Infant survival in Italy: recent trends

This paper analyzes the historical and geographical evolution of fetal and infant mortality (stillbirths + deaths in the 1st year of life) in Italy, starting from the 1950s. Particular attention is given to the last 20 years, which have marked an important turning point. Up to the beginning of the 1970s, the decline of fetal and infant mortality was above all due to the decline of post-neonatal and late fetal mortality, but later the part due to the decline of early neonatal mortality has become more and more significant since it began to decrease more rapidly and to be differentiated geographically. An important role in the decline of early neonatal mortality seems to be played by the improvement in the quality of births, attained through the reduction of prematurity, besides advancements in medical treatment. The latter have been more effective for what concerns gestation, childbirth, and the post-neonatal period than for the early neonatal period. Notwithstanding the recent improvements, the situation in Italy appears more backward than in other developed countries. To attain positive results in the future, not only from the viewpoint of quantity but also of quality, the strategy to be followed should aim, on one side, at the prevention of risk factors and on the other at the treatment of infants not at risk, as some other countries seem to be doing. A greater attention to statistical information and to cross-disciplinary working methodologies appear of great importance to attain further improvements.