Saturday, November 7, 2009

US Infant Mortality Rate: What Can We Do?

This week, the CDC reported that the US ranks 29th in infant mortality--a drop from previous years. Higher infant mortality rates provides good food for thought about what we can do better in this country to take care of moms and babies.

The Five Leading Causes of Infant Death are:

1. Birth defects
2. Disorders related to short gestation and low birth weight
3. Sudden infant death syndrome (SIDS)
4. Newborn affected by maternal complications
5. Accidents

A higher prematurity rate is one reason for our higher infant mortality rate; 36% of infant death occurs in premature infants. Prematurity is seen both in poor women who have less access to health care before pregnancy and for women who have LBW infants due to infertility treatments. Also women who are overweight and underweight and/or who gain too much or too little can also be more at risk for a LBW infant.

What Can We Do?

1. Provide better access to programs for low-income women so they start their pregnancies healthier and less likely to deliver a premature infant:
  • smoking cessation programs
  • drug treatment centers
  • weight management programs
  • ongoing treatment for chronic disease like hypertension and diabetes
  • family planning services to prevent unintended pregnancy
2. Use nutrition first to help with infertility. Infertility is sometimes caused by being underweight or overweight. Fixing those problems before pregnancy could definitely improve the rate of prematurity.

3. Improve access to weight management programs for all women. Women who start their pregnancies at a healthy weight are much more likely to have a healthier birth outcome:
  • Provide better access to weight management programs for all women before pregnancy
  • Provide insurance coverage for pre-conception counseling, which would include counseling from a registered dietitian
Finally women should be encouraged and given the tools to follow the new weight gain guidelines from the Institute of Medicine which lowered the weight gain recommendations for obese women to 11-20 pounds. Many women, overweight or not, exceed weight gain recommendaitons, which can impact the delivery and have health implications for a child's entire life.