U.S. has second worst newborn death rate in modern world,

[liberal N proud]

Research: 2 million babies die in first 24 hours each year worldwide
By Jeff Green
CNN



Tuesday, May 9, 2006; Posted: 12:37 p.m. EDT (16:37 GMT)
CNN) -- An estimated 2 million babies die within their first 24 hours each year worldwide and the United States has the second worst newborn mortality rate in the developed world, according to a new report.

American babies are three times more likely to die in their first month as children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland or Norway, Save the Children researchers found.

Only Latvia, with six deaths per 1,000 live births, has a higher death rate for newborns than the United States, which is tied near the bottom of industrialized nations with Hungary, Malta, Poland and Slovakia with five deaths per 1,000 births.

"The United States has more neonatologists and neonatal intensive care beds per person than Australia, Canada and the United Kingdom, but its newborn rate is higher than any of those countries," said the annual State of the World's Mothers report.

http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/index.html


But to the bu$h regime and their band of right to birth crowd, all that matters is that they are born.

[Midlodemocrat]

1. I wonder if they took into account

babies who were conceived by IVF, and other infertility measure? Multiple births type thing.

[Warpy]

11. No, it specified BIRTH

and not spontaneous abortion.

Nice try, though.

The US has piss poor statistics because the US hates children and despises where they come from. The US has piss poor statistics because the US doesn't consider health care a right for anyone but the super wealthy. The US has piss poor statistics because it's cutting back on the one program that made this statistic better than the third world, the WIC program which gave poor mothers extra nutrition during pregnancy and breastfeeding and to their children though early childhood.

National health now. Living wages now. Anything less is unchristian and ultimately adds to the race to the bottom that this country is currently running.

[Midlodemocrat]

15. I am talking about birth.

Nice try, though? :wtf:

I have known several people who had IVF and delivered very sick babies who subsequently died. As the IVF rate is climbing as women put off childbearing, it should have certainly factored into the study.

[moc]

16. I'll answer your question. It is unlikely that rising multiple rates

as a result of ART (assisted reproductive technology) are responsible for a very large proportion of the disparities between the U.S. and other countries with regards to infant mortality rates. It's kind of hard to explain, but it's related to something that epidemiologists refer to as population attributable risk. Although at the individual level, multiple births are at much higher risk of preterm birth (and therefore infant death), they still make up a pretty small fraction of births overall, and shifts in multiple birth rates won't translate into significant shifts in preterm birth rates at the population level. There is some indication that multiple birth rates are contributing to rising low birth weight birth rates among whites but not among blacks. (See Branum, A.M., & Schoenforf, K. (2002). Changing patterns of low birth weight and preterm birth in the United States, 1981-98. Paediatric and Perinatal Epidemiology, 16, 8-15.) This makes sense, in that ability to access ART services is largely driven by socioeconomic factors, so more whites have access to ART services than blacks.

One factor that does explain part of the disparities between the U.S. and other countries is a difference in what is declared a live birth. Although definitions of a live birth are supposedly standardized by the World Health Organization, it's not really what happens in practice. If an infant who is born near the limits of viability is declared a fetal death instead of an infant death, he isn't counted in the infant mortality statistics. There is some evidence that differences in declaring a live birth accounts for higher infant mortality rates in the U.S., but not completely. Also, this doesn't explain the atrociously high infant mortality rates among African Americans in this country, which are consistently 2-2.5x as high as whites and in some poor communities rival infant mortality rates of developing countries.

Sorry to ramble. Hope this helps.

[Midlodemocrat]

17. Thanks for that.

I had read that part about the disparity between what is considered a fetal death and an infant death, and was wondering as well if that factored into the study. While I will readily admit that this study is probably accurate, I would like to see the methodology used to obtain these results.

Admittedly, I don't know a whole lot about this. I would be interested to try and find out about the mortality rate among women in this country as well. When I was having my first child almost 16 years ago, the practitioner stated that maternal death was almost eradicated in this country. Something I still feel can't possibly be accurate. Hell, just in my community, I know of two women who died while giving birth in the last five years.

[moc]

20. Yes, that was the common wisdom when I was in graduate school

in the late 1980s - that maternal mortality was virtually eradicated in developed countries but not in developing countries. I can't remember for sure, but I think the rates are quoted per 100,000 live births (compared to 1000 live births for infant death rates). It's sufficiently rare that I hope the appropriate authorities in your community were alerted when those deaths occurred and conducted some sort of maternal mortality review. It may have been a fluke, but I'd like to know if those women were discharged from the hospital too quickly or something like that.

[Midlodemocrat]

22. Actually, what transpired was a major fluke.

One woman had a massive heart attack after delivering the last of triplets, and another had some amniotic fluid travel to her brain and kill her instantly.

Tragic, but certainly not common.

[moc]

33. That is so sad!

:cry:

[Dorian Gray]

25. Anecdotally, I have two IVF stories

that, luckily, didn't end in death. But the babies were very sick for the first year of their lives. Thankfully, however, the children lived after surgery.

I don't think the number of IVF children would make a huge mark in the statistics, even if it could possibly be proven that the children of IVF are more unhealthy (which I don't believe) than children conceived naturally.

[Midlodemocrat]

35. I don't think that IVF babies are inherently more unhealthy,

I was referring more to the multiple births that do often result from assisted pregnancies.

My own niece was conceived via IVF and she is perfect in every way, but I don't think that fertility drugs which resulted in the births of the McCaughey septuplets. Two of those little guys have CP. This isn't to say that they shouldn't have been born, I don't mean that at all. I do believe however, that God didn't intend for humans to produce that many live births at one time.

[Dorian Gray]

40. Of course, I should have realized that

with IVF comes a higher number of multiple births, and with that, a generally lower birth rate. The few people that I know who have had IVF have all had single children, so I was thinking solely of the cases I knew of! :)

[Warpy]

28. Right, that would be a part of the "live birth" statistic, but

statistically negligible. IVF is still not a major way to conceive. It's only for women who can afford it and luck still plays a big part in conception.

[FloridaPat]

2. Goes along with the report that US middle aged people are less

healthly than British middle aged people. I vote for the lousy food we produce here

[Warpy]

12. Good food choices are there

Good healthcare choices are not. By middle age, people are starting to develop chronic illnesses and are most likely to start losing health insurance due to escalating premiums being passed along by employers. Then they find they are ineligible for any affordable insurance anywhere.

The choice is between healthcare and food/shelter/transportation/clothing. Which would you choose?

[FloridaPat]

39. I personally am choosing food. But except for raw fruit & veggies,

the food that is sold in this country is not very healthy. There is a debate about the meat. With so many chemicals and hormones in the meat - to say nothing of mad cow - now sure how healthy meat is.

And even the fruit and veggies is not exactly healthy. I can't get ripe edible fruit except for a few items like oranges. The veggies have been cut from their stalks days before they get to market. The amount of vitamins in fruit and veggies has been lowered by the gov't. Fertilizers don't have trace minerals in them so no one is getting minerals except in pill for. Too much candy, cake, and junk food for a healthy America.

[WindRavenX]

3. this is beyond horrifying

Wow :scared:

I believe that US' slide to third world state is already begininng to manifest itself in these types of stats...

[moc]

6. This is not new. The U.S. has been ranked as worst in infant

mortality outcomes for as long as I've been working in the field, ~15 years.

[WindRavenX]

13. Isn't America the BESTEST country in the world?

:cry:

[moc]

4. I'm surprised we're not the worst. We have the highest infant mortality

of any developed country in the world. Infant mortality captures deaths up until the first birthday.

Unfortunately, the availability of neonatal intensive care is not going to address this problem. Virtually all of the reduction in IM over the last 30 years or so has been due to reductions in birth weight specific mortality rates, for example, the likelihood of infants born weighing 500-750g surviving. At this point, what we have to do a better job of is reducing the rates at which these very low birth weight infants are born to begin with. The problem is that VLBW rates are on the rise, not decline.

My belief is that reductions in VLBW rates will take broader societal support for women and children including improved access to contraception (short interpregnancy interval is a significant contributor to preterm birth rates), and better support for poor women, improvements in women's health, etc. Don't see that happening under a Republican agenda.

[xultar]

5. The anti-choice muthafuckas need to spend their energy on this.

[AspenRose]

18. They won't because it's mainly poor women who suffer

See the post below.

Poor, and largely minority (black and hispanic) women who can't get the healthcare they desperately need when pregnant.

The vast majority of the right wing "pro life" folks could care less about that contingency.

As a matter of fact they're the ones perpetually bitching and moaning about the "welfare mothers pumping out children," and they can't give out incentives for sterilization quick enough.

But their willingness to ignore this susceptible portion of the population is what's bringing the US numbers down overall.

Once again: Everyone does better when EVERYONE does better.

But make no mistake: When the right wing pro-lifers talk about saving the fetus, they mean the WHITE fetus.

[Dorian Gray]

26. Exactly DesertedRose...

the problem is not the healthcare that we receive. The problem is the healthcare that so many can not afford to receive. It is the absense of availability for the lower income families that is devestating, and this is a shameful statistic. One that we should really focus on improving.

[Der Blaue Engel]

19. In addition to the below, they don't care because

poor women are all stupid, unmarried alcoholics on crack. And if they really cared about their babies, they'd get health care anyway. Plus, they're not white (or if they are they're white trash), so who gives a flip?

HEAVY :sarcasm: :sarcasm: :sarcasm: :sarcasm: (But I'd bet you could find this exact post on Fascist Republican.)

[TreasonousBastard]

7. I'll read the article later, but I'll bet...

that if you look closer the problem is primarily with poor mothers who can't get proper care.

We have the best care in the world for those who can afford it, but other industrial countries not only don't have the extremes in income levels we have, but take pregnancy and child care much more seriously than we do. Good pre- and post- natal care, to say nothing of birth, is assumed in many other countries regardless of the mother's ability to find money.

Sad to say, but for all of our big talk we really hate pregnant women and kids here. Especially poor ones.

On edit...

The same report comes out year after year, but nothing's ever done.

[anarch]

8. if we try hard, I'm sure we can be # 1!

I mean, just look at the job we've done at imprisoning our citizens. #1 with a freakin' bullet, I say!

[gully]

9. This part is key:

Causes of death in the developing world were dramatically different from those in the developed world, the report said. In industrialized nations deaths were most likely to result from babies being born too small or too early, while in the developing world about half of newborn deaths were from infection, tetanus and diarrhea.

The newborn mortality rate in the United States has fallen in recent decades, the report said, but continues to affect minorities disproportionately.

Only 17 percent of all U.S. births were to African-American families, but 33 percent of all low-birthweight babies were African-American, according to the report.

The research also found that poorer mothers with less education were at a significantly higher risk of early delivery. The study added that in general lower educational attainment was associated with higher newborn mortality.

Tinker said Japan was among a number of nations highly ranked mainly because they offer free health services for pregnant women and babies, while the United States suffers from disparities in access to health care.

The "pro-life" crowd (if they REALLY gave a shit) would concern themselves with every American getting a sound education and HEALTH CARE.

[murray hill farm]

10. I clicked on the top ten best countries in the article...

and #s 3,5,6 and 8 were not included in the list....is it because these were not so called "developed" countries....all ahead of the US...wonder which ones were left out..anyone know?

[enigma000]

21. there is no #3,5,6 and 8 because of ties

so Japan has 2 per 1,000 and the US has 5 per 1,000

click on the link http://edition.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/index.html

10 worst / 10 best

[murray hill farm]

41. Thanks!

That explains it!

[chookie]

14. Best to stay a fetus

It is unfortunate that the people who condemn abortion have such little regard for the health of that very fetus and whatever difficulties it may face after birth. Once you're born, you're on your own, no matter how fragile your new life is. My conclusion: these people are hypocrites.

[bmbmd]

23. Drug, alcohol, and tobacco use

by pregnant mothers kills a lot of babies.

[moc]

32. This is a common misperception. Prenatal drug and alcohol use

contribute very little to population levels of infant mortality. I'm not suggesting these things are good, but eliminating them would do little to reduce disparities in infant mortality.

[SidDithers]

37. How about tobacco use?...

Is prenatal tobacco use a contributor to low birth weight?

Sid

[bmbmd]

38. Here is what your government has to say about that.

http://www.healthypeople.gov/Document/HTML/Volume2/16MICH.htm#_Toc494699661

Short gestation and LBW are among the leading causes of neonatal death, accounting for 20 percent of neonatal deaths. In 1998, a total of 11.6 percent of births were preterm, and 7.6 percent were LBW.<4> Included in these statistics were VLBW infants weighing less than 1,500 grams (3.3 pounds). The rate of VLBW births was 1.4 percent in 1998. The VLBW rate has increased slightly since 1990 among whites and other population groups including African Americans, Puerto Ricans, and American Indians.1

LBW is associated with long-term disabilities, such as cerebral palsy, autism, mental retardation, vision and hearing impairments, and other developmental disabilities. (See Focus Area 6. Disability and Secondary Conditions and Focus Area 28. Vision and Hearing.) Despite the low proportion of pregnancies resulting in LBW babies, expenditures for the care of LBW infants total more than half of the costs incurred for all newborns. In 1988, the cost of a normal, healthy delivery averaged $1,900, whereas hospital costs for LBW infants averaged $6,200.<5>

The general category of LBW infants includes both those born too early (preterm infants) and those who are born at full term but who are too small, a condition known as intrauterine growth retardation (IUGR). Maternal characteristics that are risk factors associated with IUGR include maternal LBW, prior LBW birth history, low prepregnancy weight, cigarette smoking, multiple births, and low pregnancy weight gain. Cigarette smoking is the greatest known risk factor.<6>

VLBW usually is associated with preterm birth. Relatively little is known about risk factors for preterm birth, but the primary risk factors are prior preterm birth and spontaneous abortion, low prepregnancy weight, and cigarette smoking.6 These risk factors account for only one-third of all preterm births.

The use of alcohol, tobacco, and illegal substances during pregnancy is a major risk factor for LBW and other poor infant outcomes. Alcohol use is linked to fetal death, LBW, growth abnormalities, mental retardation, and fetal alcohol syndrome (FAS).<7> Overall rates of alcohol use during pregnancy have increased during the 1990s, and the proportion of pregnant women using alcohol at higher and more hazardous levels has increased substantially. Smoking during pregnancy is linked to LBW, preterm delivery, SIDS, and respiratory problems in newborns. In addition to the human cost of these conditions, the economic cost of services to substance-exposed infants is great: health expenditures related to FAS are estimated to be from $75 million to $9.7 billion each year.7 Over $500 million a year is spent on medical expenses for infants exposed to cocaine in utero.<8> Smoking-attributable costs of complicated births in 1995 were estimated at $1.4 billion (11 percent of costs for all complicated births, based on smoking prevalence during pregnancy of 19 percent) and $2.0 billion (15 percent for all complicated births, based on smoking prevalence during pregnancy of 27 percent).

[KamaAina]

24. Suck it, Latvia! USA rules!

Remember when we tied you guys in Olympic hockey? Huh?

:sarcasm: :sarcasm: :sarcasm:

[Xithras]

27. There was a similar thread a few months back. The #'s are deceptive

The US has a higher infant mortality rate specifically BECAUSE of our extensive neonatal health system AND the prevalence of fundies. In most countries, babies with extensive genetic or developmental defects would likely miscarry...or failing that, be aborted. They would be "non-births".

Neonatal care in the US has advanced to the point where miscarriages in later pregnancy are now fairly uncommon. Marginal pregnancies which would have terminated 20 years ago now make it to delivery. Unfortunately many of these marginal pregnancies result in marginal babies, and many of them simply cannot survive outside of the mothers womb. Statistically, that increases our infant mortality rate.

In nations like Sweden or France, pregnant mothers who are found to be carrying marginal babies are typically advised to abort the pregnancies. In the US, the strong fundie streak means that this advice isn't given, and that more work is put into trying to "save" the pregnancy. With abortion off the table as an option for a huge percentage of women in this country, more of these pregnancies come to term.

The fact that minorities have a higher rate of infant deaths is a side-effect of other statistics. Poor people in the US generally don't eat nutritionally sound food, and don't live in the healthiest of environments. Statistically, they are also more likely to be alcohol and drug abusers (more illegal drug users are poor than rich) and live in environments tainted with lead and other chemicals. All of these factors combine to substantially increase the odds that a poor person will have a marginal pregnancy, and increase infant mortality rates among the resulting babies since more of those pregnancies make it to term in this country

The problem isn't medical, it's social. Increased medical care isn't going to fix the statistics because in many cases it's modern medicine that is exacerbating the issue.

[moc]

29. Not exactly. Although you are correct that the reasons are social

not medical, they are not the social reasons which you point out (i.e., fundamentalist ideology undermining selective termination of defective fetuses).

Rather, the roots are found in our high rates of preterm delivery, rates that are rising not falling. Many believe the roots of this are social, specifically income inequalities, poor access to health care, etc.

More information can be found in my other posts in this thread.

[Xithras]

34. High preterm delivery dates can also be traced to improved care.

There's nothing abnormal about an abnormal pregnancy. The very nature of genetic recombination during fertilization means that a substantial portion of human conceptions are going to end with miscarriage and death. That's the fault of DNA and evolution, not medical science.

While many cite income inequalities, many others believe that it is modern medicine exacerbating the issue. Again, a huge number of fetuses that would have spontaneously aborted in miscarriages 20 years ago make it to birth today. Babies that would have never taken a breath in 1985 can be kept alive for weeks or months in modern hospitals. Many of these children do NOT make it to term and are born early, but that is a side-effect of an abnormal pregnancy, not lack of medical treatment. They are coaxed and medicated to keep them alive as long as possible in the hopes that they will develop "enough" to survive on their own. Some do, many don't.

The problem when using studies like these for social purposes is that they are easily refuted. Statistically, the percentage of US pregnancies that result in successful live births are at global highs and are continuing to rise. A woman getting pregnant in the US is far more likely to have a successful pregnancy here than almost anywhere else. The side-effect of that medical advancement is that American women are also more likely to have disabled children (since those pregnancies are more likely to survive here), and many naturally abortive pregnancies are maintained until birth.

[moc]

36. Again, not exactly. Infant mortality rates are comprised of two

components - the birth weight distribution and the birth weight specific mortality rates. What you are arguing is that differentials in birth weight specific mortality rates (i.e., lower in the US vs. other developed countries) is just not accurate. Birth weight specific mortality rates of very low and extremely low birth weight infants are comparable between the US and other developed countries. What is different is that the rates of very preterm births are higher to begin with.

I've never seen any credible evidence that early spontaneous abortion rates have changed dramatically in the last number of decades, but if you have a citation, I'd be happy to consider it.

Sorry to post and run but I have a child to pick up and will be gone the rest of the afternoon.

[Ksec]

30. Thats just hideous when wealth is taken into account

Our gov has failed America.

[sakabatou]

31. Thank you pResident Bush!

:grr: