医師の一分

アクセスカウンタ

zoom RSS 未熟児の増加により乳児死亡率が上昇/米国

<<   作成日時 : 2009/11/07 21:52   >>

驚いた ブログ気持玉 1 / トラックバック 0 / コメント 0

未熟児の増加により乳児死亡率が上昇/米国
 米国では低所得層の妊婦からの未熟児出生が多く乳児死亡率が高い主な理由になっている。8人のうち約1人が未熟児で生まれており、アイルランドとフィンランドでは18人中1人などと欧州諸国に比べてはるかに多い。妊婦管理不足、母体肥満、喫煙、早期帝王切開、誘発分娩、不妊治療が未熟児出生の原因となっている。特に在胎37週未満で肺の未熟な場合が多い。
 スウェーデン、日本、フィンランド、ノルウェー、チェコ共和国の2倍の乳児死亡率であり、世界で30番目の高さである。スウェーデンと同じくらいの未熟児出生率なら、米国で約8,000人の乳児死亡は避けられ、乳児死亡率は約1/3低下するだろう。
画像

----------------------
乳児死亡率 改善不充分/米国医療事情
http://kurie.at.webry.info/200904/article_15.html
未熟児の増加と地域差/米国医療事情
http://kurie.at.webry.info/200811/article_59.html
帝王切開による未熟児が増加/米国医療事情
http://kurie.at.webry.info/200805/article_59.html
---------------------------------------------------
Premature Births Worsen US Infant Death Rate
Premature births most to blame for high US infant mortality rate, government says
By MIKE STOBBE AP Medical Writer
ATLANTA November 3, 2009 (AP) The Associated Press

画像Premature Births Worsen US Infant Death Rate
Premature births, often due to poor care of low-income pregnant women, are the main reason the U.S. infant mortality rate is higher than in most European countries, a government report said Tuesday.
(AP Photo)

Premature births, often due to poor care of low-income pregnant women, are the main reason the U.S. infant mortality rate is higher than in most European countries, a government report said Tuesday.

About 1 in 8 U.S. births are premature. Early births are much less common most of Europe; for example, only 1 in 18 babies are premature in Ireland and Finland.

Poor access to prenatal care, maternal obesity and smoking, too-early cesarean sections and induced labor and fertility treatments are among the reasons for preterm births, experts said.

Premature babies born before 37 weeks tend to be more fragile and have under-developed lungs, said the lead author of the new report, Marian MacDorman of the U.S. Centers for Disease Control and Prevention.

Premature births are the chief reason the U.S. ranks 30th in the world in infant mortality, with a rate more than twice as high as infant mortality rates in Sweden, Japan, Finland, Norway and the Czech Republic. For several years, the U.S. has ranked poorly among industrialized nations. MacDorman's report scrutinizes the reasons for that.

If U.S. infants were as mature as Sweden's are at birth, nearly 8,000 infant deaths could be avoided and the U.S. infant mortality rate would be about one-third lower than it is, according to a calculation by MacDorman and others at the CDC's National Center for Health Statistics.

Why so many more premature infants here? Experts offered several possible explanations:

―Fertility treatments and other forms of assisted reproduction probably play a role because they often lead to twins, triplets or other multiple births. Those children tend to be delivered early.

―The U.S. health care system doesn't guarantees prenatal care to pregnant women, particularly the uninsured, said Dr. Alan R. Fleischman, medical director for the March of Dimes.

―Maternal obesity and smoking have been linked to premature births and may also be a factor.

―Health officials are also concerned that doctors increasingly are inducing labor or performing C-sections before the 37th week. However, Fleischman said most infant deaths do not occur in babies just shy of 37 weeks gestation, but rather in those much younger,

Labor was induced in nearly 16 percent of premature births in 2006, up from about 8 percent in 1991. Cesarean sections were done in 36 percent of preterm births, up from 25 percent in 1991, MacDorman said.

The report used 2005 statistics to make comparisons to 14 European countries. There is more recent data: International infant mortality statistics for 2006 and 2007 indicate that since 2000, the U.S. rate has stood at about 7 infant deaths for every 1,000 live births.

The report also found that while the United States more commonly saw premature births, survival rates for infants at that gestational age were as good or better than most European countries.

"So, once the baby is born too early, we do a good job of saving it. What we have trouble with is preventing the preterm birth in the first place," MacDorman said.

―――
On the Net:
CDC report: http://www.cdc.gov/nchs
(This version Corrects statistic in 6th paragraph to "deaths," sted births.)
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

-------------------------------------------------------------
NCHS Data Brief
Number 23, November 2009

Behind International Rankings of Infant Mortality: How the United States Compares with Europe

by Marian F. MacDorman, Ph.D., and T.J. Mathews, M.S.
Key findings

Data from the United States’ Linked Birth/Infant Death Data Set and the European Perinatal Health Report

* Infant mortality rates for preterm (less than 37 weeks of gestation) infants are lower in the United States than in most European countries; however, infant mortality rates for infants born at 37 weeks of gestation or more are higher in the United States than in most European countries.
* One in 8 births in the United States were born preterm, compared with 1 in 18 births in Ireland and Finland.
* If the United States had Sweden’s distribution of births by gestational age, nearly 8,000 infant deaths would be averted each year and the U.S. infant mortality rate would be one-third lower.
* The main cause of the United States’ high infant mortality rate when compared with Europe is the very high percentage of preterm births in the United States.

Infant mortality is an important indicator of the health of a nation, and the recent stagnation (since 2000) in the U.S. infant mortality rate has generated concern among researchers and policy makers. The percentage of preterm births in the United States has risen 36% since 1984 (1). In this report we compare infant mortality rates between the United States and Europe. We also compare two factors that determine the infant mortality rate―gestational age-specific infant mortality rates and the percentage of preterm births. U.S. data are from the Linked Birth/Infant Death Data Set (2,3), and European data for 2004 are from the recently published European Perinatal Health Report (4). We also examine requirements for reporting a live birth among countries to assess the possible effect of reporting differences on infant mortality data.

Keywords: infant mortality, international comparisons, preterm birth, gestational age-specific infant mortality rates

テーマ

関連テーマ 一覧


月別リンク

ブログ気持玉

クリックして気持ちを伝えよう!
ログインしてクリックすれば、自分のブログへのリンクが付きます。
→ログインへ
気持玉数 : 1
驚いた

トラックバック(0件)

タイトル (本文) ブログ名/日時

トラックバック用URL help


自分のブログにトラックバック記事作成(会員用) help

タイトル
本 文

コメント(0件)

内 容 ニックネーム/日時

コメントする help

ニックネーム
本 文
未熟児の増加により乳児死亡率が上昇/米国 医師の一分/BIGLOBEウェブリブログ
文字サイズ:       閉じる