Postneonatal Mortality Among Alaska Native Infants — Alaska, 1989–2009

Weekly

January 13, 2012 / 61(01);1-5

“Alaska’s postneonatal mortality rate of 3.4 deaths per 1,000 live births during 2006–2008 was 48% higher than the 2007 U.S. rate of 2.3 per 1,000 (1,2). Among American Indian/Alaska Native (AI/AN) infants, the Alaska rate of 8.0 per 1,000 was 70% higher than the U.S. rate of 4.7. The Alaska Division of Public Health analyzed a linked birth-infant death file for 1989–2009 to examine temporal trends in postneonatal mortality in Alaska, specifically in the Alaska Native (AN) population. Overall and non-Alaska Native (non-AN) rates declined during the entire period, but no significant trends in AN-specific mortality were apparent. Infant mortality review committee findings indicated a decline during 1992–2007 among all postneonatal deaths attributed to sudden infant death syndrome (SIDS) or sudden unexplained infant death (SUID), but not for other causes. Lack of progress in reducing postneonatal mortality, particularly among AN infants, indicates a need for renewed emphasis within the Alaska health-care community. Current initiatives to reduce preventable causes of postneonatal mortality should be evaluated and successful models more widely implemented.

The Alaska Bureau of Vital Statistics provided an electronic file with linked records for the 222,317 recorded live births and 821 postneonatal deaths among infants aged 28–364 days born to Alaska residents during 1989–2009. Potential risk factors for infant mortality that might be determined from information included on birth certificates were identified through prior research and literature review. Those risk factors included infant birth weight and gestational age; maternal race, years of education, age, and prenatal cigarette, smokeless tobacco, and alcohol use; and a composite variable reflecting maternal marital status and presence of a father’s name on the birth certificate (1,3). Race was categorized as AN, which included all indigenous groups, or non-AN, based on mother’s race. ……”