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The leading causes of infant death vary according to the age at which they occur and can be broadly considered under three main categories: stillbirths, neonatal deaths and post-neonatal deaths (Table 2).
Table 2: Leading causes of infant death by age category (England, Wales and Northern Ireland, 1998) 4 and rates for South West England (1991-97) 1 These major causes of infant death are in turn determined by a number of underlying risk factors, which include: · Low birth weight: especially when associated with pre-term delivery 5 · Maternal and to some extent paternal smoking: increases the risk of wide range of adverse outcomes including SIDS and infections 6 · The family and social environment: poverty, lack of social support, overcrowded housing conditions, and mental health problems of the parents including drug and alcohol problems 3-6 · The quality of health care available: in preventing some deaths due to problems during labour and delivery, and in babies born prematurely 1 · Age of mother: rates are higher in mothers under 20 and over 40 1 · Registration: although changes in culture mean that birth within marriage is not a predictor for a stable family life, most babies are registered by two parents. Those 7.6% of babies who are registered by one parent alone (almost always the mother) have a higher rate of mortality (8.3% against 5.5% inside marriage) 1 Of these risk factors, maternal smoking, with its strong social class gradient possibly contributes most to the inequalities in infant mortality and offers the greatest potential for preventative action (Figure 3) 7 |
