Factors that Contribute to Infant Mortality

Infant mortality is “widely used as a measure of population health and the quality of health care” (AMCHP, n.d.). Infant mortality rate is not only seen as a measure of infant death risk, but also as a crude indicator of community health status, socioeconomic status, and availability of quality health services and medical technology (AMCHP, n.d.).

  • Infant mortality means the death of an infant before their first birthday. Infant mortality rate (IMR) is presented as the number of infant deaths per 1,000 live births, averaged over 2013-2015.
  • Oklahoma County infant mortality rate during 2013-2015 was 7.0, representing an 8 percent decline from 7.6 in 2010-2012.
  • Significant differences in infant mortality rate by race and ethnicity are apparent; the mortality rate for African American infants more than doubles that of Caucasian infants.

 

PREMATURITY

  • Premature birth (also known as preterm) occurs before 37 weeks of pregnancy. Prematurity is one of the top three leading causes of infant mortality.
  • During 2013-2015, 1-in-10 babies born to Oklahoma County women were premature
  • The rate of preterm birth among African American women, 14.2 percent, was about 50 percent higher than the rate of preterm birth among Caucasian women, 9.5 percent (2013-2015). The rate among Hispanic births was lower than all other groups.

 

LOW BIRTH WEIGHT

  • Low birth weight is defined as babies, who are born weighing less than 2,500 grams or 5 pounds, 8 ounces.
  • Nearly nine (8.5%) in every 100 live births in Oklahoma County were low birth weight during 2013-2015. This represents a 2 percent decline from 2010-2012.
  • Approximately 14 percent of births to African American women between 2013 and 2015 were low birth weight, almost twice the rate of Caucasians. The percent of low birth weight babies born among Hispanic families was 7 percent. Native Americans and Asian/Pacific Islanders recorded similar rates.

 

LATE OR NO PRENATAL CARE

Late or no prenatal care describes the proportion of births to mothers who received prenatal care only in the third trimester of their pregnancy or mothers who received no prenatal care.

  • Women who received no or late prenatal care accounted for 8.9 percent of total Oklahoma County births between 2013 and 2015, which is up 11 percent from 2010-2012. 
  • Quality prenatal care is a strong predictor of healthy birth outcomes. Mothers who received late or no prenatal care during pregnancy were more likely to give birth to babies with health problems that included low birth weight and even death (Child Trends, 2015).
  • Native American women were the most likely to receive late or no prenatal care,15.6 percent, followed by African American at 12.6 percent, and Hispanic women at 9.5 percent. Approximately 9 percent of births received late or no prenatal care among Asian/Pacific Islander women, and 7.1 percent of births among Caucasian women.  

 

SIDS (SUDDEN INFANT DEATH SYNDROME)

  • Sudden Unexpected Infant Death (SUID) is the death of an infant less than one (1) year of age that occurs suddenly and unexpectedly. Although the causes of death in many of these infants cannot be explained, the greatest numbers occur while the infant is placed in an unsafe sleeping environment (CDC, 2013). These unexplained infant deaths often lead to confusion about whether or not an infant’s death can be ruled as SIDS by the medical examiner.
  • A SIDS death is only declared after all other causes and risk factors have been eliminated through a death scene investigation, complete autopsy and review of the infant medical history. In a large number of cases, the cause of death is often ruled as unknown.

 

SAFE SLEEP

  • One out of every four infant deaths in Oklahoma County (2010-2014) was sleep-related.

 

SMOKING

  • Eight percent of births in Oklahoma County during 2013-2015 were to mothers who smoked while pregnant, a reduction of 31 percent from 2010-2012. In 2015, the Oklahoma County maternal smoking rate was 39 percent lower than the state rate and 4 percent lower than the national average.
  • Mothers who smoke are more likely to deliver their babies early, more likely to have low-birth weight babies and face an increased risk of pregnancy complications (CDC, 2016).
  • Babies whose mothers smoke while pregnant and babies who are exposed to secondhand smoke after birth are more likely to die from Sudden Infant Death Syndrome (SIDS) (CDC, 2016).

 

POVERTY

  • 15.4% of Oklahoma households live in income poverty
  • 9.1% of low-income children in Oklahoma are uninsured

 

TEEN PREGNANCY

  • The average teen birth rate in Oklahoma County declined 22 percent from 56.4 in 2010-2012 to 44.2 in 2013-2015. However, teen birth rate in Oklahoma County was 70 percent higher than the national average and 9 percent higher than the state rate in 2015.
  • 3,043 Oklahoma County teenage moms, ages 15-19 years, gave birth between 2013 and 2015—demonstrating 804 fewer births than 2010-2012.
  • Hispanics experienced the highest teen birth rate of any racial or ethnic group in Oklahoma County, and Caucasians recorded the lowest teen birth rate compared to other racial or ethnic groups.

 

SINGLE PARENTHOOD

  • In the U.S. today, nearly half (49%) of poor African American children live in single-mother families with little or no father involvement [Lu, 2010].
  • According to the 2015 American Community Survey, nearly 28 percent of African American households were headed by a female with no husband present and living with own children. Additionally, 1-in-10 Caucasian households were headed by a female. Approximately, 12 percent of Asian/Pacific Islander, 17.2 percent of Native American, and 17.2 percent of Hispanic households were headed by a female living with own children and no husband present.

 

Association of Child Health Programs (AMCHP), Child Trends Databank (2015), Centers for Disease Control and Prevention 28 Sept, 2016, Oklahoma State Department of Health (OSDH) 2015, Lu, M. et al. (2010). Closing the Black-White Gap in Birth Outcomes: A life-course approach. Ethnicity and Disease, 20(1suppl 2):S262-276