Why Are the Babies Dying?

Far more infants die in their first year of life in the United States than in most of the developed world, and new data from the Centers for Disease Control suggests one of the main reasons is premature births, and that could be helped by better access to prenatal care for mothers.

Infant mortality is a standard measure of a nation’s health. The most recent numbers show that seven in 1,000 babies die before their first birthday in the United States, compared to about two in 1,000 in Singapore, the best in the world. Twenty-nine countries rank better than the U.S. — nearly all of Europe, plus Australia, Canada, Hong Kong, Israel, Japan, New Zealand and Singapore.

A new CDC study says the U.S. has a much higher rate of premature births (before the 38th week of pregnancy), and prematurity goes hand in hand with higher death rates, not to mention long-term disabilities.

Twelve in one hundred babies are born prematurely in the U.S., compared to five in one hundred in Ireland. The CDC study says that if the prematurity rate could be cut substantially, much of the gap between the U.S. and the rest of the Western world could be eliminated.

But not all. Even among babies born at full term, the U.S. still has a higher death rate than most of the West, because of a higher risk of dying in the U.S. from sudden infant death syndrome, accidents, assaults and homicides, according to the CDC.

An article in the New York Times quotes Dr. Alan R. Fleischman, medical director for the March of Dimes, as saying

the new report was “an indictment of the U.S. health care system” and the poor job it had done in taking care of women and children. The report, Dr. Fleischman added, “puts together two very important issues, both of which we knew about but hadn’t linked tightly.”

Dr. Fleischman said the smallest, earliest and most fragile babies were often born to poor and minority women who lacked health care and social support. The highest rates of infant mortality occur in non-Hispanic black, American Indian, Alaska Native and Puerto Rican women. But other minorities have some of the lowest infant mortality rates in the United States: Asian and Pacific Islanders, Central and South Americans, Mexicans and Cubans.

The lead author of the CDC study, Marian F. MacDorman, a statistician at the National Center for Health Statistics, said American doctors also increasingly deliver babies at “late pre-term,” between 34 and 37 weeks, for conditions like high blood pressure and diabetes that in earlier times they would have waited out. These late pre-term babies also have a higher risk of dying than full-term babies, but not as much as the severely pre-term babies.

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