Perinatal and infant mortality

Abstract

Australias infant mortality rate fell below 10/1000 live births for the 1st time in 1983 (9.6/1000). Internationally Australia ranks 12th in infant mortality among countries with populations over 2.5 million. Contributing to this relatively poor international standing has been the high incidence of low birthweight infants high postneonatal mortality in disadvantaged population groups such as the Aborigines and the completeness of registration of infant mortality in Australia. There is a legal requirement that perinatal deaths from at least 20 weeks gestation or 400 gm birthweight be registered. In 1983 the national perinatal mortality rate was 12.2/1000 births. The greatest reduction in neonatal mortality has been among infants weighing 1000-2499 gms. Most of the recent improvement in the low birthweight component of the neonatal death rate is attributable to the better survival of these infants not a major reduction in the incidence of low birthweight. Several proposals are made for improving the data on perinatal and infant mortality in Australia. These deaths should be routinely linked to the maternal and fetal or neonatal data in the perinatal morbidity data collections to facilitate identification of risk factors. Also pregnancies terminated after diagnosis of fetal abnormalities should be included in these perinatal data collections. Steps such as educating the community about the adverse effects of alcohol and smoking in pregnancy increased planning of pregnancy better detection of high risk pregnancies and regionalization of the care of pregnant women at high risk of complications could contribute to further reductions in infant and perinatal mortality in Australia.