Infant mortality and low birthweight in North Carolina: the last 10 years.

Objectives: This report uses matched birth and infant death certificates to examine recent changes in birthweight distribution as well as birthweightand cause-specific infant mortality. The purpose is to discern trends and patterns in the ten years since high infant mortality promoted expanded maternal and child care programs, including the expansion of Medicaid coverage for pregnant women. Methods: Data are for white and minority infants born in 1987-88 and 1995-96. Information presented includes the percentage decline in overall infant mortality that was attributable to improved survival in specific birthweight and cause-of-death categories. Results: For both whites and minorities, North Carolina’s low-birthweight and infant death rates have consistently exceeded those of the nation. For both race groups, the state’s percentage of births in low-birthweight categories has risen while the infant death rate has declined. The fall in mortality reflects declining risk of death in all but the smallest birthweight category (under 500 grams) and substantial reductions in death from respiratory conditions, SIDS, and birth defects. Conclusion: Great progress has been made in reducing birthweight-specific infant mortality. However, our state’s worsening birthweight distribution is cause for concern. Increases in multiple births have contributed to the increasing percentage of live births in North Carolina that are low birthweight. A recent study found maternal smoking and minority race to be strong predictors of low birthweight. Low birthweight is a multifaceted problem and more than medical interventions are needed to improve it. SCHS Studies NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES A Special Report Series by the State Center for Health Statistics P.O. Box 29538, Raleigh, N.C. 27626-0538 www.schs.state.nc.us/SCHS/ North Carolina Public Health ®