal health and additionally acts as a general indicator of society’s overall health. In the United States, the IM rate was reported to be at 5.7 deaths for every one thousand live births, in 2018 (CDC, 2020). The states with the highest IM rates in 2009 in the United States were: Mississippi, Louisiana, Alabama, North Dakota and Oklahoma with 9.07, 8.07, 7.89, 7.35 and 7.08 deaths per one thousand live births respectively.
According to the CDC, two factors linked to IM rate are preterm births and pregnancy complications. When a newborn is delivered before 37 weeks after conception, it is referred to as a preterm birth. In the United States in 2019, preterm births were witnessed in 10 percent of all infants born, which was the 5^th consecutive year when preterm births increased. Low birth weight and preterm births accounted for nearly 20% of all infant deaths (CDC, 2020). The CDC is focused on numerous research programs set out to reduce and understand preterm births. The CDC collaborates with numerous partners such as university professors, state health organizations and various qualified healthcare specialists to help reduce preterm births and understand contributing factors. Pregnancy complications can be described as health issues occurring in the duration of pregnancy that could lead to complications for the baby or mother or both. Some of these common complications include amenia, urinary tract infections, infections, mental health issues, diabetes, hypertension and obesity (CDC, 2020). The CDC is also focusing on research to understand pregnancy complications with the objective to prevent them and make pregnancy healthier which ultimately leads to better health outcomes. With about 6 million annual pregnancies in the U.S., any advances in pregnancy complications no matter how small could have a significant effect on improving the quality of life especially for pregnant women.
Despite advances in the medical field helping reduce IM, the U.S. still registers a poor global rate. In 2010, America’s IMR was thrice that of countries with the least IM rates. This is largely due to the country’s high preterm births at about 12% (MacDorman & Mathews, 2009). Efforts to lower IM rates need to be focused on addressing certain risk factors such as smoking while pregnant which leads to low birthweight. These risk factors can only be understood through research which also helps to identify evidence-based practices on the best interventions to employ. For example, congress approved funds to the CDC to run surveillance programs to collect data related to the mortality and morbidity of infants and their mothers in 1987. The data collected though the program, (PRAMS), is used to guide health program efforts. Information is relayed to the CDC through questionnaires answered by new mothers over the telephone. Key questions in the survey concentrate on topics such as smoking while pregnant, breastfeeding, prenatal care and infant sleeping position. With this knowledge and information, infant mortality risk factors can be identified. For example, West Virginia was found to have the highest number of mothers who smoked in the last trimester. In response, the state launched the “Tobacco Free Pregnancy Initiative” aimed at helping pregnant women quit tobacco especially when pregnant (Danberry, 2009).
In the years 2007-2011, IM rates in the U.S. reduced by about 3% every year due to targeted efforts. In 2012, the Department of Health and Human services introduced plans to design a national strategy to address IM, in collaboration with state agencies. A committee was formed to coordinate efforts with state programs and agencies. Some of the strategies include: promoting community, public and private collaboration, improving mothers’ health before pregnancy, promoting prenatal care safety and quality, investing in health prevention and bolstering research and surveillance. Additionally, research has proven that infants born with high risk but afforded high levels of care in neonatal intensive care demonstrate better health outcomes. Therefore, funds need to go into improving facilities in regions States with high IM rates so that infants can get the best medical care. Furthermore, there needs to be more initiatives aimed at increasing access to high quality prenatal, periconceptional and pre-conceptional healthcare across geographical and ethnic/racial boundaries, in order to offer the best care to infants and their mothers. Finally, risk lowering education meant to address knowledge gaps in the public may reduce certain factors linked to IM such as preterm birth and low birthweight. This can be achieved through the provision of adequate resources such as quitting smoking or lactation support material that increases skills and knowledge to avoid behaviors related to infant mortality determinants (Fastring et al., 2018).

References

CDC. (2020). Infant Mortality | Maternal and Infant Health | Reproductive Health | CDC. Cdc.gov. Retrieved 5 July 2021, from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm.

CDC. (2020). Pregnancy Complications | Maternal and Infant Health | CDC. Cdc.gov. Retrieved 5 July 2021, from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-complications.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Freproductivehealth%2Fmaternalinfanthealth%2Fpregcomplications.htm.

CDC. (2020). Preterm Birth | Maternal and Infant Health | Reproductive Health | CDC. Cdc.gov. Retrieved 5 July 2021, from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm.

Danberry, K. (2009). The Tobacco Free Pregnancy Initiative Of West Virginia. Cdn.ymaws.com. Retrieved 5 July 2021, from https://cdn.ymaws.com/www.naquitline.org/resource/resmgr/2009_conference_materials/wvpostpartum.pdf.

Fastring, D., Johnson, S., & Madison, J. (2018). Evaluation of a Health Education Intervention to Improve Knowledge, Skills, Behavioral Intentions and Resources Associated with Preventable Determinants of Infant Mortality. Diversity & Equality In Health And Care, 15(1). https://doi.org/10.21767/2049-5471.1000124

MacDorman, M., & Mathews, T. (2009). Behind International Rankings of Infant Mortality: How the United States Compares with Europe. Cdc.gov. Retrieved 5 July 2021, from https://www.cdc.gov/nchs/data/databriefs/db23.pdf.