Infant Mortality Rates in US, Poland and Slovakia

U.S. Infant Mortality Rate Equals that of Poland and Slovakia
By Todd Neale, Staff Writer, MedPage TodayPublished: October 15, 2008
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
HYATTSVILLE, Md., Oct. 15 -- Amid hints that the U.S. infant mortality rate is starting to improve after a five-year plateau, the country continues to slide down the list of developed countries in this key indicator of national health.
The U.S. ranked 29th in 2004, with a rate of 6.78 deaths per 1,000 live births, tied with Poland and Slovakia, Marian MacDorman, Ph.D., and T.J. Mathews, M.S., of the CDC's National Center for Health Statistics here, reported in a data brief.
The U.S. had been ranked 12th in 1960 and 23rd in 1990, the researchers said.
"The gap between the U.S. infant mortality rate and the rates for the countries with the lowest infant mortality appears to be widening," they said.
Japan had the best rate, less than 3 deaths per 1,000 live births.
However, preliminary data showed that the U.S. infant mortality rate declined from 6.86 to 6.71 deaths per 1,000 live births from 2005 to 2006, marking the first drop since 2000.
Racial disparities remained in 2005, the last year with complete data, such that the infant mortality rate for non-Hispanic black women was 2.4 times the rate for non-Hispanic whites (13.63 versus 5.76 deaths per 1,000 live births).
Puerto Rican (8.30) and American Indian or Alaskan Native women (8.06) had above-average rates as well.
The only ethnic group that met the government's Healthy People 2010 target of fewer than 4.5 infant deaths per 1,000 live births was Cubans (4.42).
The researchers said that the disparities may be the result of differences in risk factors for infant mortality, such as preterm and low birth weight delivery, socioeconomic status, and access to medical care, although "many of the racial and ethnic differences in infant mortality remain unexplained."
To explain the plateau in the infant mortality rate from 2000 to 2005, Dr. MacDorman and Mathews pointed to the increase in the percentage of births before 37 weeks gestation -- which carry a higher mortality risk -- from 11.6% to 12.7%.
The rise in preterm births was partially driven by an increase in multiple births resulting from artificial reproductive technologies and in the use of Caesarean delivery or induced labor for mothers with serious medical conditions, according to Dr. MacDorman.