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why the US infant mortality rate is artificially high

April 7, 2009

First, it’s shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don’t reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates. For this very reason, the Organization for Economic Cooperation and Development, which collects the European numbers, warns of head-to-head comparisons by country.

Infant mortality in developed countries is not about healthy babies dying of treatable conditions as in the past. Most of the infants we lose today are born critically ill, and 40 percent die within the first day of life. The major causes are low birth weight and prematurity, and congenital malformations. As Nicholas Eberstadt, a scholar at the American Enterprise Institute, points out, Norway, which has one of the lowest infant mortality rates, shows no better infant survival than the United States when you factor in weight at birth.

via Bernadine Healy, M.D.: Behind the baby count – US News and World Report.

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One Comment
  1. jirka6 permalink
    April 19, 2009 10:14 am

    “The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths.”

    Well. First, WHO recommends to track the statistics certain way (e.g. including babies over 500 g and above 22 weeks), so I would provide them with that data, Not including those babies below 500 g. It would make the statistics more useful. And I actually the WHO data are standardized and are not always identical to the national statistics.

    But more importantly, this still does not give me much better numbers. One would expect that this would make the number of stillbirths in those countries higher than in the U.S. But this is not the case. Say Sweden or Czech Republic have 3 stillbirths per 1000 births, but U.S. has 4 (Germany 4, France 5). So Sweden has the SUM of stillbirths and infant mortality lower than the U.S.

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