The state of South Dakota's child: 2009

A confluence of variables led to South Dakota's 2008 infant mortality rising to its highest rate per 1000 live births (8.3) since 1999 and above the 6.5 per 1000 rate for the United States. The number of live births in the state decreased for the first time since 2000. In 2008, one hundred infants died, more in any one year since 1995. The increase in the infant mortality rate occurred for both white and minority infants in both the neonatal and post-neonatal periods of the first year of life. Analyzes show that in 2008, there was an increase in the percent of all births that were very low birth weight (VLBW) and that multiple births accounted for this increase. Further, survival in the VLBW category for infants decreased in 2008 compared to recent years. Accounting for the largest increase in the rate of death, however, were those attributed to causes "other" than perinatal causes, sudden infant death syndrome (SIDS), congenital anomalies or accidents. The possibility is discussed that a potential diagnostic shift in how deaths are certified may be reflected by the 2008 data, with increasing numbers of deaths occurring sleep now being certified as having an "undetermined" cause rather than SIDS.