Trends and patterns of postneonatal mortality in Alaska 1977 through 1984.

Several determinants of Alaska postneonatal mortality rate were examined to determine whether very low birth weight (less than 1500 g) and low birth weight (1500-2499 g) surviving neonates contributed to the lack of improvement in postneonatal mortality rate. For an eight year period (1977 through 1984), all infant deaths (n = 1020) of the 82,301 resident births were reviewed through vital statistics data. The infant's place of birth, ethnic group, birth weight and age at death were available. Ethnic and rural-specific postneonatal mortality rate (PNMR) significantly improved, but there was no change in birth weight distribution or birth weight-specific postneonatal mortality rate. However, surviving very low birth weight infant proportion of postneonatal mortality has increased from 5% to 8.2% and low birth weight proportion has remained unchanged (15.6%). These proportions were not offset by the decline in normal birth weight (greater than 2500 g) postneonatal mortality rate. This trend suggests that infants born weighing less than 2500 g have slowed the decline of the postneonatal mortality rate.