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Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Says



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Nov 04, 2009 12:01 PM

Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Says

by herring_RN allnurses Guide

High rates of premature birth are the main reason the United States has higher infant mortality than do many other rich countries, government researchers reported Tuesday in their first detailed analysis of a longstanding problem.

In Sweden, for instance, 6.3 percent of births were premature, compared with 12.4 percent in the United States in 2005, the latest year for which international rankings are available.
Infant mortality also differed markedly: for every 1,000 births in the United States, 6.9 infants died before they turned 1, compared with 2.4 in Sweden. Twenty-nine other countries also had lower rates.

If the United States could match Sweden’s prematurity rate, the new report said, “nearly 8,000 infant deaths would be averted each year, and the U.S. infant mortality rate would be one-third lower.”…


…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….

Taking care of women’s illnesses and problems like drinking, drug use and smoking before and during pregnancy can help prevent prematurity, he said, adding that a state program in Kentucky to provide home visits by nurses to poor women during pregnancy had decreased preterm births. …

http://www.nytimes.com/2009/11/04/health/04infant.html


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26 Comments
No. 1
from canoehead
Old Nov 04, 2009, 01:09 PM

Default Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
Probably some of those infants wouldn't survive as embryos in other countries too. Women who are medically fragile would not get pregnant without medical intervention, and multiple births of tiny babies certainly increases the American death rate.
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No. 2
from Bree124
Old Nov 04, 2009, 04:33 PM

Default Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
Originally Posted by herring_RN View Post
In Sweden, for instance, 6.3 percent of births were premature, compared with 12.4 percent in the United States in 2005, the latest year for which international rankings are available.
Infant mortality also differed markedly: for every 1,000 births in the United States, 6.9 infants died before they turned 1, compared with 2.4 in Sweden. Twenty-nine other countries also had lower rates.
If the United States could match Sweden’s prematurity rate, the new report said, “nearly 8,000 infant deaths would be averted each year, and the U.S. infant mortality rate would be one-third lower."
So we could be one-third lower, but we'd still be almost twice as high as Sweden... How does that work?
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No. 3
Old Nov 04, 2009, 05:06 PM

Default Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
"So we could be one-third lower, but we'd still be almost twice as high as Sweden... How does that work?"

Sweden also uses far fewer interventions (c-sections, vacuum extractions, etc...) which snowball into complications and most births are attended by Midwives. Docs in this country have a tendency to use techniques that aren't really necessary just to cover their butts.
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No. 4
from Bree124
Old Nov 04, 2009, 05:48 PM
Updated Nov 04, 2009 at 05:54 PM by Bree124

Default Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
Originally Posted by dancingdoula View Post
Sweden also uses far fewer interventions (c-sections, vacuum extractions, etc...) which snowball into complications and most births are attended by Midwives. Docs in this country have a tendency to use techniques that aren't really necessary just to cover their butts.
I was making a poor attempt at sarcasm, and in retrospect I see that it did not translate well across a computer.
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No. 5
from feisty
Old Nov 04, 2009, 06:24 PM

Default Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
I wonder how the teenage pregnancies compare statistically between the US and other countries. I read a report that said the US has the highest rate of teen pregnancies among industrialized nations. About 745,000 teen pregnancies occur each year in the US. Teen mothers are more likely to receive inconsistent prenatal care, deliver preterm, and have low birth weights. This age group also participates in risk taking behaviors. This could be an important factor in the overall high premature births and mortality rates reported in the US.
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No. 6
from TiffyRN
Old Nov 04, 2009, 06:44 PM

Default Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
The report I read elaborated on how the US has many factors that increase their rate of prematurity. If we could reduce our risk factors for prematurity (induced labor, fertility with resultant multiple gestation, high rates of obesity, smoking, poor & no prenatal care), we would have a very comparable rate of infant mortality, but until we reduce our rate of prematurity, we will compare to 3rd world countries.

I believe it was also reported that we have a very superior rate of saving premature infants once they are born. Which I'm proud of because that's my field, however, hands down, no care we can provide compares to just staying a few more weeks inside mama.
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No. 7
Old Nov 04, 2009, 07:35 PM

Default Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
Bree124, I totally understood what you were trying to say. But, I do also understand that the US as a whole probably has more teen pregnancy's than other countries. And yes I understand that it does happen in other countries but you also have to think about that in some of those other countries they can get married younger and that might give these women a (albeit maybe only slightly) better financial option than the single teen moms. And some of thses other countries probably have a religion where they can be punished for participating in premarital sex. Just so thoughts. Although I am totally glad that we have NICU nurses(that is what I would love to be) and I think that you do a fabolous job!
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No. 8
from dawngloves
Old Nov 05, 2009, 08:59 PM

Default Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
I may be wrong, been trying to find the info, but I believe in 2005 the resusutation guidlines in Sweden were less liberal than in the US. While we resusitate @ 23 weeks/400 gms, Sweden may label it as a "miscarrriage.
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No. 9
from TiffyRN
Old Nov 05, 2009, 09:51 PM

Default Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
Originally Posted by dawngloves View Post
I may be wrong, been trying to find the info, but I believe in 2005 the resusutation guidlines in Sweden were less liberal than in the US. While we resusitate @ 23 weeks/400 gms, Sweden may label it as a "miscarrriage.
I've always suspected that this unnaturally elevated our infant mortality rates. This latest CDC report counted all US infants born >22 weeks. I would say many if not most hospitals don't routinely attempt resuscitation until 23 weeks and I think I heard the survival to discharge rate of 22 weekers was <1%.
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