In some parts of America, infants have as much chance of dying before their first birthdays as they do in less developed countries, according to the Centers for Disease Control (CDC). The top cause of infant mortality is simply being born too soon.
How to give babies a better start is not completely obvious, but healthy mothers are more likely to have healthy, full-term babies, according to the CDC.
However, researchers and funders do not agree on how to prevent premature birth and stillbirth, according to an article in the American Journal of Obstetrics and Gynecology.
Michael G. Gravett, M.D., scientific director of the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children’s Hosptial, and Craig E. Rubens, M.D., Ph.D., executive director of GAPPS, co-authored the article, “A framework for strategic investments in research to reduce the global burden of preterm birth.”
The publication of the article is meant to coincide with World Prematurity Day on Nov. 17.
The authors wrote that funders do not understand where the field is going, and they therefore do not know what projects they should support. Even if all current interventions were applied, the infant death rate would only drop by less than 20 percent, they estimated. Better knowledge is crucial.
Gravett and Rubens want researchers, funders, doctors, the private sector, and nongovernmental organizations to “organize a set of grand challenges centered on pregnancy and childbirth that could yield a substantial improvement in the development and delivery of new and much more effective interventions, even in low-resource settings,” according to an announcement from Seattle Children’s.
The authors noted: “Pregnancy remains one of the least explored aspects of human biology, creating a tremendous opportunity. Long-term funding commitments for research could advance discovery science and the development of interventions targeted at pregnancy and early life and impact maternal and newborn health around the world.”
Effective interventions for low-resource settings are important, even in the United States. The areas with highest infant mortality are also the areas with highest poverty levels.
Racial disparities for infant mortality are notable, with non-Hispanic African-American babies being far more likely not to survive their first year than babies from other groups, according to the CDC.
The District of Columbia has concentrated poverty and an infant death rate of 11.17 babies per 1,000, according to 2008 figures from the CDC. Mississippi has the worst rate of any state with 9.5 deaths per 1,000 births.
In the United States, the places with the worst health outcomes for infants are the Deep South and American territories such as Guam and Puerto Rico—all areas with less wealth and higher unemployment than most other parts of the nation.
According to Seattle Children’s, Gravett and Rubens recommend that doctors and policymakers “emphasize that healthy outcomes in pregnancy benefit everyone, directly and indirectly” and “raise awareness of personal and public burden of prematurity, stillbirth, and other pregnancy and early life problems,” among other recommendations, in order to work “toward making every pregnancy a healthy pregnancy.”
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