Neonatal Mortality in Montana

Montana

Infant mortality is a key indicator of a country’s population health and the effectiveness of its health care system. Nearly two-thirds of all infant deaths occur between birth and 27 days (the neonatal period). Maternal health, prenatal and postnatal care and access to quality health care before, during and after birth influence the likelihood of infant death. The leading causes of neonatal mortality are:

• Premature birth.
• Low birth weight. 
• Birth defects. 
• Pregnancy complications, such as preeclampsia or problems with the placenta or umbilical cord.
• Infections.
• Asphyxia, or not getting enough oxygen before or during birth.

Significant sociodemographic disparities, predominantly by race. The prevalence of infant mortality is higher among:

• Babies born to non-Hispanic Black women compared with those born to non-Hispanic white women.
• Babies born to women with high and low body mass index (BMIs) compared with those who have middling BMIs.
• Babies born preterm or with intrapartum-related complications compared with babies born at full gestational age and those without intrapartum complications.

Babies born to women who smoke during pregnancy are more likely to be born prematurely, with low birth weight and with birth defects, all of which are risk factors for neonatal mortality.

Key prenatal and postnatal strategies for reducing the risk of neonatal and infant mortality include:

• Improving access to and use of pre-pregnancy and prenatal care.
• Increasing access to and use of home visits for new and expecting parents to address child care topics, such as safe sleep, injury prevention, nutrition and breastfeeding, and to offer health services and support to pregnant women and new parents.
• Implementing newborn screening programs, which can detect conditions not readily apparent to parents or health care professionals. 
• Encouraging healthy choices during pregnancy, such as maintaining a healthy weight, managing existing health conditions, as well as avoiding smoking, alcohol consumption and marijuana or substance use
• Increasing state minimum wages, which has been shown to be associated with reduced rates of low birth weight and infant mortality.

Reducing the infant mortality rate is a Healthy People 2030 leading health indicator.

Barfield, Wanda, Denise D’Angelo, Rachel Moon, Michael Lu, Betty Wong, and John Iskander. “CDC Grand Rounds: Public Health Approaches to Reducing U.S. Infant Mortality.” MMWR. Morbidity and Mortality Weekly Report, CDC Grand Rounds, 62, no. 31 (August 9, 2013): 625–28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604989/.

Ely, Danielle M., and Anne K. Driscoll. “Infant Mortality in the United States, 2020: Data From the Period Linked Birth/Infant Death File.” National Vital Statistics Reports 71, no. 5 (September 29, 2022). https://doi.org/10.15620/cdc:120700.

Komro, Kelli A., Melvin D. Livingston, Sara Markowitz, and Alexander C. Wagenaar. “The Effect of an Increased Minimum Wage on Infant Mortality and Birth Weight.” American Journal of Public Health 106, no. 8 (August 2016): 1514–16. https://doi.org/10.2105/AJPH.2016.303268.

Reidpath, D. D., and P. Allotey. “Infant Mortality Rate as an Indicator of Population Health.” Journal of Epidemiology & Community Health 57, no. 5 (May 1, 2003): 344–46. https://doi.org/10.1136/jech.57.5.344.

Singh, Gopal K., and Stella M. Yu. “Infant Mortality in the United States, 1915-2017: Large Social Inequalities Have Persisted for Over a Century.” International Journal of MCH and AIDS 8, no. 1 (March 20, 2019): 19–31. https://doi.org/10.21106/ijma.271.

Thornton, Hannah V., Rosie P. Cornish, and Deborah A. Lawlor. “Non-Linear Associations of Maternal Pre-Pregnancy Body Mass Index with Risk of Stillbirth, Infant, and Neonatal Mortality in over 28 Million Births in the USA: A Retrospective Cohort Study.” eClinicalMedicine 66 (December 2023): 102351. https://doi.org/10.1016/j.eclinm.2023.102351.