Infant and Maternal Mortality Flashcards
Infant Mortality
Death of an infant before 1st birthsay
Provides key information about state of intant and maternal health
Infant Mortality Rate (IMR)
annual number of infants death per 1000 live births (can be gestational age specific)
(US 6.1/1000)
Non-hispanic black have the highest rate
Why are babies dying?
Birth defects
Preterm and low birth weight
Maternal pregnancy complications
sudden infant death syndrome
Injuries (suffocation)
Birth rate
total nmber of live birhs per 1000 in a population (in a year or designated period)
premature delivery
delivery of neonate <37 weeks gestation
premature birth rate
number of live births to infants in a specific gestational age category divided by all live burths excluding those missing data on gestational age multiplied by 100
(getting worse by year)
Maternal mortality
women dies while pregnant or within 42 days of termination of pregnancy, irrespective of duration and site of pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes
each year about 700 women die of pregnancy related causes
MAternal Mortality rate (MMR)
annual number of maternal deaths per 100,000 live births
Why are moms dying?
Inequalities in access to quality health care -> disparities
Nearly 75% of global maternal death are caused by
Severe bleeding
infetions
high blood pressure
delivery complication
unsafe abortion
undermanagement of chronic conditions - cardiac conditions, diabetes
African Americans are __________ more likely to die of pregnancy complication than white women
3 to 4 times
Women age ______ are almost _____ more likely to die of pregnancy complications vs women 20-24
age 35-39
2 x
Washington DC maternal mortality rate
41.6/100,000
Contributors to infant and maternal mortality
Obesity/Exercise (causes metabolic disease states that increase risk of preterm delivery)
Birth spacing (in us, 33.1% <18m, increase risk of premature birth and other adverse efects, ideal 1.5 years)
Maternal smoking (increase risk for preterm labor, ectopic pregnancy, placental patholog, miscaraige/stillbirth, baby at risk for birth defects, low birth weight, SIDS)
Insured or not
SUIDs (sudden unexpected infant death, sudden infant death syndrome, unknown, accidental suffocation and strangulation in bed)
Social Determinants of HEalth
Environment
Economis
Social
Health Care
Education
Food
Structural Determinants of Health Inequalities
Governance and Policies
Culture and Social Values
Governance and Policies
Education
Health Finance and Infrastructure
Social Protection
Law (gender equality, anti-violence)
reproductive health and rights
Culture and Social values
Womens staus
gender norms
religion
health beliefs
social cohesion
Intermediary Determinants of Health
Health Services
Community Context
Family and Peer Influence
Individual Attributes
Health Services
Availability of relevant services
staff skills and technical competence
acceptability to the community
fees and related cost
Community context
Rural/urban residence
social position class, wealth, ethnicity,
awarness of care
perceptions of quality
distance to facilities
social capital
Family and peer influence
family structure and decision making
mental relationship
spousal communication
income
access to resources
support network
Individual attributes
age
number of children
knowledge
self efficacy
(MATERNAL HEALTH OUTCOMES)
How can we keep the babies from dying?
Improve pre-natal care
skilled practioners during birth
access to emergency obsterics and newborn care
postnatal visits
adequate nutrition and education
decrease number of unwanted pregnancies
Pre-natal care
Preconception counseling
mom in best health possible (chronic condition management)
Once they are pregnant
initiate in first trimester
doctor visist every 4 week until 28 weeks, then every 2 weeks until 36 week, then weekly untl delivery
anticipatory guidance
prep for social support
Preconception care
Ideal time to identify risk to a person’s health
about people getting and staying healthy overall, throughout their lives
for babies, preconception health means their parents to steps to get healthy before preganncy (decrease in preterm and LBW babies)
Things considered:
- manangement of chronic conditions
nutrition counseling - folic acid
immunizations
IPV and depression screening
tabacco cessation and substance abuse
Prenatal care
- CAre while baby is cooking
- monitor mom and baby’s health
- ideal time for teaching
- anticipatory guidance: nutrition, healthy behaviors, substance abuse, IPV, denal care
- delivery preperations
- Ideal start ASAP (or earlier)
- Routine testing and genetic screening
- Inadequate care is linked to increased maternal and neonatal mortality
Post partum care
2-6 weeks after delivery
anticipatory guidance: family planning, breastfeeding, management of family dynamics, depression
Also assessing baby’s life on earth
Anticipatory guidance
2-4 weeks
- Issues: sleep (position), feeding, crying, response, growth
–Safety: car seats, exposure to smoking, shaking baby
Anticipatory guidance
2 mo
–Issues: sleep (position), feeding, growth
–Safety: burns, sun exposure, smoking, car seats, shaking baby
Anticipatory guidance
4mo
–Issues: introducing food, sleep, talking to baby
–Safety: falling, car seats
Anticipatory guidance
6mo
–Issues: food
–Safety: child-proofing house, poisons, walkers, car seats
Anticipatory guidance
9mo
–Issues: table food, using cup, teeth
–Safety: drowning, burns, car seats
Anticipatory guidance
–Issues: weaning, brushing teeth, lead screening, playing with baby
–Safety: child-proofing house, choking, car seats
BRreastfeeding
- AAP, AAFP & WHO recommend exclusively breastfeeding x6 months
- Baby friendly initiatives
- Initiate within one hour of birth
- Lactation support is vital
Activities, attitudes and procedures during delivery impact breastfeeding
Safe Sleep for baby
Place baby in prone position to sleep
- baby sleeps in a crib, bassinet, or pack n play
- baby sleeps alone
- use a one piece sleeper
- use firm matterss with fitted sheets
- baby sleeps on his back
- make a bare naked sleep area - no pillows, blankets, bumper pads or toys
Increase risk of pre-term birth
Socioeconomic status at both the individual and community level (e.g., income/poverty, job status, education) as well as psychosocial factors (e.g., chronic stress, lack of social support
