ATLANTA — Scientists now say a third of infant deaths are because of premature births — a much larger percentage than previously thought.
In the past, "preterm birth" has been the listed cause of death in fewer than 20 percent of newborn fatalities. But that number should be 34 percent or more, said researchers at the federal Centers for Disease Control and Prevention.
That's because at least a dozen causes of newborn death are actually problems that go hand in hand with premature births, such as respiratory distress syndrome caused by underdeveloped lungs.
"This brings preterm birth, as a cause of death, to the kind of level
that we think it deserves," said the CDC's Dr. Bill Callaghan [William M. Callaghan, MD],
the lead author of a study appearing today in the journal Pediatrics. Request for reprint to:
The revised statistic may lead to greater efforts to counsel pregnant women about taking care of themselves and avoiding actions that can lead to preterm births — such as smoking and drug use.
It also may help organizations lobbying for more research into why some women who follow medical advice still have preterm babies.
The March of Dimes is advocating to expand federal research into preterm labor and delivery and the care and treatment of premature infants.
At issue is how to label the causes of deaths for infants who die before they reach their first birthday.
"Preterm birth" generally describes infants who are born before 37 weeks' gestation, and the term is also used as an official cause of death. Two-thirds of infant deaths occur in children who were preterm, but their cause of death is often attributed to one of the several specific problems that can occur in preterm babies.
"The only way that an infant gets assigned ("preterm birth") is if there's nothing else on the death certificate," said Callaghan, a senior scientist in the CDC's maternal and infant health branch. "That may result in an underestimation of what the real problem is."
Callaghan and other researchers reviewed about 28,000 U.S. infants that occurred in 2002.
More than 4,600 of those — or 17 percent — were attributed only to preterm birth. But the researchers also grouped in about 5,000 other deaths that were attributed to preterm-related conditions including respiratory distress syndrome, brain hemorrhage and maternal complications such as premature rupture of membranes.
In that counting, nearly 9,600 births — or 34 percent — could be classified as preterm, Callaghan said. The researchers believe that figure is conservative and likely underestimates the true picture.
source: http://seattlepi.nwsource.com/national/287176_infants02.html 2oct2006
CHICAGO - Premature births accounted for more than one-third of U.S. infant deaths in 2002, twice what was previously reported, making it the leading cause of infant mortality, government researchers said on Monday.
A reclassification of infant deaths by the Centers for Disease Control and Prevention concluded that 34 percent of infant deaths in America in 2002 should be blamed on premature births, said a study by CDC researchers in the journal Pediatrics, published by the American Academy of Pediatrics.
Previously, the National Center for Health Statistics reported 17 percent of infant deaths were directly caused by premature birth or low birth weight, with the leading cause listed as birth defects.
Several other listed causes of infant death, such as respiratory distress from underdeveloped lungs, should have been ascribed to premature birth, the study said.
Overall, two-thirds of the nearly 28,000 infant deaths in 2002 were babies born prematurely — or before 37 weeks gestation and many much earlier.
The United States ranks 23rd among industrialized nations in infant mortality and has a growing rate of premature births, which defy an easy explanation.
A report released in July by the Institute of Medicine said premature births, which accounted for one-in-eight U.S. births last year and have increased 30 percent since 1981, cost society at least $26 billion a year.
Assisted fertility methods are used more often and there are a larger number of older mothers, both of which tend to produce multiple births and such babies are more likely to be born early.
The U.S. infant mortality rate declined sharply throughout most of the 20th century but has been relatively stable in recent years — coincident with the rise in preterm births.
The earliest preterm births — newborns weighing less than 750 grams (about 1.6 pounds) with a gestational age of less than 28 weeks, who face particular health risks — contributed to a rise in the 2002 U.S. infant mortality rate, the CDC study said.
In 2002, seven babies out of every 1,000 died in their first year. In 2003, the mortality rate went back down to 6.8 babies per 1,000.
"This study found that efforts to reduce infant mortality rates must focus on preterm birth," and find ways to safely delay such births, lead author Dr. William Callaghan wrote.
source: http://www.topix.net/content/reuters/2841682866404013936317009407471132706489 2oct2006
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