An Epidemiological Approach to Infant Mortality

Erhardt, Carl L.; Abramson, Harold; Pakter, Jean; Nelson, Frieda

doi:10.1080/00039896.1970.10665654

Cited by 12 publications

(3 citation statements)

References 5 publications

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“…[11][12][13][14][15][16][17][18][19][20][45][46][47] Most of these studies have also shown a relationship between these factors and birthweight, the latter being a factor that far outweighs all others as a determinant of neonatal mortality. One may ask whether the effect of socio-demographic factors on neonatal mortality is mediated only through birthweight, or whether there is an additional effect on mortality independent of birthweight.…”

Section: Components Of the Change In Neonatal Mortalitymentioning

confidence: 99%

“…[7][8][9][10][11][12][13][14][15][16][17][18][19] Over that 10-year interval, no improvement was noted in any weight category under 2500 grams, and only small improvements in the mortalities of infants over 2500 grams at birth.…”

Section: Components Of the Change In Neonatal Mortalitymentioning

confidence: 99%

“…With the exception of perinatal medical care, factors known to affect survival at a given birthweight have not changed in prevalence in the 25-year period. It is a plausible hypothesis that improved perinatal medical care is a major factor in declining neonatal mortality in the U.S. (Am JPublic Health 70: [15][16][17][18][19][20][21]1980.) nant of overall neonatal mortality.6-'0 Birthweight-specific mortality rates are the second major determinant of overall neonatal mortality.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Neonatal mortality: an analysis of the recent improvement in the United States.

Lee¹,

Paneth²,

Gartner³

et al. 1980

Am J Public Health

185

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To test the hypothesis that the recent substantial decline in the United States neonatal mortality rate (20.0/1000 in 1950 to 11.6/1000 in 1975) is associated with improvements in perinatal medical care, we examined this change in relation to the two primary components which determine neonatal mortality: birthweight distribution and birthweight-specific mortality.No improvement in the weight distribution of U.S. live births has occurred during this 25-year period, indicating that the change in neonatal mortality isIn the early 1960s considerable national attention was focused on the lack of improvement in United States infant and neonatal mortality rates.'3 This lack of improvement stood in contrast to steady declines in these mortality rates during the preceding decade.' 5 In recent years, however, the picture has changed and a resumption in the decline in these rates has occurred. In the 15 years from 1950 to 1965 neonatal mortality declined only 12 per cent; in the 10 years from 1965 to 1975, it declined 35 per cent. The improvement in neonatal mortality in the latter period amounts to an elimination of 6.1 deaths per 1000 live births, and accounts for 76 per cent of that period's decline in infant mortality rate.Neonatal mortality is inversely related to birthweight, with the proportion of low birthweight (.2500 grams) and particularly very low birthweight (<1500 grams) live births in the newborn population tending to be the major determi- attributable to improved survival for one or more birthweight groups. Decline in the mortality rate in the first 15 years was slow; three-fourths of the decline in the entire 25-year period occurred since 1965. With the exception of perinatal medical care, factors known to affect survival at a given birthweight have not changed in prevalence in the 25-year period. It is a plausible hypothesis that improved perinatal medical care is a major factor in declining neonatal mortality in the U.S. (Am JPublic Health 70:15-21, 1980.) nant of overall neonatal mortality.6-'0 Birthweight-specific mortality rates are the second major determinant of overall neonatal mortality. It is useful, therefore, to view the neonatal mortality rate as the sum of birthweight-specific neonatal mortality rates multiplied by the proportion of live births in each birthweight category. Comparing neonatal mortality rates from different time periods or different geographic areas is of limited utility unless account is taken of these two components of neonatal mortality. Factors intimately associated with neonatal mortality, such as socioeconomic status, parity, and medical complications of pregnancy, powerfully affect the birthweight distribution."-20 There is little evidence that they similarly affect birthweight-specific mortality rates.9' 10 17-21 On the other hand, immediate perinatal care8' 22-32 the infant's sex 7-20 33 34 and appropriateness of birthweight in relation to gestational age33 [35][36][37] are factors associated with differences in birthweight-specific mortality rates, whil...

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