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[Infantile mortality in Ile-et-Vilaine (1970-1986)]
J Sénécal1, M Roussey, J Morellec
1Institut de la Mère et de l'Enfant, CHU de Pontchaillou, Rennes.
Insights
Infant mortality in Ille-et-Vilaine significantly decreased from 1970-1986, with congenital abnormalities now the leading cause of death. Continued focus on prenatal care and addressing socio-economic factors is crucial for further reductions in infant deaths.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Context:
- Infant mortality rates in Ille-et-Vilaine, France, between 1970 and 1986.
- Analysis of trends in neonatal and post-neonatal mortality.
- Identification of leading causes of infant death over the study period.
Purpose:
- To report and analyze the rates and causes of infant mortality in Ille-et-Vilaine from 1970 to 1986.
- To assess the impact of medical care programs on infant mortality.
- To identify key factors influencing infant mortality trends.
Summary:
- Infant mortality rate decreased from 18.7% to 7.06% overall and from 12.4% to 3.6% in the first week of life.
- Congenital abnormalities emerged as the primary cause of death (34%), surpassing prematurity (24.58%).
- Sudden Infant Death Syndrome is now the leading cause of post-neonatal death, with infections decreasing.
Impact:
- Demonstrates the effectiveness of pediatric medical care programs in reducing infant mortality.
- Highlights the shift in primary causes of infant death towards congenital abnormalities and SIDS.
- Underscores the need for continued improvements in prenatal care and addressing socio-economic disparities to further reduce infant mortality.
Abstract:
The rates and the causes of infantile mortality between 1970 and 1986 in the district of Ille-et-Vilaine are reported. During that period, infantile mortality rate decreased from 18.7 to 7.06% and from 12.4 to 3.6% during the first week (0-6 days), thereby suggesting the efficacy of medical care programs for this pediatric age group in France. Since 1980, with more accurate record keeping, using the recommended international classifications, there is a relative stagnation in the rate or early neonatal deaths (3.97 to 3.67) as compared to a sizable drop in the rates of late neonatal deaths (1.90 to 0.73) and post neonatal deaths (4.63 to 2.57). Congenital abnormalities have become the most important cause of death (34%) before prematurity (24.58%). However, the number of congenital anomalies should quickly decrease with prenatal screening programs leading to interruption of pregnancies. Although the percentage of infantile deaths due to prematurity has decreased from 66% between 1970 and 1974 to 24.58% in recent years, prematurity remains an important cause of death. Infections have decreased and the Sudden Infant Death Syndrome is currently the most important cause of death during the postneonatal period. The well known factors of risks are confirmed and particularly increased vulnerability of the population with a low socio-economic status which should lead to appropriate prevention programs. Despite these very impressive results, birth remains the most vulnerable period of life and current efforts should continue. Priority must be given to the improvement of prenatal care which requires good ongoing collaboration between obstetrics and pediatrics and the use of the Maternity Health Booklet.