In the 1990s, US infant mortality rates stratified by age at death revealed that about two-thirds of infant deaths occur in the neonatal period and the remainder in the postneonatal period. Deviations from this expected distribution require careful analysis, as interventions that decrease neonatal and postneonatal deaths are different. Further stratification of age at death by first hour, first day, first week and first month provide additional information, particularly if these distributions are compared to a reference distribution for the nation, and found to vary within a specific region for subgroups of the population such as by maternal age, race, ethnicity and plurality. Linked birth/infant death files from the National Center for Health Statistics, for the combined years 1996-1998, were analyzed to provide reference age at infant death distributions (AIDD) for three birthweight-categories (>2500g, 1500-2499g, <1500g). For all infant deaths it was found that 40% occur within the first day of life, with 14% occurring in the first hour. Among very low birthweight infants, more than 60% die within the first day following birth, compared to only 10% of not low birthweight infants. Infant death distributions by plurality, gestational age, maternal age and race/ethnicity and geographic region reveal important differences in infant survival around the time of birth. Comparisons of these national reference AIDDs with region specific distributions implicate differences in access to care, health care systems for high-risk infants and medical management of infants.
Learning Objectives: At the conclusion of the session, the participant will: 1. Learn about the merits of a underutilized variable in perinatal health. 2. Understand ways to apply this indicator to their own analyses.
Keywords: Infant Mortality, Methodology
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.