Compared to other developed nations the United States appears to be falling behind in infant mortality, that is the percentage of babies that die before reaching their first birthday.

According to new figures from the National Center for Health Statistics of the US Centers for Disease Control and Prevention published on 15th October, the US ranked 29th in infant mortality in 2004, the most recent year for which figures are available from all countries, 27th in 2000, 23rd in 1990 and 12th in 1960.

The gap between the US and countries with the lowest infant mortality appears to be widening, and in 2004, the US shared its 29th place with Poland and Slovakia.

The US infant mortality rate was 6.78 infant deaths per 1,000 live births in 2004. 22 countries had infant mortality rates below 5 in 2004, and the lowest rates, below 3.5 deaths per 1,000, were in Scandinavian (Sweden, Norway, Finland) and East Asian (Japan, Hong Kong, Singapore) countries.

Between 2000 and 2005 the US infant mortality rate stayed steady, but preliminary data for 2006 suggests a significant 2 per cent decline over the previous year, said the report.

The current infant mortality rate in the US is running at around 50 per cent above the national goal of 4.5 deaths per 1,000 live births. Other findings include:

• For babies born to non-Hispanic black women the infant mortality rate was 2.4 times that of those born to non-Hispanic white women.
• In 2005, the infant mortality of babies born to non-Hispanic black women was 13.63 death per 1,000 live births, compared to 5.76 for babies born to non- Hispanic white women.
• Infant mortality of babies born to Puerto Rican and American Indian women were also higher at 8.30 and 8.06 respectively.
• The lack of decline in the infant mortality rate in the US from 2000 to 2005 is mostly explained by increases in preterm birth and preterm-related infant mortality.

Preterm birth was defined as birth before 37 completed weeks of gestation.

The only group to reach the Healthy People 2010 target (4.5) as of 2005 was the Cuban population (4.42), said the report.

The report concludes that:

"Despite the dramatic decline in infant mortality during the 20th century, the U.S. infant mortality rate appears to have plateaued in the first few years of the 21st century."

It also points out there are large disparities by race and ethnicity, with the highest infant mortality occuring in babies born to Non-Hispanic black, American Indian or Alaska Native, and Puerto Rican women, while the lowest occurs among babies born to Asian or Pacific Islander, Central and South American, and Cuban women.

Preterm birth appears to play an important role, with the plateau in infant mortality between 2000 and 2005 being mainly due to an increase in the percentage of babies born preterm (including very preterm and late preterm), plus a lack of fall in the rate of deaths among the very preterm.

The percentage of preterm births in the US has gone up since the mid 1980s, said the report, and while some of this is because of increased multiple births, it is also because there are more preterm births among single births.

"Recent Trends in Infant Mortality in the United States." Marian F. MacDorman, and T.J. Mathews. CDC, National Center for Health Statistics, 15 October 2008.

Click here for full report. [1]