- The Washington Times - Wednesday, February 11, 2004

Infant mortality in the United States rose for the first time in more than 40 years in 2002, but federal analysts are not ready to say this could be the start of an alarming trend.

The National Center for Health Statistics (NCHS) yesterday released a report showing that infant mortality climbed from a rate of 6.8 per 1,000 live births in 2001 to a rate of 7.0 per 1,000 live births in 2002. The rise was called “significant.”

Authors of the report, titled “Deaths: Preliminary Data for 2002,” said they were surprised by the findings, because each year since 1958, the overall infant mortality rate in the United States had either dropped steadily or remained unchanged.

“This [increase] may be a one-year blip, since early data for 2003 suggests that the 2003 infant mortality rate will be lower than in 2002. But we won’t know for certain for several months,” said Joyce Martin, NCHS’s lead statistician for reproductive information, who contributed to the report.

Ms. Martin said she and her research associate, Kenneth D. Kochanek, “don’t have enough data on 2002 mortality to explain the increase.” But she strongly denied wire reports yesterday that tied the increase to complications resulting from women delaying motherhood.

The “two important measures” in at-risk pregnancies and births, she said, are whether the child is born “preterm,” meaning less than 37 weeks of gestation, and if it has a low birth weight, meaning 5.5 pounds or less. There were increases in both in 2002.

The NCHS report found that the rise in deaths for babies younger than 1 in 2002 was “concentrated in the neonatal period,” meaning infants younger than 28 days. Deaths were especially high among infants in the first week of life, which the authors said is when “more than half of all infant deaths typically occur.”

The research showed a 4 percent increase in the 2002 neonatal mortality rate. In contrast, there was a 3 percent drop in the late fetal mortality rate, while the rate for children beyond neonatal remained constant.

“One possible reason for the increase [in infant mortality] is that higher-risk births have finally had an impact on mortality” data, said Ms. Martin.

She said the heightened use of fertility drugs is one factor because such medications can cause multiple births of undersized babies.

In a supplement to the NCHS “Deaths” report, she and Mr. Kochanek point out that in multiple births, “more than half are born preterm and/or low birth weight.” They noted that the multiple birth rate jumped 42 percent between 2001 and 2002 and said multiple births have “contributed importantly” to the problem of at-risk newborns.

The data for 2002 showed a continuation of the longtime trend of higher infant mortality among blacks than whites. Among white infants, Ms. Martin said, the mortality rate climbed from 5.7 deaths per 1,000 births in 2001 to 5.9 per 1,000 births in 2002.

The black rate edged up from 14 to 14.3 per 1,000 births during the same period. “The increase among whites was statistically significant,” but the one for blacks was not, she said.

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