More babies die here.Byline: The Register-Guard
Simply stating these facts is FACTS I Federal Agencies' Centralized Trial-Balance System likely to bring everyday conversation to a halt: Lane County's overall fetal-infant mortality rate - the number of babies who die anywhere from the 24th week of pregnancy to one year of age - is higher than the nation's; higher than the state of Oregon's; higher than in Multnomah, Clackamas or Washington counties Washington County is the name of 30 counties and one parish in the United States of America, all named for George Washington. It is the most common county name in the United States. ; and higher than in the Portland metropolitan area The Portland-Vancouver, Oregon-Washington, Metropolitan Statistical Area, also known as the Portland metropolitan area or Greater Portland, is an urban area in the U.S. states of Oregon and Washington centered around the city of Portland, Oregon. .
In a county that's home to a major research university, two excellent hospitals, an educated population, extensive social service organizations and a large urban center, babies are dying at a higher rate than anywhere else in Oregon.
Why? Why, in the span between 1999 and 2003, did Lane County experience 174 fetal-infant deaths, to log a mortality rate of 9.5 per 1,000 live births? (For comparison, see accompanying chart.)
Lane County Public Health officials are trying to drill deeper into the statistics in the hope of discovering the missing puzzle pieces. But it will take more money than the county now has to build a database that narrows the potential field of causes and points toward the best strategies to help more babies survive.
Public Health Officer Dr. Sarah Hendrickson already knows a lot about where the problem is occurring, thanks to a Perinatal Periods Perinatal defines period occurring around the time of birth (5 months before and 1 month after). The perinatal period commences at 22 completed weeks (154 days) of gestation (the time when birth weight is normally 500 g), and ends seven completed days after birth. of Risk analysis that compared Lane County resident data with fetal death records and linked infant birth and death certificate files from 1999-2003. The PPOR PPOR Per Pupil Operating Revenue
PPoR Principal Place of Residence
PPOR Post Proof or Retract (message boards)
PPOR Provide Proof or Retract (message boards) analysis looks at fetal and infant deaths Noun 1. infant death - sudden and unexpected death of an apparently healthy infant during sleep
cot death, crib death, SIDS, sudden infant death syndrome from 24 weeks of gestation GESTATION, med. jur. The time during which a female, who has conceived, carries the embryo or foetus in her uterus. By the common consent of mankind, the term of gestation is considered to be ten lunar months, or forty weeks, equal to nine calendar months and a week. to one year after birth. It examines birthweight and gestational age ges·ta·tion·al age
See estimated gestational age.
The estimated age of a fetus expressed in weeks, calculated from the first day of the last normal menstrual period. , separating data for babies with very low birthweight (17.6 ounces to 3.3 pounds) from higher birthweight babies.
A portrait of Lane County's fetal-infant deaths shows that during the study period, 56 deaths occurred in the low birthweight category, the area most associated with maternal health Maternal health care is a concept that encompasses preconception, prenatal, and postnatal care. Goals of preconception care can include providing health promotion, screening and interventions for women of reproductive age to reduce risk factors that might affect future pregnancies. and premature birth premature birth
Birth less than 37 weeks after conception. Infants born as early as 23–24 weeks may survive but many face lifelong disabilities (e.g., cerebral palsy, blindness, deafness). .
Forty-three deaths were recorded in the higher birthweight category (over 3.3 pounds) from 24 weeks gestation to birth, the area most affected by maternal care. From birth to 28 days, during which newborn care is most important, 31 deaths occurred in the higher birthweight category.
The final segment - 29 days to one year after birth - had 44 deaths. This area is most associated with infant health care.
To make the numbers make sense in the real world, health officials establish a reference group presumed to have the best potential for healthy babies. The national reference group, defined by maternal characteristics, is comprised of non-Hispanic white women 20 years of age or older with 13 or more years of education. Among this reference group, the fetal-infant mortality rate is 5.8 per 1,000 live births.
In Lane County, that same reference group's fetal-infant mortality rate is an astonishing a·ston·ish
tr.v. as·ton·ished, as·ton·ish·ing, as·ton·ish·es
To fill with sudden wonder or amazement. See Synonyms at surprise. 8.5 for 1,000, higher than the rate for the entire state. Hendrickson doesn't have enough information to explain what's happening here.
One particularly heart-wrenching way to portray this death rate in Lane County is by comparing it to the national reference group. It allows health officials to graphically illustrate the "excess" deaths occurring as a result of yet-to-be-determined local factors.
Subtracting the national reference rate from Lane County's fetal-infant death rate (9.5 minus 5.8) produces an "excess death rate" of 3.7 per 1,000 in Lane County. That means that from 1999-2003, in which there were 18,334 live births and fetal deaths, Lane County experienced 68 more fetal and infant deaths than the national reference group.
Right now, Hendrickson knows a lot about where fetal-infant deaths are occurring, but not nearly enough about why. Is it associated with drug and alcohol abuse? Smoking? Socio-economic factors?
The need for additional information is urgent. Lane County Public Health is seeking grants to pay for a Fetal-Infant Mortality Review that would provide more specific data about the infant deaths occurring in the county. But the entire community has a stake in making certain this review occurs as soon as possible.
Reducing the number of "excess" infant deaths is a priority that cannot be postponed.