Infant Survival Rate Projections Downgraded

ATLANTA — The nation’s infants and mothers will not have the survival rates in 1990 that health officials hoped for a decade ago, according to a new report from the Centers for Disease Control.

Of the 13 top-priority goals concerning pregnancy and infant health in the government’s 1990 health objectives for the nation, only three are likely to be met, the CDC said.

“It’s certainly sobering and concerning,” said Dr. Ann Koontz, a specialist with the Health Resources and Services Administration in Rockville, Md. “This indicates that we have some significant problems relating to maternal and infant health.”

The CDC, using National Center for Health Statistics data, projects that the nation’s infant mortality rate--infants dying before age 1--will be 9.1 per 1,000 live births.

That’s a drop from the 10.6 rate in 1985, but still short of the 9.0 rate in the 1990 objectives, which were published in 1979.

Based on earlier data from 1970-81, health officials had projected a 1990 infant mortality rate of 7.8, but “the decline in the infant mortality rate has slowed,” the CDC said.

The reasons, Koontz said, are not known for certain: “It’s a very complex field. We’d all like to see improvements, but there’s not been a simple solution.”

Another objective was that no racial or ethnic group should have an infant mortality rate worse than 12 per 1,000. Among black Americans, the rate stood at 18.2 in 1985 and is projected to decline to 15.9 by 1990, the CDC said.

The infant mortality rate among whites stood at 9.3 per 1,000 in 1985 and is projected to fall to 7.9 by 1990, the CDC said.

Economics may play a part in the discrepancy between the mortality rates for blacks and whites. “We know that poor economic circumstances are distributed disproportionately among minority populations,” Koontz said.

But the complete reason is not clear, she said, noting that previous studies have shown that among college-educated mothers, black infants still have nearly twice the mortality rate of comparable white infants.

Among the other goals not likely to be met:

- No county, racial or ethnic group should have a maternal death rate above five per 100,000 live births. The 1990 national rate is projected at 7.0, with black mothers at 20.5.

- No more than 5% of babies should be born under 5.5 pounds. The 1990 projection: 6.7%.

- No more than 10% of pregnant women in any county, racial or ethnic group should go without prenatal care in the first three months of pregnancy. The 1990 national projection: 23.6%, 38.5% for blacks.

One of the goals that is likely to be met concerns the nation’s neonatal mortality rate--babies dying in the first 28 days of life. That rate is projected to be 5.7 per 1,000 in 1990, below the target of 6.5.

Two other goals are considered likely to be met: having most babies leave the hospital in car safety seats, and putting into place programs to screen newborns for metabolic disorders.

A 1987 survey found safety-seat use at hospitals of 75%, and all states now have such metabolic screening programs, the CDC said.