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U.S. has high rate of newborn deaths
Kristen Gerencher, "U.S. has high rate of newborn deaths", Market
Watch, May 10, 2006, Link: http://www.marke****ch.com/News/Stor...F8%7D&keyword= Newborns in the United States have the second lowest survival rate in the industrialized world, according to a report released this week. Babies in their first month of life have the best odds in Japan, which boasts the lowest newborn mortality rate of 1.8 deaths per 1,000 live births, according to a report from the nonprofit group Save the Children. Latvia had the highest mortality rate among the 33 industrialized nations surveyed, at six newborn deaths per 1,000 live births. The U.S. ranked next to last and tied with Hungary, Malta, Poland and Slovakia, which all averaged five deaths per 1,000 live births. The U.S. newborn mortality rate is nearly three times higher than that of Finland, Iceland, Norway and Japan, the study found. Minorities had disproportionately high rates. Black Americans had a newborn mortality rate nearly twice the national average, at 9.3 deaths per 1,000 live births. African American babies are twice as likely as white babies to be born prematurely, have low-birth weight and to die at birth, according to Save the Children. A growing number of people without health insurance, a lack of education in some areas and underlying factors such as poor maternal nutrition, uncontrolled chronic conditions and risky behaviors all play a role in the low U.S. standing, said David Oot, director of the office of health for Save the Children U.S., a member of the global Save the Children Alliance. "There are real issues around access and use of health services," Oot said. Education and access to universal health care contribute to the success of nations such as Norway and Finland that ranked near the top for newborn survival, he said. "There are high levels of education pretty uniformly across the populations of those countries," Oot said. "That has a lot to do with whether mothers seek and use care before, during and after pregnancy. It also has to do with how they care for themselves with nutritional and other practices that might otherwise put them at risk." Broader focus on maternal health The study may overstate the problem in the U.S. because what's counted as a newborn death here -- such as a baby born 23 weeks into pregnancy who dies soon thereafter -- may be counted as a fetal death in other nations, said Dr. Nancy Green, medical director for the March of Dimes. "We are not as good as we should be, but maybe we're not as bad as the numbers would suggest," she said. Still, the U.S. should be doing more to help women take care of their health before they start families, Green said. Increased attention to family planning and maintaining adequate time between births also reduces the risk of newborn deaths, she said. "We have not as a nation reached a point of optimizing maternal health, and that's what you're seeing with these sort of mediocre standings in terms of neonatal mortality," Green said. Maternal health shouldn't focus exclusively on prenatal care but health care in general, she said. "For example, women who are extremely underweight or extremely obese have higher rates of prematurity/low birth weight. There is some rough correlation with overall health and well-being in those issues." Last month, the Centers for Disease Control and Prevention released recommendations for improving women's health before conception. Among the highlights, the CDC recommends women who want to get pregnant stop smoking and drinking alcohol and take daily supplements of folic acid, which reduces the risk of neural tube defects by two-thirds. The infant mortality rate, defined as death before the first birthday, was flat in 2003, with 6.8 deaths for every 1,000 live births, according to data from the National Center for Health Statistics. Two-thirds of all infant deaths occurred within the first month of life. In 2002, about 25% of U.S. newborn deaths were caused by prematurity and low birth weight, and 20% were caused by birth defects, Green said. The rest were due to other problems such as maternal, placental and umbilical cord complications. Even the lowest-ranking industrialized nations have substantially better infant mortality rates than in sub-Saharan Africa, which has the highest newborn death rates, the report said. One in five mothers there has lost at least one baby in childbirth, and Liberia had the highest mortality rate of all surveyed nations at 65 deaths per 1,000 live births. Western countries, including the U.S., account for only about 1% of the annual 4 million newborn deaths worldwide, according to Save the Children. "It's important to remember, while it is an issue certainly in the U.S. and in certain groups in the U.S., globally 99% of deaths in the first month of life occur in the developing world," Oot said. "The tragedy .... is that 70% of those deaths could be prevented with low-cost, low-tech interventions if they were made more available." Routine childhood vaccines, promotion of immediate and exclusive breastfeeding, warming of the infant and care of a newborn by a skilled birth attendant would raise the survival rate considerably, he said. |
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U.S. has high rate of newborn deaths
"It's important to remember, while it is an issue certainly in the U.S.
and in certain groups in the U.S., globally 99% of deaths in the first month of life occur in the developing world," Oot said. "The tragedy .... is that 70% of those deaths could be prevented with low-cost, low-tech interventions if they were made more available." That makes it OK, what comes from vaccinating too soon, especially hep b at birth, and what part does cord cutting play |
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