Nearly 28,000 US Infants Died in 2004

Preterm birth contributes to more than one-third of all infant deaths, according to a U.S. National Vital Statistics report.

Although the national infant mortality rate is the lowest it's been since the U.S. started collecting data a century ago, there's been little change recently – 6.78 deaths for every 1,000 live births in 2004 compared to 6.89 in 2000, the US National Center for Health Statistics (NCHS) report finds.

The report, "Infant Mortality Statistics from the 2004 Period Linked Birth/Infant Death Data Set" includes a new analysis tracking preterm birth-related infant deaths. The analysis, first published in the October 2006 edition of Pediatrics, found preterm birth contributes to nearly twice as many infant deaths within the first year of life than previously estimated.

"We have long known babies born too soon face many developmental challenges – even death," says Joann Petrini, director of the March of Dimes Perinatal Data Center. "This closer look at preterm birth gives us a better understanding of the impact of prematurity on infant survival and provides insights into the factors that have contributed to the lack of improvement in the U.S. infant mortality rate."

Preterm related deaths accounted for more than 10,000 of the nearly 28,000 infant deaths in 2004, according to the NCHS. Birth defects remain the leading cause of infant death, followed by prematurity, according to official reporting systems. But, using this new classification, premature birth would be the most frequent cause of infant death. The traditional methods cannot accurately gauge the true impact of preterm birth on the infant mortality rate, the NCHS says.

The new method reviews all causes of infant death and combines conditions, such as respiratory distress syndrome, which frequently occur in premature babies. The analysis published in October 2006 looked at only the top 20 leading causes of infant death.

More than a half million babies are born too soon each year and the preterm birth rate has increased more than 30 percent since 1981.


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Study Notes Decline in Male Births in US, Japan

A study published in this week’s online edition of Environmental Health Perspectives reports that during the past 30 years, the number of male births has decreased each year in the U.S. and Japan. In a review of all births in both countries, the University of Pittsburgh-led study found significantly fewer boys being born relative to girls in the U.S. and Japan, and that an increasing proportion of fetuses that die are male.

They note that the decline in births is equivalent to 135,000 fewer white males in the U.S. and 127,000 fewer males in Japan over the past three decades and suggest that environmental factors are one explanation for these trends.

“The pattern of decline in the ratio of male to female births remains largely unexplained,” says Devra Lee Davis, lead investigator of the study, director of the University of Pittsburgh Cancer Institute’s Center for Environmental Oncology and professor of epidemiology, University of Pittsburgh Graduate School of Public Health. “We know that men who work with some solvents, metals and pesticides father fewer baby boys. We also know that nutritional factors, physical health and chemical exposures of pregnant women affect their ability to have children and the health of their offspring. We suspect that some combination of these factors, along with older age of parents, may account for decreasing male births.”

Davis explains that environmental factors, such as prenatal exposure to endocrine--disrupting environmental pollutants may impact the SRY gene – a gene on the Y chromosome that determines the sex of a fertilized egg. Other environmental factors that also may affect the viability of a male fetus include the parents’ weight, nutrition and the use of alcohol and drugs.

In the study, Davis and her colleagues reported an overall decline of 17 males per 10,000 births in the U.S. and a decline of 37 males per 10,000 births in Japan since 1970. They also found that while fetal death rates have generally decreased, the proportion of male fetuses that die has continued to increase. In Japan, among the fetuses that die, two-thirds are male, up from just over half in 1970.

The study also examined the ratio of African-American male to female births to that of whites in the U.S. The researchers found that while the number of African-American male births has increased modestly over time, the ratio of male to female births for African-Americans remains lower than that of whites. In addition, they noted that African-Americans have a higher fetal mortality rate overall and a higher proportion of male fetuses that die.

“These results are not surprising since the black-white ratio in terms of infant mortality has remained the same for almost 100 years,” says Lovell Jones, study co-investigator and professor and director, Center for Research on Minority Health, department of health disparities research, University of Texas M.D. Anderson Cancer Center. “Given the higher mortality rates for African-American males in the United States, these results reemphasize the need to determine all factors, including environmental contaminants, which are responsible for this continuing health disparity.”

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