Khoury M J, Erickson J D, Adams M J
JAMA. 1984 Jul 20;252(3):367-72.
Trends in postneonatal mortality (PNM) rates in the United States were analyzed for the period 1962 through 1978 using National Center for Health Statistics birth and death certificate data. The PNM rates declined from 5.5 to 3.6 per 1,000 live births for whites and from 15.6 to 7.6 per 1,000 live births for blacks. Most of the decline in PNM rates could be accounted for by a drop in mortality from infectious diseases. A dramatic increase occurred in the reported rates of unexplained sudden infant death (SID), which emerged as the leading reported cause of PNM. The second leading cause of PNM was birth defects among whites and infectious diseases among blacks. Gaps in PNM continued to exist between whites and blacks, and between metropolitan and nonmetropolitan areas. These gaps suggest that further improvement in PNM may be possible by improving access to health care. The massive increase in the rates of SID, although partially explained by coding or reporting phenomena, warrants active pursuit for a better pathophysiologic and etiologic delineation of the entity.
利用美国国家卫生统计中心的出生和死亡证明数据，对1962年至1978年期间美国新生儿后期死亡率（PNM）的趋势进行了分析。白人的PNM率从每1000例活产中的5.5例降至3.6例，黑人则从每1000例活产中的15.6例降至7.6例。PNM率的下降大部分可归因于传染病死亡率的下降。不明原因的婴儿猝死（SID）报告率急剧上升，成为报告的PNM的主要原因。PNM的第二大原因，白人是出生缺陷，黑人是传染病。白人和黑人之间，以及大都市和非大都市地区之间，PNM差距依然存在。这些差距表明，通过改善医疗保健可及性，有可能进一步降低PNM。SID率的大幅上升，虽然部分可由编码或报告现象解释，但仍需积极探寻对该疾病更好的病理生理学和病因学描述。
