Strobino D, O'Campo P, Schoendorf K C
Department of Maternal and Child Health, Johns Hopkins University, Baltimore, Maryland 21205, USA.
Milbank Q. 1995;73(4):507-33.
The high infant mortality rate in the United States, especially in urban areas, remains a major federal concern. Four strategies for reducing infant mortality in cities participating in the federal ¿Healthy Start¿ are reducing high-risk pregnancies; reducing the incidence of low birthweight and preterm births; improving birthweight-specific survival; and reducing specific causes of post-neonatal mortality. Estimates of the impact of known interventions indicate that the reduction in infant mortality would be large for only one strategy: improving birthweight-specific survival. Most interventions yield a 2 percent reduction, or less, in mortality and when combined, would amount to about 30 percent. This strategic model provides a realistic framework to assess the impact of the Healthy Start demonstration and is useful in highlighting the interventions most likely to reduce infant mortality in a population.
美国尤其是城市地区的高婴儿死亡率仍然是联邦政府主要关注的问题。参与联邦“健康开端”项目的城市中，降低婴儿死亡率的四项策略包括：减少高危妊娠；降低低体重儿和早产的发生率；提高特定出生体重儿的存活率；以及减少新生儿后期死亡的特定原因。对已知干预措施影响的估计表明，只有一项策略能大幅降低婴儿死亡率：提高特定出生体重儿的存活率。大多数干预措施使死亡率降低2%或更低，综合起来约为30%。这种战略模型为评估“健康开端”示范项目的影响提供了一个现实的框架，有助于突出那些最有可能降低某一人群婴儿死亡率的干预措施。
