Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1980 Jan;70(1):15–21. doi: 10.2105/ajph.70.1.15

Neonatal mortality: an analysis of the recent improvement in the United States.

K S Lee, N Paneth, L M Gartner, M A Pearlman, L Gruss
PMCID: PMC1619337  PMID: 7350819

Abstract

To test the hypothesis that the recent substantial decline in the United States neonatal mortality rate (20.0/1000 in 1950 to 11.6/1000 in 1975) is associated with improvements in perinatal medical care, we examined this change in relation to the two primary components which determine neonatal mortality: birthweight distribution and birthweight-specific mortality. No improvement in the weight distribution of U.S. live births has occurred during this 25-year period, indicating that the change in neonatal mortality is attributable to improved survival for one or more birthweight groups. Decline in the mortality rate in the first 15 years was slow; three-fourths of the decline in the entire 25-year period occurred since 1965. With the exception of perinatal medical care, factors known to affect survival at a given birthweight have not changed in prevalence in the 25-year period. It is a plausible hypothesis that improved perinatal medical care is a major factor in declining neonatal mortality in the U.S.

Full text

PDF
15

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abernathy J. R., Greenberg B. G., Donnelly J. F. Application of discriminant functions in perinatal death and survival. Am J Obstet Gynecol. 1966 Jul 15;95(6):860–867. doi: 10.1016/0002-9378(66)90091-3. [DOI] [PubMed] [Google Scholar]
  2. Alden E. R., Mandelkorn T., Woodrum D. E., Wennberg R. P., Parks C. R., Hodson W. A. Morbidity and mortality of infants weighing less than 1,000 grams in an intensive care nursery. Pediatrics. 1972 Jul;50(1):40–49. [PubMed] [Google Scholar]
  3. Battaglia F. C., Frazier T. M., Hellegers A. E. Birth weight, gestational age, and pregnancy out- come, with special reference to high birth weight-low gestational age infant. Pediatrics. 1966 Mar;37(3):417–422. [PubMed] [Google Scholar]
  4. Bergner L., Susser M. W. Low birth weight and prenatal nutrition: an interpretative review. Pediatrics. 1970 Dec;46(6):946–966. [PubMed] [Google Scholar]
  5. Calame A., Prod'hom L. S. Pronostic vital et qualité de survie des prématurés peasant 1500 g et moins à la naissance, soignés en 1966-1968. Schweiz Med Wochenschr. 1972 Jan 22;102(3):65–70. [PubMed] [Google Scholar]
  6. ERHARDT C. L., JOSHI G. B., NELSON F. G., KROLL B. H., WEINER L. INFLUENCE OF WEIGHT AND GESTATION ON PERINATAL AND NEONATAL MORTALITY BY ETHNIC GROUP. Am J Public Health Nations Health. 1964 Nov;54:1841–1855. doi: 10.2105/ajph.54.11.1841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Erhardt C. L., Abramson H., Pakter J., Nelson F. An epidemiological approach to infant mortality. Arch Environ Health. 1970 Jun;20(6):743–757. doi: 10.1080/00039896.1970.10665654. [DOI] [PubMed] [Google Scholar]
  8. Erkan N. V., Stark C. R., Cardany G. An evaluation of newborn mortality and premature trends at Columbia Hospital for Women, Washington, D.C. 1967-1970. Med Ann Dist Columbia. 1972 Mar;41(3):152–155. [PubMed] [Google Scholar]
  9. Gendell Murray, Hellegers André E. The influence of the changes in maternal age, birth order, and color on the changing perinatal mortality, Baltimore, 1961-66. Health Serv Rep. 1973 Oct;88(8):733–742. [PMC free article] [PubMed] [Google Scholar]
  10. Gortmaker S. L. Poverty and infant mortality in the United States. Am Sociol Rev. 1979 Apr;44(2):280–297. [PubMed] [Google Scholar]
  11. Kendall N. The challenge of neonatal mortality in an urban hospital. Health Serv Rep. 1974 May-Jun;89(3):263–266. [PMC free article] [PubMed] [Google Scholar]
  12. Kitchen W. H., Campbell D. G. Controlled trial of intensive care for very low birth weight infants. Pediatrics. 1971 Nov;48(5):711–714. [PubMed] [Google Scholar]
  13. Kitchen W. H., Ryan M. M., Rickards A., Gaudry E., Brenton A. M., Billson F. A., Fortune D. W., Keir E. H., Lundahl-Hegedus E. E. A longitudinal study of very low-birthweight infants. I: study design and mortality rates. Dev Med Child Neurol. 1978 Oct;20(5):605–618. doi: 10.1111/j.1469-8749.1978.tb15279.x. [DOI] [PubMed] [Google Scholar]
  14. Kleinman J. C., Kovar M. G., Feldman J. J., Young C. A. A comparison of 1960 and 1973--1974 early neonatal mortality in selected states. Am J Epidemiol. 1978 Dec;108(6):454–469. doi: 10.1093/oxfordjournals.aje.a112644. [DOI] [PubMed] [Google Scholar]
  15. Lanham J. T., Kohl S. G., Bedell J. H. Changes in pregnancy outcome after liberalization of the New York State abortion law. Am J Obstet Gynecol. 1974 Feb 15;118(4):485–492. doi: 10.1016/s0002-9378(16)33688-2. [DOI] [PubMed] [Google Scholar]
  16. Lee K. S., Eidelman A. I., Kandall S. R., Gartner L. M. Letter: Quality of care vs neonatal mortality rate. J Pediatr. 1976 Jul;89(1):161–162. doi: 10.1016/s0022-3476(76)80966-3. [DOI] [PubMed] [Google Scholar]
  17. Lee K., Tseng P. I., Eidelman A. I., Kandall S. R., Gartner L. M. Determinants of the neonatal mortality. Am J Dis Child. 1976 Aug;130(8):842–845. doi: 10.1001/archpedi.1976.02120090052009. [DOI] [PubMed] [Google Scholar]
  18. Lubchenco L. O., Searls D. T., Brazie J. V. Neonatal mortality rate: relationship to birth weight and gestational age. J Pediatr. 1972 Oct;81(4):814–822. doi: 10.1016/s0022-3476(72)80114-8. [DOI] [PubMed] [Google Scholar]
  19. MORIYAMA I. M. Recent change in infant mortality trend. Public Health Rep. 1960 May;75:391–405. [PMC free article] [PubMed] [Google Scholar]
  20. MORRIS J. N., HEADY J. A. V. Mortality in relation to the father's occupation; 1911-1950. Lancet. 1955 Mar 12;268(6863):554–560. doi: 10.1016/s0140-6736(55)91237-x. [DOI] [PubMed] [Google Scholar]
  21. Meyer M. B., Jonas B. S., Tonascia J. A. Perinatal events associated with maternal smoking during pregnancy. Am J Epidemiol. 1976 May;103(5):464–476. doi: 10.1093/oxfordjournals.aje.a112248. [DOI] [PubMed] [Google Scholar]
  22. Morris N. M., Udry J. R., Chase C. L. Shifting age-parity distribution of births and the decrease in infant mortality. Am J Public Health. 1975 Apr;65(4):359–362. doi: 10.2105/ajph.65.4.359. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Pakter J., Nelson F. Factors in the unprecedented decline in infant mortality in New York City. Bull N Y Acad Med. 1974 Jul-Aug;50(7):839–868. [PMC free article] [PubMed] [Google Scholar]
  24. Rawlings G., Stewart A., Reynolds E. O., Strang L. B. Changing prognosis for infants of very low birth weight. Lancet. 1971 Mar 13;1(7698):516–519. doi: 10.1016/s0140-6736(71)91124-x. [DOI] [PubMed] [Google Scholar]
  25. Rush D., Davis H., Susser M. Antecedents of low birthweight in Harlem, New York City. Int J Epidemiol. 1972 Winter;1(4):375–387. doi: 10.1093/ije/1.4.375. [DOI] [PubMed] [Google Scholar]
  26. Rush D., Kass E. H. Maternal smoking: a reassessment of the association with perinatal mortality. Am J Epidemiol. 1972 Sep;96(3):183–196. doi: 10.1093/oxfordjournals.aje.a121447. [DOI] [PubMed] [Google Scholar]
  27. Schlesinger E. R. Neonatal intensive care: planning for services and outcomes following care. J Pediatr. 1973 Jun;82(6):916–920. doi: 10.1016/s0022-3476(73)80417-2. [DOI] [PubMed] [Google Scholar]
  28. Shah F. K., Abbey H. Effects of some factors on neonatal and postneonatal mortality. Analysis by a binary variable multiple regression method. Milbank Mem Fund Q. 1971 Jan;49(1):33–57. [PubMed] [Google Scholar]
  29. Stanley F. J., Alberman E. V. Infants of very low birthweight. I: Perinatal factors affecting survival. Dev Med Child Neurol. 1978 Jun;20(3):300–312. doi: 10.1111/j.1469-8749.1978.tb15220.x. [DOI] [PubMed] [Google Scholar]
  30. Thompson R. E., Souma M. L., Cassady G., Sumners J. Impact of intensive newborn care on neonatal mortality in a community hospital. South Med J. 1976 Jun;69(6):688–690. doi: 10.1097/00007611-197606000-00005. [DOI] [PubMed] [Google Scholar]
  31. Wright N. H. Family planning and infant mortality rate decline in the United States. Am J Epidemiol. 1975 Mar;101(3):182–187. doi: 10.1093/oxfordjournals.aje.a112085. [DOI] [PubMed] [Google Scholar]
  32. Yerushalmy J. The classification of newborn infants by birth weight and gestational age. J Pediatr. 1967 Aug;71(2):164–172. doi: 10.1016/s0022-3476(67)80067-2. [DOI] [PubMed] [Google Scholar]
  33. Zachman R. D., Graven S. N. A neonatal intensive care unit: a four-year summary. Am J Dis Child. 1974 Aug;128(2):165–170. doi: 10.1001/archpedi.1974.02110270039008. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES