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Changes in infant mortality among extremely preterm infants: US vital statistics data 1990 vs 2000 vs 2010

M H Malloy1

  • 1Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|July 31, 2015
PubMed

Insights

Infant mortality for extremely preterm infants significantly decreased between 1990 and 2000. However, little progress was made in reducing infant mortality from 2000 to 2010, except for those born at 25 weeks gestation.

Area of Science:

  • Neonatalogy
  • Perinatology
  • Public Health

Background:

  • Infant mortality rates for extremely preterm infants (22-28 weeks gestation) vary significantly by gestational age.
  • Understanding trends in mortality over time is crucial for assessing care improvements and informing parents.

Purpose of the Study:

  • To analyze infant mortality trends (birth to 365 days) for infants born between 22 and 28 weeks gestation in the US.
  • To compare mortality rates across three decades (1990, 2000, 2010), adjusting for maternal and infant characteristics.

Main Methods:

  • Utilized US vital statistics linked birth and infant death certificate files for 1990, 2000, and 2010.
  • Included births from 22 to 28 weeks gestation, with outlier birth weights removed.
  • Calculated infant mortality rates and adjusted odds ratios using logistic regression.

Main Results:

  • Infant mortality at 22 weeks gestation was 904/1000 in 1990, 835/1000 in 2000, and 866/1000 in 2010.
  • An approximate 50% adjusted reduction in mortality odds was observed between 1990 and 2000.
  • No significant mortality reduction occurred between 2000 and 2010, except at 25 weeks gestation (aOR=0.81).

Conclusions:

  • A significant decrease in infant mortality for extremely preterm infants occurred between 1990 and 2000.
  • Progress in reducing mortality for this population has stagnated between 2000 and 2010.
  • Further research is needed to identify factors limiting mortality reduction in recent years.
Abstract

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