#Infant mortality

[rjzimmerman]

Surprising New Research Links Infant Mortality to Crashing Bat Populations. (New York Times)

Excerpt from this New York Times story:

The connections are commonsense but the conclusion is shocking.

Bats eat insects. When a fatal disease hit bats, farmers used more pesticides to protect crops. And that, according to a new study, led to an increase in infant mortality.

According to the research, published Thursday in the journal Science, farmers in affected U.S. counties increased their use of insecticides by 31 percent when bat populations declined. In those places, infant mortality rose by an estimated 8 percent.

“It’s a seminal piece,” said Carmen Messerlian, a reproductive epidemiologist at Harvard who was not involved with the research. “I actually think it’s groundbreaking.”

The new study tested various alternatives to see if something else could have driven the increase: Unemployment or drug overdoses, for example. Nothing else was found to cause it.

Dr. Messerlian, who studies how the environment affects fertility, pregnancy and child health, said a growing body of research is showing health effects from toxic chemicals in our environment, even if scientists can’t put their fingers on the causal links.

“If we were to reduce the population-level exposure today, we would save lives,” she said. “It’s as easy as that.”

The new study is the latest to find dire consequences for humans when ecosystems are thrown out of balance. Recent research by the same author, Eyal Frank, an environmental economist at the University of Chicago, found that a die-off of vultures in India had led to half a million excess human deaths as rotting livestock carcasses polluted water and spurred an increase in feral dogs, spreading waterborne diseases and rabies.

“We often pay a lot of attention to global extinctions, where species completely disappear,” Dr. Frank said. “But we start experiencing loss and damages well before that.”

[reasonsforhope]

"When Ellen Kaphamtengo felt a sharp pain in her lower abdomen, she thought she might be in labour. It was the ninth month of her first pregnancy and she wasn’t taking any chances. With the help of her mother, the 18-year-old climbed on to a motorcycle taxi and rushed to a hospital in Malawi’s capital, Lilongwe, a 20-minute ride away.

At the Area 25 health centre, they told her it was a false alarm and took her to the maternity ward. But things escalated quickly when a routine ultrasound revealed that her baby was much smaller than expected for her pregnancy stage, which can cause asphyxia – a condition that limits blood flow and oxygen to the baby.

In Malawi, about 19 out of 1,000 babies die during delivery or in the first month of life. Birth asphyxia is a leading cause of neonatal mortality in the country, and can mean newborns suffering brain damage, with long-term effects including developmental delays and cerebral palsy.

Doctors reclassified Kaphamtengo, who had been anticipating a normal delivery, as a high-risk patient. Using AI-enabled foetal monitoring software, further testing found that the baby’s heart rate was dropping. A stress test showed that the baby would not survive labour.

The hospital’s head of maternal care, Chikondi Chiweza, knew she had less than 30 minutes to deliver Kaphamtengo’s baby by caesarean section. Having delivered thousands of babies at some of the busiest public hospitals in the city, she was familiar with how quickly a baby’s odds of survival can change during labour.

Chiweza, who delivered Kaphamtengo’s baby in good health, says the foetal monitoring programme has been a gamechanger for deliveries at the hospital.

“[In Kaphamtengo’s case], we would have only discovered what we did either later on, or with the baby as a stillbirth,” she says.

The software, donated by the childbirth safety technology company PeriGen through a partnership with Malawi’s health ministry and Texas children’s hospital, tracks the baby’s vital signs during labour, giving clinicians early warning of any abnormalities. Since they began using it three years ago, the number of stillbirths and neonatal deaths at the centre has fallen by 82%. It is the only hospital in the country using the technology.

“The time around delivery is the most dangerous for mother and baby,” says Jeffrey Wilkinson, an obstetrician with Texas children’s hospital, who is leading the programme. “You can prevent most deaths by making sure the baby is safe during the delivery process.”

The AI monitoring system needs less time, equipment and fewer skilled staff than traditional foetal monitoring methods, which is critical in hospitals in low-income countries such as Malawi, which face severe shortages of health workers. Regular foetal observation often relies on doctors performing periodic checks, meaning that critical information can be missed during intervals, while AI-supported programs do continuous, real-time monitoring. Traditional checks also require physicians to interpret raw data from various devices, which can be time consuming and subject to error.

Area 25’s maternity ward handles about 8,000 deliveries a year with a team of around 80 midwives and doctors. While only about 10% are trained to perform traditional electronic monitoring, most can use the AI software to detect anomalies, so doctors are aware of any riskier or more complex births. Hospital staff also say that using AI has standardised important aspects of maternity care at the clinic, such as interpretations on foetal wellbeing and decisions on when to intervene.

Kaphamtengo, who is excited to be a new mother, believes the doctor’s interventions may have saved her baby’s life. “They were able to discover that my baby was distressed early enough to act,” she says, holding her son, Justice.

Doctors at the hospital hope to see the technology introduced in other hospitals in Malawi, and across Africa.

“AI technology is being used in many fields, and saving babies’ lives should not be an exception,” says Chiweza. “It can really bridge the gap in the quality of care that underserved populations can access.”"

-via The Guardian, December 6, 2024

[mapsontheweb]

US states by infant mortality rate.

[thebat-musicman]

me: *obsessively explaining how infant morality rate affected naming conventions and how it was common that if a baby died you would get another one and name it the same thing. Common example of this is Philip Hamilton who died in 1800 (or 1801) and the other Philip Hamilton who was born a year later*

person im talking to: …please stop calling him Philip the Sequel

me: no.

[odinsblog]

Rest In Peace, Tori Bowie

While some vehemently deny that structural racism exists and that even individual doctors hold internal biases against Black women, maternal mortality rates do not lie.

👉🏿 https://firstandpen.com/torie-bowie-serena-williams-allyson-felix-pregnancy-black-maternal-health-mortality/

Even though 60% of all childbirth-related deaths in the US are preventable, the "[racial] disparities around maternal health are not improved by access to insurance, access to education," according to double board-certified neonatologist and pediatrician Dr. Terri Maior-Kincade.

"Having a higher socio-economic status for Black women is not protective," Major-Kincade told Insider. "These disparities are related to systemic issues, and they're not going to get better until we provide equitable care. So we have to improve the way we deliver care to Black women so that we can have the full joy of pregnancy."

👉🏿 https://www.insider.com/allyson-felix-near-death-pregnancy-issues-black-moms-face-2022-6

[swforester]

In memory of Joel who died in 1802 at 4 years of age.

Blandford Cemetery 11/20/24

[sickofthis666]

The french government having the fucking Audacity of complaining about France's low birth rate when the medical care for women before, during and after birth, has been heavily deteriorating for the past 20 years??

How the fuck can it be more dangerous for me to give birth in 2024 than it was for my mom in the late 90s/early 2000s!? Why the fuck are we going backwards!?

How the fuck can we be one of the wealthiest country on the planet and yet have among the highest infant mortality in Europe!? Are we a fucking joke??

[justinspoliticalcorner]

Amee Vanderpool at SHERO:

A study published in June, led by Johns Hopkins Bloomberg School of Public Health researchers, has concluded that in the year following the state’s 2021 ban on abortion, infant deaths in Texas increased more than expected, especially among infants with congenital anomalies.  The analysis of monthly death certificate data in Texas and the rest of the United States by the John Hopkins team following the enactment of the SB8 Texas law, that prohibits abortions after a fetal heartbeat could be detected that went into effect September 1, 2021, found that between 2021 and 2022 infant deaths in Texas rose from 1,985 to 2,240. The study defined infants as under 12 months of age, and this reported number represents a year-over-year increase of 255 total infant deaths. The report revealed that the State of Texas had a 12.95% increase during this time in infant deaths, as compared to an average 1.8% increase in infant deaths throughout the entire country. The investigation, which was was led by John Hopkins assistant professors in Population, Family and Reproductive Health, Suzanne Bell and Alison Gemmill, ultimately determined that Texas Heartbeat ban “led directly to immediate and significant decreases in facility-based abortions provided in Texas.” This lack of resources created more requests for medication abortion pills so that patients could self-manage an abortion, and ultimately caused greater than expected live births among people residing in Texas.

Gemmill and Bell used Texas birth certificate data and compared it to several other states in order to determine what would have happened to infant mortality in Texas in the absence of this policy. Professor Gemmill commented on the findings saying, “The big takeaway is that we found an unexpected increase in infant mortality in Texas—about a 13% increase—that wasn't observed in the rest of the United States [and] this suggests that SB-8 was driving this increase in infant mortality.” “We saw similar findings with neonatal mortality, which are deaths of infants less than 28 days old,” Gemmill continued, “and then we also found — which was a bit surprising — that deaths due to congenital anomalies rose by 23% in Texas, while in the rest of the United States, there was a decrease in these deaths.” Professor Gemmill went on to explain that the congenital abnormality increase in Texas was due to the heightened medical restrictions and a lack of options for the patient.  

[...] Currently, at least 13 states have complete abortion bans with few exceptions for things like fetal anomalies, and another seven states have abortion restrictions pre-viability and in some cases, many weeks before we would even be able to test for congenital malformations. Both professors expect that in these places with extreme abortion restrictions, we can expect to “see something similar play out” where abortion has been banned. While studies up to now have focused on the health impacts for women who have been denied emergency medical care as a result of these abortion bans all over the country, this is the first study to examine the effects of restrictive abortion limitations on the deformed infants who are born as a result of improper medical care. The only thing worse than being denied access to abortion services when you are not ready to start a family, is the proposition of carrying a baby to term that you grow to love and want, that is ultimately destined to suffer and die within the first year of life.

A study done by Johns Hopkins Bloomberg School of Public Health reveals that abortion ban law Texas SB8 is the cause of increased infant deaths in the Lone Star State.

[follow-up-news]

Texas’ abortion restrictions – some of the strictest in the country – may be fueling a sudden spike in infant mortality as women are forced to carry nonviable pregnancies to term. Some 2,200 infants died in Texas in 2022 – an increase of 227 deaths, or 11.5%, over the previous year, according to preliminary infant mortality data from the Texas Department of State Health Services that CNN obtained through a public records request. Infant deaths caused by severe genetic and birth defects rose by 21.6%. That spike reversed a nearly decade-long decline. Between 2014 and 2021, infant deaths had fallen by nearly 15%. In 2021, Texas banned abortions beyond six weeks of pregnancy. When the Supreme Court overturned federal abortion rights the following summer, a trigger law in the state banned all abortions other than those intended to protect the life of the mother. The increase in deaths could partly be explained by the fact that more babies are being born in Texas. One recent report found that in the final nine months of 2022, the state saw nearly 10,000 more births than expected prior to its abortion ban – an estimated 3% increase. But multiple obstetrician-gynecologists who focus on high-risk pregnancies told CNN that Texas’ strict abortion laws likely contributed to the uptick in infant deaths. “We all knew the infant mortality rate would go up, because many of these terminations were for pregnancies that don’t turn into healthy normal kids,” said Dr. Erika Werner, the chair of obstetrics and gynecology at Tufts Medical Center. “It’s exactly what we all were concerned about.”

[geezerwench]

Texas abortion ban linked to sharp rise in infant and newborn deaths

Texas abortion ban linked to 13% increase in infant and newborn deaths

I wonder what the mother post partum mortality rate is now?

Don't matter what the woman or girl child needs or wants. So what if infant mortality goes up! Once that female is knocked up, she's gonna stay knocked up! It's not about #RightToLife it's about men controlling women.

#RepublicansAreGarbage

[thefirsthogokage]

Not to post a zionist-run paper, but

WHAT DO YOU EXPECT WHEN YOU BAN ABORTION AND FORCE PEOPLE TO GIVE BIRTH TO BABIES WHO WON'T FUCKING MAKE IT?!

[dickensianenglishbulldog]

“The average person has 3 children in 25 years"

factoid actualy just statistical error. average person has 1 child per quarter century. Children Tolstoy, who lived in Russia & had 13 in that time, is an outlier and should not have been counted”

[reasonsforhope]

Article

The number of children dying under five years of age declined by two thirds over the past two decades in Southern Asia, according to new mortality estimates released by UNICEF, the World Health Organization (WHO), the United Nations Population Division and the World Bank Group. Southern Asia includes nine countries: Afghanistan, Bangladesh, Bhutan, India, Iran, Maldives, Nepal, Pakistan, and Sri Lanka.

The report reveals that the number of child deaths under 5 years of age decreased from 5 million in 1990 to 1.3 million in 2022.  The report also shows that Southern Asia’s under five mortality rate, or the probability that a child would die before five years of age, reduced by 72 per cent since 1990, and 62 per cent since 2000.

“We have made heartening progress to save millions of children’s lives since 1990.  These aren’t just numbers on a page – these are children’s lives saved, sons and daughters, brothers and sisters. This success is largely due to investments in trained health workers, improvements in newborn care, treatment of childhood illnesses and vaccinations for children against deadly diseases,” said Sanjay Wijesekera, UNICEF Regional Director for Southern Asia. “This progress shows us that change is possible. These lives saved are testament to the engagement and will of governments, local organizations, health care professionals such as skilled birth attendants, parents, and families to save the most vulnerable children.” ...

Despite this progress, however, much more needs to be done...

The report also reveals that progress among countries is uneven. Three countries (Iran, Sri Lanka and Maldives) have achieved the SDG 2030 target for under five child mortality reduction and four are on track to meet the target (India, Bangladesh, Bhutan and Nepal). For example, Bangladesh’s neonatal mortality rate decreased from 66 deaths per 1,000 live births in 1990, to 17 deaths per 1,000 live births in 2022.

However, in Pakistan and Afghanistan, urgent action is required to accelerate their annual rates of reduction substantially to meet 2030 targets...

“We call on governments across the region to invest in simple solutions such as having trained birth attendants at every birth, ensuring that all newborns have essential care, better care of small and sick newborn babies, medicines, clean water, electricity, and vaccines to save lives. Every child has the right to healthcare.”

-via UNICEF, March 14, 2024

[mapsontheweb]

US states by infant mortality rate.

[thoughtportal]

Childbirth Is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds 

https://www.nytimes.com/interactive/2023/02/12/upshot/child-maternal-mortality-rich-poor.html

In the United States, the richest mothers and their newborns are the most likely to survive the year after childbirth — except when the family is Black, according to a groundbreaking new study of two million California births. The richest Black mothers and their babies are twice as likely to die as the richest white mothers and their babies.

Research has repeatedly shown that Black mothers and babies have the worst childbirth outcomes in the United States. But this study is novel because it’s the first of its size to show how the risks of childbirth vary by both race and parental income, and how Black families, regardless of their socioeconomic status, are disproportionately affected.

“This is a landmark paper, and what it makes really stark is how we are leaving one group of people way behind,” said Atheendar Venkataramani, a University of Pennsylvania economist who studies racial health disparities and was not involved in the research.

The study, published last month by the National Bureau of Economic Research, includes nearly all the infants born to first-time mothers from 2007 to 2016 in California, the state with the most annual births. For the first time, it combines income tax data with birth, death and hospitalization records and demographic data from the Census Bureau and the Social Security Administration, while protecting identities.

That approach also reveals that premature infants born to poor parents are more likely to die than those born into the richest families. Yet there is one group that doesn’t gain the same protection from being rich, the study finds: Black mothers and babies.

Are you a Black parent who recently gave birth? Tell us about it.

“It suggests that the well-documented Black-white gap in infant and maternal health that’s been discussed a lot in recent years is not just explained by differences in economic circumstances,” said Maya Rossin-Slater, an economist studying health policy at Stanford and an author of the study. “It suggests it’s much more structural.”

If anything, the study’s findings understate the dangers of childbirth in much of the United States, a variety of researchers said, because California’s maternal mortality rate has been declining over the last decade, as deaths have gone up in the rest of the country.

Rich Families Have More Premature Babies. But Those Babies Are Less Likely to Die.

Perhaps unexpectedly, babies born to the richest 20 percent of families are the least healthy, the study finds. They are more likely to be born premature and at a low birth weight, two key risk factors for medical complications early in life. This is because their mothers are more likely to be older and to have twins (which are more common with the use of fertility treatments), the researchers found.

But even with those early risk factors, these babies are the most likely to survive both their first month and first year of life.

A similar pattern emerged when it came to the health of the parents themselves: Rich and poor mothers were equally likely to have high-risk pregnancies, but the poor mothers were three times as likely to die — even within the same hospitals. Rich women’s pregnancies “are not only the riskiest, but also the most protected,” the paper’s authors wrote.

 A pair of charts showing the relationship between a mother’s income and rates of premature births and infant mortality. The first chart shows that as a woman’s income rises, the likelihood of preterm birth rises. The second chart shows that as a woman’s income rises, rates of infant mortality fall.  

This finding suggests that the American medical system has the ability to save many of the lives of babies with early health risks, but that those benefits can be out of reach for low-income families.

Resources outside the medical system also play a role. Separate research on children with leukemia, for example, has found that even when treated at the same hospital and using the same protocol, those from high-income families fared better than those from poorer families.

“It’s not just about the medical care that kids are receiving,” said Anna Aizer, a health economist at Brown University. “There are all sorts of other things that go into having healthy babies. If you’re a higher-income mom who can take time off work, who doesn’t have to worry about paying rent, it’s not surprising you’ll be able to manage any health complications better.”

Money Protects White Mothers and Babies. It Doesn’t Protect Black Ones.

The researchers found that maternal mortality rates were just as high among the highest-income Black women as among low-income white women. Infant mortality rates between the two groups were also similar.

 Two charts showing the relationship between a mother’s income and rates of infant mortality by race. The first chart shows that as a Black mother’s income increases, the rate of infant mortality generally drops. The same is true in the second chart for white mothers, but at much lower rates than for Black women.  

The richest Black women have infant mortality rates at about the same level as the poorest white women.

The babies born to the richest Black women (the top tenth of earners) tended to have more risk factors, including being born premature or underweight, than those born to the richest white mothers — and more than those born to the poorest white mothers. It’s evidence that the harm to Black mothers and their babies, regardless of socioeconomic status, begins before childbirth.

“As a Black infant, you’re starting off with worse health, even those born into these wealthy families,” said Sarah Miller, a health economist at the University of Michigan. She was an author of the study with Professor Rossin-Slater and Petra Persson of Stanford, Kate Kennedy-Moulton of Columbia, Laura Wherry of N.Y.U. and Gloria Aldana of the Census Bureau.

Black mothers and babies had worse outcomes than those who were Hispanic, Asian or white in all the health measures the researchers looked at: whether babies were born early or underweight; whether mothers had birth-related health problems like eclampsia or sepsis; and whether the babies and mothers  died. There was not enough data to look at other populations, including Native Americans, but other research has shown that they face adverse outcomes nearing those of Black women and infants in childbirth.

 Charts that show the relationship between a mother’s income by group. The groups are Hispanic mothers and Asian mothers. Generally, rates for Hispanic mothers and Asian mothers track more closely with those of white mothers than Black mothers.  

Even before the new paper, research found that Black women with the most resources, as measured by education and class mobility, did not benefit during childbirth the way white women did. The new study demonstrates that disparities are not explained by income, age, marital status or country of birth. Rather, by showing that even rich Black mothers and babies have a disproportionately higher risk of death, the data suggests broader forces at play in the lives of Black mothers, Professor Rossin-Slater said.

“It’s not race, it’s racism,” said Tiffany L. Green, an economist focused on public health and obstetrics at the University of Wisconsin-Madison. “The data are quite clear that this isn’t about biology. This is about the environments where we live, where we work, where we play, where we sleep.”

There is clear evidence that Black patients experience racism in health care settings. In childbirth, mothers are treated differently and given different access to interventions. Black infants are more likely to survive if their doctors are Black. The experience of the tennis star Serena Williams — she had a pulmonary embolism after giving birth, yet said health care professionals did not address it at first — drew attention to how not even the most famous and wealthy Black women escape this pattern.

But this data shows how the effects of racism on childbirth start long before people arrive at the hospital, researchers across disciplines say, and continue after they leave. The stress of experiencing racism; air pollution in Black communities; and inequitable access to paid family leave, for example, have all been found to affect the health of mothers and babies.

“Even when it’s not about the direct disrespect that’s going on between the patient and the care provider, there are many ways systemic racism makes its way into the well-being of a pregnant or birthing person,” said Dr. Amanda P. Williams, the clinical innovation adviser at the California Maternal Quality Care Collaborative.

California Is a Best-Case Scenario. It Still Lags Behind Other Wealthy Parts of the World.

Many parts of the United States have much higher maternal mortality than California, and fewer policies to support families. California was the first state to offer paid family leave. It has one of the most generous public insurance programs for pregnant women. The state has invested in specific programs aimed at reducing maternal deaths and racial disparities in childbirth.

Yet even in this best-case American scenario, mothers and babies fare worse compared with another rich country the researchers examined: Sweden. At every income level, Swedish women have healthier babies. This held true for the highest-income Swedish women and those from disadvantaged populations, including low-income and immigrant mothers.

 A pair of charts showing the relationship between birth outcomes in Sweden and California. The first chart shows that Swedish women have heavier babies at every income level. The second chart shows that Swedish women have lower rates of preterm birth than California women at every income level.  

Swedish women have heavier babies at every income level ...

... and far lower instances of preterm birth.

In the United States, earning more regularly translates into superior access to the fastest, most expensive health care. But even with that advantage, the richest white Californians in this study still gave birth to less healthy babies than the richest Swedish women. Their newborns were more likely to be premature or underweight. The two groups had roughly equal maternal death rates.

“That finding really does strongly suggest that it’s something about the care model,” said Dr. Neel Shah, chief medical officer of Maven Clinic for women’s and family health and a visiting scientist at Harvard Medical School. “We have the technology, but the model of prenatal care in the United States hasn’t really gotten an update in the last century.”

 A chart showing where the U.S. falls on the spectrum of maternal mortality among peer countries. The U.S. is last in a ranking that includes New Zealand, Norway, the Netherlands, Germany, Sweden, Switzerland, Australia, Britain, Canada and France, in that order.  

Paper

Sweden, like most European countries, has universal health insurance with low out-of-pocket costs for the patient. Midwives deliver most babies in Sweden and provide most of the prenatal care, which has been linked to lower C-section rates and lower rates of preterm births and low birth weights. It has long paid leaves and subsidized child care.

Like California, Sweden has also started targeted efforts to reduce maternal deaths. When officials there recognized that African immigrants giving birth were dying more frequently, they began piloting a “culture doula” program, with doulas who were immigrants themselves helping pregnant women navigate the country’s health system.

Local maternal health programs could begin to help reduce racial disparities in the United States, too, as could a more diverse medical workforce, research suggests. Nonprofits and universities have experimented with ways to address racism and poverty, with programs like cash transfers for low-income pregnant women and initiatives to improve the environments of Black communities.

By the time a woman is pregnant, Professor Miller said, “it’s almost too late.”

“Health is going to depend on exposures throughout her life, health care she’s received, environmental factors,” she said. “A lot goes on prior to the pregnancy that affects the health of the mother and baby.”

About the data

The researchers collected birth certificate data for all babies born to first-time mothers in California from 2007 to 2016. The final sample included 1.96 million births. They collected hospitalization and death records for babies for one year from the California Department of Health Care Access and Information, as well as hospitalization records for mothers for nine months before the birth and a year after. They collected maternal death records for the same period from a Social Security Administration data set. They provided birth records to the Census Bureau, which assigned anonymous identification codes to access I.R.S. data and determine new parents’ incomes in the two years before the birth. (Infant mortality records were  available only until 2012. Maternal mortality data covers a longer period than in government records, which generally include data for six weeks after a birth, and most likely capture some deaths unrelated to childbirth.)

In Sweden, the researchers collected similar health and mortality data from the National Board of Health and Welfare. The final sample included 463,865 births. Analogous maternal morbidity data was unavailable. They linked babies to their parents and collected parents’ demographic and financial data from Statistics Sweden. Sweden has a smaller gap between the highest and lowest earners than the United States.

[homoqueerjewhobbit]

If you think about it, it's pretty gutsy/insane that The Decemberists decided to open their very first LP with a song narrated from the point of view of a dead baby rotting in a ditch.