Insights in Public Health: Saving Babies: Reducing Infant Mortality in Hawaia??i

摘要

Nationally and in Hawai‘i, there have been substantial reductions in infant mortality over the past century. Estimates of infant mortality in Hawai‘i prior to 1920 were in excess of 100 deaths per 1,000 live births compared to 5.9 in 2009.2 Much of this improvement has been related to medical advances and improved management of pregnancy and childbirth. However, there was little improvement from 1990–2010 with the IMR in Hawai‘i ranging from 5.3 to 7.6 deaths per 1,000 live births (Figure 1). Data from 2011 is encouraging with the State IMR at an all-time low of 4.9 deaths per 1,000 live births. Nationally in 2010, the leading causes of death among infants were congenital malformations (127.7 per 100,000 live births), preterm-related (105.3), sudden unexpected infant death (91.5, SUID), and maternal complications of pregnancy (39.5) (Table 1).3 In Hawai‘i (data from 2009–2011 is aggregated due to small number of events), the leading cause of infant death was somewhat different with preterm-related (107.7) and congenital malformations (86.5) reversing ranking compared to the national ranking; meanwhile SUID (58.2) was lower, but maternal complications (58.2) higher than found nationally.