WASHINGTON, Sept. 10, 2014—In recognition of September as National Infant Mortality Awareness Month, the Society for Maternal-Fetal Medicine encourages its members, U.S. policymakers and citizens to recognize the need to reduce America’s infant mortality rate. Despite recent declines, the rates of infant mortality in the U.S. remain at the bottom of the list of developing countries.
One key factor that will improve SMFM’s goals of reducing infant mortality is to reduce preterm birth –the leading cause of infant morbidity and mortality. Preterm birth accounts for nearly 70 percent of infant deaths, and women in the U.S. suffer among the highest preterm birth rates in the world: one in nine babies born in the United States (11.5 percent) is delivered before 37 completed weeks of gestation. While babies born before 32 weeks represent only 2 percent of all births, they result in half (54 percent) of infant deaths. The rate of infant mortality for babies born very low birth weight (less than 1,500 grams) is 100 times higher than that for babies born weighing more than 2,500 grams.
Reducing infant mortality starts with preventing pregnancy complications that result in preterm birth, including preterm labor, preeclampsia, and placental dysfunction. SMFM strongly believes that wider implementation of guidelines on the use of progesterone and cervical cerclage to reduce preterm birth as published in 2012 by SMFM, the American Congress of Obstetricians and Gynecologists and American College of Nurse-Midwives would go a long way to reducing infant mortality rates in this country. Along those lines, SMFM, along with ACOG and ACNM sent a letter on August 13 to U.S. Department of Health and Human Services Secretary Sylvia Mathews Burwell regarding this very issue.
Other areas for improvement include wider use of low dose aspirin to prevent preeclampsia, strategies for smoking cessation, appropriate use of antibiotics to prevent neonatal Group B Strep sepsis, timely corticosteroid administration to accelerate fetal lung maturity, Doppler ultrasound for management of fetal growth restriction, and strategies to prolong pregnancy in women with preterm premature rupture of the membranes. Any initiative to decrease infant mortality by improving pregnancy outcomes should address racial and ethnic health disparities as well as improving pre-pregnancy health and access to prenatal and inter-pregnancy care. While these approaches should decrease infant mortality to some degree, reducing it further will require investment in more research in order to improve our understanding of the etiology, prevention, and management of these pregnancy complications.
As high-risk pregnancy doctors and caregivers to those most vulnerable women and their babies, SMFM members are in the unique position to deal with obstetrical conditions that, in aggregate, have the largest impact on infant mortality. Those include preterm birth, preeclampsia, congenital anomalies, perinatal infections and utero-placental insufficiency. SMFM is committed to ensuring that our nation’s mothers and babies are the healthiest they can be.
The Society for Maternal-Fetal Medicine (est. 1977) is the premiere membership organization for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine. The society is devoted to reducing high-risk pregnancy complications by sharing expertise through continuing education to its 2,000 members on the latest pregnancy assessment and treatment methods. It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine. The group hosts an annual meeting in which groundbreaking new ideas and research in the area of maternal-fetal medicine are shared and discussed. For more information visit www.smfm.org.