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Infant
Mortality
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Reduce
neonatal mortality (death of an infant less than 28 days).
Target:
5.9 per 1000 live births
Baseline, 1997-1999: 6.5 per 1000 neonatal deaths
(within the first 28 days of life).
Target Setting Method: Better than the best.
Reduce
infant deaths within the first year of life.
Target:
7.4 per 1000 live births.
Baseline, 1997-1999: 9.1 per 1000 all infant
deaths (within first year of life).
Target Setting Method: 18.6 percent improvement.
Increase
the proportion of pregnant women who receive prenatal care
beginning in the first trimester of pregnancy.
Target:
90 percent.
Baseline, 1997-1999: 84.0 percent of pregnant
women received prenatal care in first trimester.
Target Setting Method: Better than the best.
Reduce
the incidence of low birth weight.
Target:
7.0 percent of live births.
Baseline, 1997-1999: 8.9 percent of infants were
born weighing less than 2500 grams.
Target Setting Method: Better than the best.
Reduce
alcohol use among women prior to becoming pregnant and during
pregnancy.
Target:
19 percent women consume alcohol 3 months prior to pregnancy;
0.6 percent women consume alcohol during pregnancy.
Baseline, July 1997-December 1998: 38 percent
of women consumed alcohol 3 months before they were pregnant;
3.7 percent of women consumed alcohol during pregnancy.
Target Setting Method: Better
than the best. 50 percent reduction in women drinking
prior to pregnancy; 85 percent improvement for women drinking
during pregnancy.
Reduce
cigarette smoking among pregnant women.
Target:
7.0 percent.
Baseline, 1998: 15.2 percent of women smoked
while pregnant.
Target Setting Method: 54 percent improvement.
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Infant Mortality
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| North Carolina
has the third-highest infant death rate in the nation. The rate for
infant mortality has decreased 14 percent since 1990. However, there
has been little progress since 1995. The North Carolina infant mortality
rate still remains high, especially among African American/Black women.
The infant mortality rate for African American/Black babies is almost
two times the rate of White babies. Short gestation and low birth
weight are among the leading causes of neonatal deaths (death occurring
within the first 28 days of the infant’s life). The low birth
weight (less than 2500 grams) has increased 9 percent during the past
decade. Low birth weight is associated with long-term disabilities,
such as cerebral palsy, autism, mental retardation, vision and hearing
impairments, and other developmental disabilities. Birth defects are
also a leading cause of infant death in North Carolina. Taking multivitamin
containing 400 micrograms of folic acid daily beginning three months
prior to pregnancy and continued throughout gestation would significantly
decrease a the number of birth defects and infant deaths.
Substance abuse
among pregnant women: Spontaneous abortion, low birthweight, and
preterm delivery have been associated with prenatal use of alcohol,
tobacco, cocaine, marijuana, and other illicit drugs. Specifically,
tobacco use is associated with low birthweight and spontaneous abortion;
heavy alcohol use with fetal alcohol syndrome and preterm delivery.
Children born to a substance-abusing mother can be impaired as infants
with birth defects and growth deficiencies, and can experience developmental
problems. Substance use and abuse among pregnant women is a growing
problem in North Carolina. Substance abuse treatment for mothers
is fraught with problems including fear of loss of the child, unwillingness
to leave a child behind when entering residential treatment services,
and difficulty in accessing childcare while the mother is receiving
treatment services. Pregnant substance-abusing women and their children
are often victims of drug-related violence. Resources in the public
sector are not adequate to meet the increased incidence of substance
abuse by the poor.
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Disparities
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| The disparities
between White and minority groups in infant death, maternal death,
and low birth weight are wide and in many cases not improving in North
Carolina. In 1999, the minority infant mortality rate was 2.2 times
that of Whites. In 1990, the minority infant mortality rate was 1.9
times that of Whites. The 1999 rates of low birth weight infants for
minorities was 13.1 percent, compared to 7.2 percent of Whites. African
American/Black and Hispanic/Latino women are less likely than White
women to enter prenatal care early. |
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Determinants/Risk
Factors
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| Pre-term
birth, low birth weight, late access to prenatal care, teen pregnancy,
tobacco use, alcohol, drugs use, Racism, stress, and poverty |
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| Infant
Mortality |
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