Does reducing infant mortality depend on preventing low birthweight? An analysis of temporal trends in the Americas.

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  • Additional Information
    • Subject Terms:
    • Abstract:
      Low birthweight (LBW) is highly associated with death during infancy, and countries with the highest LBW rates also have the highest infant mortality rates. We compared temporal trends in LBW with both overall and birthweight-specific infant mortality in United States, Canada, Argentina, Chile, and Uruguay over two time periods, using cohort and cross-sectional analysis of national population-based vital statistics for 1985–89 and 1995–98. Infant mortality diminished substantially (RR = 0.60–0.80 for the later vs. earlier periods) and to a similar degree in all birthweight categories in all five study countries, despite an increase in LBW in the US and Uruguay, minimal changes in Canada and Argentina, and a decrease in Chile. The strength of the (positive) association between LBW and overall infant mortality diminished over the two time periods (from rs = +0.80 to +0.25 and RR per SD increase in LBW rate from 2.13 [2.09, 2.17] to 1.76 [1.74, 1.79]). The proportion of infant deaths occurring among LBW infants was negatively correlated with overall infant mortality in both time periods (rs = −0.30 and −0.60, RR = 0.68 [0.67, 0.68] and 0.47 [0.46, 0.47]). Developed and less developed countries in the Americas have succeeded in reducing infant mortality in all birthweight groups despite inconsistent changes in LBW rates, and none has achieved this success primarily by reducing LBW. Although our results are not necessarily generalisable to the least developed countries in South Asia and sub-Saharan Africa, it is likely that all countries can substantially reduce their infant mortality rates by improving the care of infants at normal and low birthweights. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1Departments of Pediatrics and of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, Quebec, Canada
      2PAHO/WHO Centro Latinoamericano de Perinatologia, Montevideo, Uruguay
      3Department of Epidemiology and Community Medicine, University of Medicine and Dentistry of New Jersey, Piscataway, NJ, USA
      4Health Surveillance and Epidemiology Division, Centre for Healthy Human Development, Public Health Agency of Canada, Ottawa, Ontario, Canada
      5National Center of Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
      6Perinatal Epidemiology Research Unit, Departments of Obstetrics & Gynecology and of Pediatrics, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
    • ISSN:
      0269-5022
    • Accession Number:
      10.1111/j.1365-3016.2005.00681.x
    • Accession Number:
      18724886
  • Citations
    • ABNT:
      KRAMER, M. S. et al. Does reducing infant mortality depend on preventing low birthweight? An analysis of temporal trends in the Americas. Paediatric & Perinatal Epidemiology, [s. l.], v. 19, n. 6, p. 445–451, 2005. DOI 10.1111/j.1365-3016.2005.00681.x. Disponível em: http://widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=1&encode=0&proxy=&find_1=&replace_1=&target=http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=18724886&authtype=sso&custid=s5834912. Acesso em: 29 jan. 2020.
    • AMA:
      Kramer MS, Barros FC, Demissie K, Shiliang Liu, Kiely J, Joseph KS. Does reducing infant mortality depend on preventing low birthweight? An analysis of temporal trends in the Americas. Paediatric & Perinatal Epidemiology. 2005;19(6):445-451. doi:10.1111/j.1365-3016.2005.00681.x.
    • APA:
      Kramer, M. S., Barros, F. C., Demissie, K., Shiliang Liu, Kiely, J., & Joseph, K. S. (2005). Does reducing infant mortality depend on preventing low birthweight? An analysis of temporal trends in the Americas. Paediatric & Perinatal Epidemiology, 19(6), 445–451. https://doi.org/10.1111/j.1365-3016.2005.00681.x
    • Chicago/Turabian: Author-Date:
      Kramer, Michael S., Fernando C. Barros, Kitaw Demissie, Shiliang Liu, John Kiely, and K. S. Joseph. 2005. “Does Reducing Infant Mortality Depend on Preventing Low Birthweight? An Analysis of Temporal Trends in the Americas.” Paediatric & Perinatal Epidemiology 19 (6): 445–51. doi:10.1111/j.1365-3016.2005.00681.x.
    • Harvard:
      Kramer, M. S. et al. (2005) ‘Does reducing infant mortality depend on preventing low birthweight? An analysis of temporal trends in the Americas’, Paediatric & Perinatal Epidemiology, 19(6), pp. 445–451. doi: 10.1111/j.1365-3016.2005.00681.x.
    • Harvard: Australian:
      Kramer, MS, Barros, FC, Demissie, K, Shiliang Liu, Kiely, J & Joseph, KS 2005, ‘Does reducing infant mortality depend on preventing low birthweight? An analysis of temporal trends in the Americas’, Paediatric & Perinatal Epidemiology, vol. 19, no. 6, pp. 445–451, viewed 29 January 2020, .
    • MLA:
      Kramer, Michael S., et al. “Does Reducing Infant Mortality Depend on Preventing Low Birthweight? An Analysis of Temporal Trends in the Americas.” Paediatric & Perinatal Epidemiology, vol. 19, no. 6, Nov. 2005, pp. 445–451. EBSCOhost, doi:10.1111/j.1365-3016.2005.00681.x.
    • Chicago/Turabian: Humanities:
      Kramer, Michael S., Fernando C. Barros, Kitaw Demissie, Shiliang Liu, John Kiely, and K. S. Joseph. “Does Reducing Infant Mortality Depend on Preventing Low Birthweight? An Analysis of Temporal Trends in the Americas.” Paediatric & Perinatal Epidemiology 19, no. 6 (November 2005): 445–51. doi:10.1111/j.1365-3016.2005.00681.x.
    • Vancouver/ICMJE:
      Kramer MS, Barros FC, Demissie K, Shiliang Liu, Kiely J, Joseph KS. Does reducing infant mortality depend on preventing low birthweight? An analysis of temporal trends in the Americas. Paediatric & Perinatal Epidemiology [Internet]. 2005 Nov [cited 2020 Jan 29];19(6):445–51. Available from: http://widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=1&encode=0&proxy=&find_1=&replace_1=&target=http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=18724886&authtype=sso&custid=s5834912