Today, neonatal and post-neonatal mortality rates are examined separately because most deaths during the neonatal period are associated with events surrounding the prenatal period and delivery. Post-neonatal mortality deaths are more likely to be associated with conditions or events that arise after the delivery. Deaths from birth defects can occur in both neonatal and post-neonatal stages.
For the past several decades, neonatal mortality in the United States has been declining at a faster rate that post-neonatal. Neonatal deaths accounts for the majority of infant deaths. The decline in neonatal deaths has mainly been due to the improvements of hospital settings, advances in medical techniques and equipment. These improvements in the neonatal stages have also attributed to prevention of deaths in post-neonatal stages.
There are longstanding disparities in birth outcomes between whites, Hispanics, and African Americans in the United States. For infant mortality, African Americans and Hispanics have rates at least two times higher than those for whites, and the gap has been increasing over time. This paper will discuss the different factors that cause the disparities and how they compare in regards to the risk associated with neonatal mortality.
Statistics from the Centers of Disease Control and Prevention, National Center for Health Statistics, and the National Vital Statistics System (2006) have estimated neonatal mortality rates for Caucasians at 3.7 deaths per 1,000 live births in 2006. For the same time period, post-neonatal mortality rates were estimated at 1.9 deaths per 1,000 live births. These deaths were association to low birth weight, congenital malformations, infection, and birth trauma.
The Centers of Disease Control (2006) have estimated that neonatal mortality rates for African Americans were 9.1 deaths per 1,000 live births. In 2006 the post-neonatal mortality rates were 4.7 deaths per 1,000 live births. The higher level of neonatal infant deaths occurred due to sudden infant death syndrome, respiratory diseases, and complication from premature birth deaths. Post-neonatal deaths were primarily caused by accidents and environmental hazards.
Hispanic neonatal deaths were estimated at 3.8 deaths per 1,000 live births. Post-neonatal deaths were reported at 1.7 per 1,000 live births. Neonatal deaths among Hispanics were caused from premature births, maternal complications, respiratory and cardiac diseases. Post-neonatal deaths were contributed to environmental hazards, accidents, and infections.
The leading causes of infant death havent changed in the last several years, despite advanced technology and increased focus on prenatal care. While most people would expect the rate of infant death to be decreasing rapidly, it has actually remained pretty stable since 2000. The overall rate of infant mortality in the United States is 6.86 deaths per 1,000 births. This data from the CDCs (Center for Disease Control) National Center for Health Statistics is based on the latest statistics available from 2006.
Birth weight has been well recognized as a cause of neonatal mortality among all ethnic groups. Causes of low birth weight have been attributed to risk factors such as: carrying more than one baby, smoking or exposure to second hand smoke, stress, infections, and previous abortions.
Congenital defects, also known as birth defects, are problems that occur while a fetus is developing in the womb. Congenital defects can affect the way the body looks or functions and range from mild to severe. Some defects, such as cleft lip or palate, can be easily fixed or treated. Other congenital defects may need life-long treatment to manage such as Down syndrome and heart defects. The most severe congenital defects prove fatal and lead to infant death. In 2006, 5,571 infants died as a result of congenital defects (Centers for Disease Control 2006).
There are several factors that have contributed to the differences in neonatal and pre-natal mortality rates among several ethnic groups. Demographic risks such as low socioeconomic status, low level of education, race, age ranges, and marital status play a role in the death rate of infants. Other factors that can play a role are medical risks predating pregnancy, including number of children previously born to the mother. Poor obstetric history and chronic diseases can affect the fetus or newborn.
Health care risks such as absent or inadequate prenatal care and premature delivery can affect a neonatal. Many low income families cannot afford the prenatal vitamins and resources during a full term pregnancy. Other causes can be related to behavioral and environmental risks. Poor dieting, smoking, alcohol, and drug use exposes fetuses to toxic substances and inadequate nutrition. Many Hispanics and African Americans fall into the low income levels thus causing many of these health risks which then get passed on to the infants which in turn increases the infant death rate among these ethnic groups.
References:
U.S. Department of Health and Human Services (2009). Child Health USA 2008-2009.
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Joint Center DataBank (2007). African Americans and Health. Retrieved from the web on
6/21/2010 at http://www.jointcenter.org/DB/factsheet/infanth.htm.
Ottawa Coalition for the Prevention of Low Birth Weight (2007) Causes of Low Birth Weight.
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http://www.successby6ottawa.ca/lbwfpn/english/causes_of_lbw.html
Encyclopedia of Death and Dying (2010). Mortatlity, Infant. Retrieved from the web on
6/21/2010 at http://www.deathreference.com/Me-Nu/Mortality-Infant.html
National Vital Statistics Reports, Vol 58 No. 1 (2009). Deaths: Preliminary Data for 2007.
Retrieved from the web on 6/21/2010 at
http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_01.pdf