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Premature birth and the changing composition of newborn infectious disease mortality: reconsidering "exogenous"
1Department of Sociology, Washington State University, Pullman 99164-4020, USA. sowardsk@vancouver.wsu.edu
Insights
Infectious infant mortality is increasingly linked to premature birth and low birth weight, with a significant rise in deaths involving these factors over decades. Advanced perinatal technology challenges the traditional view of infant mortality causes.
Area of Science:
- Public Health
- Neonatalogy
- Epidemiology
Background:
- Historically, infectious infant mortality was considered largely exogenous.
- Recent trends indicate a growing association between infant deaths and prematurity/low birth weight.
Purpose of the Study:
- To analyze the changing relationship between infectious infant mortality, prematurity, and birth weight.
- To evaluate the contemporary relevance of the exogenous-endogenous distinction in infant mortality.
Main Methods:
- Analysis of linked birth and death records from San Antonio, Texas.
- Comparison of data from 1935-1944 with data from 1980.
Main Results:
- The proportion of infectious infant deaths linked to prematurity increased from 4% (1935-1944) to 25% (1980).
- In 1980, over 40% of these infants weighed less than 2,500 grams, driven by an increase in very low-weight births.
- This shift suggests infectious infant mortality is increasingly endogenous.
Conclusions:
- Infectious infant mortality is now significantly influenced by prematurity and low birth weight.
- Advanced perinatal technology has altered the landscape of infant mortality.
- The traditional exogenous-endogenous classification of infant mortality causes is becoming less relevant.
Abstract:
Linked death and birth records from San Antonio, Texas revealed that infectious infant mortality is increasingly a function of premature birth and low birth weight. Between 1935 and 1944, 4% of infectious infant deaths had associated causes involving prematurity and related conditions; by 1980, 25% of infectious infant deaths involved prematurity and more than 40% of those infants weighed less than 2,500 grams. The shift in birth-weight composition results almost entirely from an increase in very low-weight births. Under conditions of advanced perinatal technology, infectious infant mortality should no longer be viewed as wholly exogenous. These findings further undermine the contemporary relevance of the exogenous-endogenous distinction.