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At least 19 recordsLinked to original sources
PubMed1997

The first injustice: socioeconomic disparities, health services technology, and infant mortality.

"Infant mortality has long been viewed as a synoptic indicator of the health and social condition of a population. In this article we examine critically the structure of this reflective capacity with a particular emphasis on how new health care technologies may have altered traditional pathways of social influence.... Current patterns of infant mortality in the United States provide a useful illustration of the dynamic interaction of underlying social forces and technological innovation in determining trends in health outcomes. We review the implications of this perspective for [future] sociological research into disparate infant mortality...."

Americas↗
PubMed1990

The use of logit models to investigate social and biological factors in infant mortality. V: A multilogit analysis of stillbirths, neonatal and post-neonatal mortality.

Infant mortality data for England and Wales, cross classified by mother's age, parity and social class were published for 1949/50 and 1975. Previous analyses of these data have been based on graphical, tabular and logit models of stillbirths, neonatal and post-neonatal deaths separately. This paper summarizes the overall changes in infant mortality using a multilogit model. The model selected is illustrated by appropriate graphical presentations.

Adolescent↗
PubMed1994

[A record-linkage study on risk factors for cause-specific infant mortality].

Infant death certificates were linked with birth certificates for infants born to residents of Tohoku, Tokai and Kyushu regions in 1989 (n = 409, 679, or about one-third of all births in Japan), to examine the effects of variables, as reported on birth certificates, on cause-specific infant mortality. "Certain conditions originating in the perinatal period" and "congenital anomalies" accounted for nearly 90 percent of neonatal deaths, while "congenital anomalies", "injuries and poisoning" and "sudden infant death" were responsible for about 65 percent of postneonatal deaths. Mortality rates for almost all causes of infant deaths, except injuries and poisonings, increased as birth weight decreased not only in the neonatal period but also in the postneonatal period. This suggests that low birth weight places some infants at higher risk of death, and conditions that lead to low birth weight independently contribute to the risk of infant death. Cox's proportional hazards linear model was used to assess the effects of variables on infant mortalities by causes of death. An extremely strong birth weight effect was noted for "certain conditions originating in the perinatal period" and "congenital anomalies". Being a male infant and late order of birth in multiparity were other risk factors for deaths from "congenital anomalies", while being a male infant, resident of Tohoku region and maternal stillbirth experience related to deaths from "certain conditions originating in the perinatal period". Elevated risks of sudden infant death syndrome (SIDS), of which mortality rate in Japan was considerably lower than those in most developed Western countries, i.e. 0.23 per 1,000 live births in 1989, were associated with low birth weight, being a male infant, low maternal age, late order of birth in multiparity and illegitimacy. Low maternal age, late order of birth in multiparity and illegitimacy, also, related significantly to increased risk of infant deaths for "injuries and poisoning". These results suggest the independent contributions of socioeconomic factors to infant mortality, especially postneonatal mortality, from SIDS, "injuries and poisonings".

Adult↗
PubMed1993

Infant mortality.

Infant mortality continues to be a major public health issue in the United States. Although some preventive strategies for neonatal mortality are emerging for congenital malformations, notably neural tube defects, the prevention of preterm deliveries among disadvantaged populations remains elusive, suggesting the need for different approaches to women's health needs. Despite the lack of success in preventing preterm birth, neonatal mortality rates continued to decline substantially, a decline attributed to improvements in neonatal intensive care associated with surfactant use. The increasing survival of very preterm infants continues to raise questions about their longer term outcomes especially with several recent studies on difficulties in school, and about the need for postdischarge developmental interventions. Attempts to decrease postneonatal mortality received marked attention with the recommendations for specific positioning to prevent sudden infant death syndrome and heightened attention to increased immunization completion rates. The dismal ranking of the United States in infant mortality rates among industrialized countries, however, continues to present a social policy challenge.

Humans↗
PubMedDate not supplied

The use of logit models to investigate social and biological factors in infant mortality. III. Neonatal mortality.

Infant mortality data for England and Wales, cross-classified by mother's age, parity and social class have been published on two occasions, the first giving the relevant data for 1949/50, the second for 1975, some 25 years later. Published analyses of these separate data sets have been based on graphical and tabular analysis. This paper develops the methodology from an earlier paper by Murrells et al. to the analysis of the neonatal data.

Adolescent↗
PubMed2000

Pulmonary macrophage counts in deceased infants: baseline data for further study of infant mortality.

Infant lung samples were obtained prospectively at autopsy by medical examiner pathologists in five areas of the United States and regardless of the cause of death. Four sections were examined for each case and were taken from the anterior and posterior aspects of the right and left upper lung lobes. Lung sections were stained with HAM-56 immunostain, which is specific for macrophages. Sixty-one cases were evaluated for the study. Three pathologists independently counted the number of macrophages per 40x field (10x ocular) in 10 contiguous fields near the center of each lung section examined. There was good agreement between pathologists on the average number of macrophages observed in each case. The mean macrophage count for all fields counted was 16.5 per 40x field (range 0-136), and the mean for individual cases was 16 (range 6.6-39.4). There was no observed difference between right, left, anterior, and posterior lung sections. There was a tendency for cases certified as sudden infant death syndrome to show lower macrophage counts than those with other causes of death, but the difference was of only marginal statistical significance. Seven of 10 cases in which infants died after a survival period in the hospital had a mean macrophage count greater than the overall mean of 16 per 40x field. These data suggest that mean pulmonary macrophage counts > 16 per 40x field may be a marker for causes of death other than sudden infant death syndrome or that there was a survival interval. These data may be useful as baseline data for further studies of infant mortality possibly involving pathologic changes in the lungs.

Autopsy↗
PubMed2000

Pulmonary hemosiderin in deceased infants: baseline data for further study of infant mortality.

Infant lung samples were obtained prospectively at autopsy by medical examiner pathologists in five areas of the United States. Tissues were submitted regardless of the cause of death. Lung sections were stained with Prussian blue to detect deposits of hemosiderin. Fifty-nine cases were evaluated for the study. The four sections examined for each case were taken from the anterior and posterior aspects of the right and left upper lung. Three pathologists independently scanned the lung sections microscopically using a 10x objective lens (with 10x ocular lens) and indicated an "iron score" by indicating for each section if it showed no staining for iron-hemosiderin (Score 0), occasional staining with most fields negative (Score 1), focally abundant staining with most fields having no staining (Score 2), focally abundant staining with most fields showing positive staining (Score 3), or prominent staining throughout the section (Score 4). There was good agreement between pathologists on the iron score for each case. A total iron score was calculated by adding the scores based on each pathologist's observations. The mean total iron score was 6 (range, 1-44), with the range of possible total iron scores being 0 to 48. There was no significant difference between the four lung sections in a given case. Six cases had total iron scores that were at least twice the mean (i.e., total iron score > 12); in five of these cases death was caused by conditions other than sudden infant death syndrome, including one case in which asphyxia was the cause of death. These data are consistent with other reports that pulmonary hemosiderin in deceased infants is suggestive of a cause of death other than sudden infant death syndrome. The data may be useful as baseline data for further studies of infant mortality involving possible pathologic changes in the lungs.

Autopsy↗
PubMedDate not supplied

The use of logit models to investigate social and biological factors in infant mortality. IV: Post-neonatal mortality.

Infant mortality data for England and Wales, cross-classified by mother's age, parity and social class have been published on two occasions, the first giving the relevant data for 1949/50, the second for 1975, some 25 years later. Published analyses of these separate data sets have been based on graphical and tabular analysis. This paper describes the application of logit models using the methodology presented by Murrells et al. to investigate post-neonatal deaths.

Adolescent↗
PubMed2001

Pulmonary hemorrhage in deceased infants: baseline data for further study of infant mortality.

Infant lung samples were obtained at autopsy by medical examiner pathologists in five areas of the United States regardless of the cause of death. Lung sections were stained with hematoxylin and eosin. Sixty cases were evaluated for the study. The four sections examined for each case were taken from the anterior and posterior aspects of the right and left upper lung lobes. Histologic sections were scored for the extent of alveolar hemorrhage using the following scoring system: 0, no hemorrhage; 1, focal hemorrhage but less than score 2; 2, patchy, focal hemorrhage not present throughout the section; 3, focal hemorrhage more extensive than score 2 but not meeting the criteria for score 4; 4, patchy focal hemorrhage distributed throughout the section; 5, more extensive hemorrhage than score 4 but not meeting the criteria for score 6; 6, diffuse hemorrhage throughout the section. Total possible scores ranged from 0 to 24. Intraalveolar hemorrhage was observed in 40 cases. Overall, the mean score for the 60 cases was 5 (range, 0-24); for the 40 cases with hemorrhage, 7 (range, 1-24). Scores were compared with other descriptive variables like cause of death; interval between onset of fatal events and death; whether resuscitation was attempted; and pulmonary macrophage counts and hemosiderin scores reported in earlier studies of the same cases. In none of the 60 cases was death attributed to pulmonary hemorrhage or hemosiderosis. Pulmonary hemorrhage tends to be common among deceased infants; more prominent when there is medical treatment or resuscitation during the agonal period; infant position may partially explain distribution of hemorrhage in lungs; postmortem interval may exacerbate pulmonary hemorrhage; and infant deaths caused by acute idiopathic pulmonary hemorrhage (AIPH) or pulmonary hemorrhage/hemosiderosis (PHH) probably are rare. Specific case definitions for AIPH and PHH are needed, along with further study of these conditions.

Autopsy↗
PubMed1978

Postneonatal infant mortality in infants to a neonatal intensive care unit.

The postneonatal infant mortality (PNIM) of 2,205 infants admitted to a neonatal intensive care unit from January 1971 to December 1974 was 44 in 1,000 infants who survived to age 28 days. This rate is approximately ten times that of the general population. Congenital malformations (59%), infections (12%), sudden infant death syndrome (10%), and asphyxial brain damage (10%) were the most common causes of death. One third (26) of the infants remained in the hospital whereas two thirds (52) had been dismissed prior to death. All who remained in the hospital plus 36 who had been dismissed died of severe illnesses that were incompatible with prolonged survival. The remaining PNIM was 10 in 1,000 neonatal survivors. This rate is still twice that of the general population. These deaths occurred in infants who were apparently well at the time of dismissal and subsequent examinations. Sudden infant death syndrome and infections constituted the largest portion of this mortality. Factors contributing to mortality in this group were poor socioeconomic status and low birth weight. Maternal age, race, marital status, and neonatal illnesses including apnea were not significantly related. Factors that appear to be important in the birth of high-risk infants continued to be operative in the postneonatal period, and contribute to a high mortality in apparently normal infants dismissed from the neonatal intensive care unit.

Abnormalities, Multiple↗
PubMed1989

A comparison of low birth weight, perinatal mortality, and infant mortality between first and second births to women 17 years old and younger.

Several studies and vital statistics reports have indicated that second pregnancies in the young adolescent have worse outcomes than first pregnancies. This study compared the birth weights and mortality rates of first and second births to 407 teenagers who were less than or equal to 17 years old at the time of the second delivery. Contrary to previous studies, the mean birth weight was significantly lower for first births than for second births (p = 0.0001), even though patients registered for care earlier with their first pregnancy. The perinatal and infant mortality rates for first births were nearly double the rates for second births.

Adolescent↗
PubMed1999

Short-term morbidity and infant mortality among infants who slept supine at 1 month of age--a follow-up report.

Following evidence that prone sleeping is causally related to sudden infant death syndrome (SIDS), intervention campaigns to avoid prone sleeping in many countries have led to a large reduction in SIDS and total infant mortality. The supine position has been recommended for healthy infants in several countries. The objective of this report was to determine how usual sleep position at 1 month relates to morbidity indicators at 1 month and 12 weeks and to SIDS and postneonatal mortality using a prospective population-based live birth cohort in Tasmania, Australia. Eligible infants were the one-fifth of Tasmanian live births at higher risk of SIDS using a perinatal score. From 1 January 1988 to 31 December 1995, 9826 (89% of eligible) infants participated in the home interview. Fifty-three eligible infants died of SIDS, 51 (96%) with hospital interview data and 35 (81% of those eligible for home visit) with home visit data. The main outcome measures were SIDS, postneonatal mortality and parentally reported infant morbidity. The postneonatal mortality rates (cases per 1000 live births) by usual sleep position at 1 month of age were supine 1.60 [95% CI 0.04, 8.87], side 2.87 [1.79, 4.35], prone 10.27 [5.62, 17.18] and other (including no usual position) 6.37 [0.16, 34.98]. None of the study infants who slept supine died of SIDS at a later time. Of 25 morbidity indicators studied, only noisy breathing was increased for supine compared with side-sleeping babies. In this study, there was no evidence to suggest that supine sleeping at 1 month of age was associated with an increase in important short-term morbidity or postneonatal mortality. These findings provide further support for the recent recommendations of the American Academy of Pediatrics that healthy infants should preferably sleep in the supine position.

Analysis of Variance↗
PubMed1991

Preventing and postponing death: trends in Tennessee infant mortality.

Infants born in Tennessee between 1984 and 1988 experienced reduced mortality compared with those born in the 5 years previous. For all birthweight singleton infants, the reduction from 10.2 to 8.4 deaths per 1000 live births represents an 18% decline in mortality. The most impressive gain made was for very low birthweight (less than 1500 g) infants in the neonatal period, where mortality was reduced 24%. However, for these infants there was nearly a sixfold increase in the postneonatal mortality associated with prematurity-related causes.

Birth Weight↗