Scott C L, Iyasu S, Rowley D, Atrash H K
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion.
MMWR CDC Surveill Summ. 1998 Jul 3;47(2):15-30.
PROBLEM/CONDITION: This report contains public health surveillance data that describe trends in postneonatal mortality (PNM) and that update information published in 1991.
1980-1994.
National death certificate data characterizing PNM were reported by hospital physicians, coroners, and medical examiners. Data for 1980-1994 were compiled by the National Center for Health Statistics (NCHS) and obtained from NCHS public-use mortality tapes.
The PNM rate per 1,000 live births declined 29.8% from 4.1 in 1980 to 2.9 in 1994 (31.7% decline among white infants and 25.8% among black). Most of the decline resulted from reduced mortality from infections and sudden infant death syndrome (SIDS). The PNM ratio between blacks and whites remained steady at approximately 2.1 during 1982-1988 and gradually increased to 2.4 by 1994 [corrected]. Autopsy rates for cases of SIDS increased from 82% to approximately 95% and did not differ among black infants and white infants. The decline of PNM rates for birth defects was greater for white infants than for black infants. The racial gap in PNM rates widened regionally during the study period, except in the South and the Northeast where ratios remained stable. In 1994, the largest gap persisted in the north-central region followed by the West and Northeast.
In 1994 as in 1980, PNM remained an important contributor to infant mortality, but nearly half of these deaths are caused by potentially preventable causes such as SIDS, infections, and injuries. The use of interventions for SIDS, birth defects, infections, and injuries can help reduce PNM and narrow the associated racial gap.
This surveillance information, which will be distributed to administrators of state maternal and child health programs and to community-based organizations nationwide, will be useful in planning infant mortality reduction programs and to target PNM prevention efforts.
问题/状况：本报告包含描述新生儿后期死亡率（PNM）趋势的公共卫生监测数据，并更新了1991年发布的信息。
1980 - 1994年。
医院医生、验尸官和法医报告了表征PNM的国家死亡证明数据。1980 - 1994年的数据由国家卫生统计中心（NCHS）汇编，并从NCHS的公开使用死亡率磁带中获取。
每1000例活产的PNM率从1980年的4.1下降了29.8%，至1994年为2.9（白人婴儿下降31.7%，黑人婴儿下降25.8%）。下降主要源于感染和婴儿猝死综合征（SIDS）导致的死亡率降低。1982 - 1988年期间，黑人和白人之间的PNM比率稳定在约为2.1，到1994年[校正后]逐渐增至2.4。SIDS病例的尸检率从82%增至约95%，黑人和白人婴儿之间无差异。白人婴儿出生缺陷导致的PNM率下降幅度大于黑人婴儿。在研究期间，PNM率的种族差距在区域上有所扩大，但南部和东北部的比率保持稳定。1994年，最大差距存在于中北部地区，其次是西部和东北部。
1994年与1980年一样，PNM仍然是婴儿死亡率的重要因素，但近一半的此类死亡是由SIDS、感染和伤害等潜在可预防原因导致的。对SIDS（婴儿猝死综合征）、出生缺陷、感染和伤害采取干预措施有助于降低PNM并缩小相关的种族差距。
这些监测信息将分发给各州母婴健康项目的管理人员以及全国的社区组织，有助于规划降低婴儿死亡率项目并针对PNM预防工作。
