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News of the Day ... In Perspective

10/04/2006

Preemies lead infant deaths

Premature births accounted for one-third of U.S. infant deaths in 2002, twice what was previously reported, making it the leading cause of U.S. infant mortality, said U.S. government researchers.

The CDC will now ascribe deaths from such causes as brain hemorrhage or respiratory distress in babies with undeveloped lungs to prematurity. With the reclassification, 34% of infant deaths will now be attributed to prematurity. Of the 28,000 infant deaths in 2002, two-thirds occurred in babies born before 37 weeks of gestation.

The U.S. is ranked 23rd among industrialized nations in infant mortality, and has a growing rate of premature births, “which defy an easy explanation.”

According to a study by the Institute of Medicine, one in eight U.S. births was premature last year, an increase of 30% since 1981. The leveling off of infant mortality, which had been decreasing sharply throughout much of the 20th century, coincides with the increase in prematurity.

“Efforts to reduce infant mortality rates must focus on premature birth,” said Dr. William Callaghan, lead author of a recently published study in Pediatrics.

The news report stated that causes of prematurity include advanced age of the mother or assisted fertility methods, both of which tend to produce multiple births (Reuters, Ariz Daily Star 10/2/06, Gautam Naik, Wall St J 10/2/06).

A frequently suggested cause of U.S. infant mortality is lack of socialized medicine. Additionally, AMA President Elect Ronald Davis, M.D., in a Sept 25 presentation to the Arizona Medical Association, mentioned maternal exposure to second-hand smoke as a risk factor for prematurity, although he didn’t explain why the incidence of prematurity is increasing as the number of smokers decreases. The Chicago Tribune referred to a genetic factor in African Americans linked to risk of prematurity, but this can hardly explain an increasing incidence (Judith Graham, Chicago Tribune 8/22/06).

Not mentioned in the print media, although it has been covered on radio news networks, is the association of prior abortion with a heightened risk of prematurity, states Karen Malec of the Coalition on Abortion/Breast Cancer. A 2006 report by the Institute of Medicine (IOM) entitled “Preterm Birth: Causes, Consequences, and Prevention” listed “prior first trimester induced abortion” as one of the “immutable medical risk factors associated with premature birth” (Appendix B, Table 5).

Prematurity and low birth weight are also associated with an enhanced risk of cerebral palsy.

A study of 187 women seeking obstetric or gynecologic services at a Milwaukee hospital showed that 95% wanted to be informed of all risks of a procedure, Malec stated.

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