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Does reducing infant mortality depend on preventing low birthweight? An analysis of temporal trends in the Americas

Michael S Kramer1, Fernando C Barros, Kitaw Demissie

  • 1Departments of Pediatrics and of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, Quebec, Canada. michael.kramer@mcgill.ca

Paediatric and Perinatal Epidemiology
|November 5, 2005
PubMed

Insights

Reducing infant mortality is achievable for all countries, even with varying low birthweight (LBW) rates. Improving care for both normal and low birthweight infants is key, not solely focusing on reducing LBW.

Area of Science:

  • Public Health
  • Demography
  • Neonatal Medicine

Background:

  • Low birthweight (LBW) is a significant risk factor for infant mortality, with high LBW rates often correlating with high infant mortality rates.
  • Understanding the relationship between LBW trends and infant mortality is crucial for public health interventions.

Purpose of the Study:

  • To compare temporal trends in low birthweight (LBW) with infant mortality across different birthweight categories in five countries.
  • To analyze the association between LBW and infant mortality over time and assess the impact of LBW on overall infant mortality reduction.

Main Methods:

  • Utilized national population-based vital statistics from the United States, Canada, Argentina, Chile, and Uruguay for two periods: 1985-89 and 1995-98.
  • Employed cohort and cross-sectional analyses to examine temporal trends and associations between LBW and infant mortality.

Main Results:

  • Infant mortality decreased significantly across all birthweight categories in all five countries, irrespective of changes in LBW rates.
  • The association between LBW and infant mortality weakened over time, and the proportion of infant deaths among LBW infants was negatively correlated with overall infant mortality.
  • Countries reduced infant mortality by improving care for all infants, not primarily by reducing LBW.

Conclusions:

  • Developed and less developed countries in the Americas have successfully reduced infant mortality through comprehensive care strategies.
  • While not directly generalizable, these findings suggest that improving care for both normal and low birthweight infants can substantially lower infant mortality globally.
  • Reducing LBW is not the sole driver for decreasing infant mortality; overall infant care improvements are paramount.

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