The State of Our Health - Causes Of Death: Infants

In 1999, 3.959 million babies were born — and 27,937 infants died. Of these, 67% (18,728) died before they had reached 28 days of age. Neonatal deaths thus dominate infant deaths. The most common causes of death of all infants, defined as children less than 11 months of age, are congenital malformations, deformations, and chromosomal abnormalities. These categories comprise an umbrella term for several hundred malformations of body systems (nervous, respiratory, circulatory, digestive) as well as disturbances in the chromosomes that produce, for instance, Down's Syndrome, which shortens life, retards development, and is associated with congenital heart problems.

Among neonatals (less than 28 days of age) disorders due to low birth weight — not specifically pinpointed — is the leading cause. Among infants (28 days to 11 months old), the leading cause is Sudden Infant Death Syndrome (SIDS). Congenital malformations are the second cause of death of both groups and thus the leading cause for all infants.

Low weight at birth is one of the factors tracked by the U.S. Department of Health and Human Services as part of its "Healthy People 2000" (more recently "Healthy People 2010") program. Improvements in neonatal care — from technology — are keeping more and more of such babies alive. Babies may simply be small or may have low blood sugar, low body temperature, and polycythemia (increased level of red blood cells), all contributing to low birth weight. High blood pressure in the mother, heart disease, malnutrition, and drug addiction are thought to contribute to low birth weight.

The cause of SIDS is unknown. Deaths occur when infants are thought to be asleep. There is speculation that the babies may have problems with sleep arousal and that their bodies cannot detect the build-up of carbon dioxide in the blood. The incidence of SIDS has dropped since 1992 when parents were told to put their babies to sleep on their sides — because, as MEDLINEplus puts it, "risk factors include babies who sleep on their stomachs (up to 4 months. of age)." MEDLINEplus continues, citing other risk factors as including "soft bedding in the crib (up to 1 yr. of age), multiple births, prematurity, a history of a sibling who had SIDS, maternal smoking, maternal substance abuse, young maternal age, short intervals between pregnancies, late prenatal care and low socioeconomic status."

Among the leading causes are two not heretofore defined. Bacterial sepsis is an infection of the blood stream caused by bacteria. Atelectasis is a partial collapse of the lungs sometimes caused by shallow breathing.

The number of neonatal deaths (less than one half of one percent of total births-0.47%) is thankfully small; nature is imperfect. It is much more disturbing to note that humans are too: among infants who survived the first 28 days of life in 1999 but died before age one, the seventh most common cause of death was homicide. In 1999, 272 of 9,209 infants in this age group were killed.

Death is a painful subject. We continue, now, on a more hopeful note, by examining progress in the health status of the nation overall as measured by various indicators, for women, men, and children — and what progress has meant for us in extended life expectancy. We begin with a look at women's health issues.

Source: Anderson, Robert N. "Deaths: Leading Causes for 1999." National Vital Statistics Reports. v. 49, no. 11. 12 October 2001. U.S. Department of Health and Human Services. Quotations from MEDLINEplus. Online. Available: http://www.nlm.nih.gov/medlineplus/ency/article/001566.htm.