Even if they are born full-term, American babies are as much as 200 percent more likely to die in infancy than babies in many European countries, new research reveals.
More than 7,000 full-term babies die in the US each year, but infants are at much higher risks in some states than others, according to a Harvard University study.
High rates of mortality in places like Mississippi as compared to New York or California suggest that the nation’s high infant mortality rate could be curbed as many of these full-term babies’ deaths were likely preventable.
Many of the babies died of sudden infant death syndrome (SIDS) or suffocation, both of which suggested to the authors that too many Americans are not using the safest sleeping arrangements for their babies.
A map reveals that full-time babies are at as much as three times greater risks of dying in infancy in states like Mississippi than in New York or California
Between January 2010 and December 2012, more than 10.1 million babies were born full-term in the US.
Being born after a full, 39-40 week gestation period is one of the best survival advantages an infant can have.
Conversely, with every additional week early a baby is born, its mortality risks falls precipitously.
In the US, the mortality rate for babies born between 22 and 23 weeks of gestation is 4.2 per every 1,00 live births.
Overall in the US, 5.9 infants per every 1,000 die, according to the most recent data from the Centers for Disease Control and Prevention.
Because premature babies are typically weaker and less resilient than those carried to term, this high infant mortality rate is thought to be driven up by their deaths.
But, according to the study authors, mortality rates for premature infants in the US are similar to those in other high-income countries, so their deaths do not explain why the country is ranked 44th out of 199 countries for overall infant mortality rates.
‘Children born after 36 weeks of gestation…in the US faced more than twice the mortality risk of children in European countries with low infant mortality rates,’ the authors wrote.
The new research revealed that infant mortality among full-term babies remained high at 2.23 per 1,000 live births, which, the CDC estimates, accounts for more than half of the disparity in infant mortality between the US as Sweden, the authors wrote.
Even more staggering was the wide range of state-to-state variation.
Mortality rates were highest for full-term babies in Mississippi, where an infant was three times more likely to die than in the state with the lowest rate, Connecticut.
Sudden unexplained death of infants (SUDI) was listed as the cause on 43 percent of the full-term babies death certificates.
SUDI encapsulates a number of incidents ranging from wholly unexplained sudden infant death syndrome (SIDS) to other fatal sleep accidents.
In states where a greater number of full-term babies died, SUDI tended to account for the difference in death rates from cities with better odds.
New York and California saw fewer than six deaths per 10,000 births, but 12 states, including Ohio, South Dakota and Tennessee, had infant mortality rates more than twice that high.
The researchers reasoned that, because premature infant mortality is similar in the US and other countries, and most of these deaths were due to SUDI – rather than birth defects – immediate post-delivery care quality was not a likely cause.
Instead, they pointed to studies done in European countries that suggested that ‘a large majority of SIDS deaths could historically be attributed to prone sleeping [positions] and maternal drug consumption’.
Both Sweden and Scotland have reduced the number of babies that die from SIDS by as much as 75 percent through ‘active public health programs,’ the researchers wrote.
Although the American Academy of Paediatrics – like pediatric associations in most high-income countries – recommends that babies sleep in the same room but not the same bed as their parents, ‘general compliance with sleeping recommendations continues to be a challenge in the US,’ the authors wrote.
They observed that women with lower income sand education levels are more likely to sleep in the same bed with their babies, and the infants of these mothers are more likely to die of suddenly during the night.
‘The results presented in this paper suggest that a substantial proportion of these deaths are preventable, with particularly large improvements possible for SUDI,’ the study authors wrote.