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Infant mortality rate rises in county

April 10, 1997

By STEVEN T. DENNIS

Staff Writer

Washington County's infant mortality rate has risen sharply to become the highest in the Tri-State area, according to the most recent statistics.

Washington County's infant mortality rate for the two-year period 1994-95 was 10.1 per 1,000 live births. The next highest infant mortality rate for that period was in Berkeley County, W.Va., which had 8.4 deaths per 1,000 live births.

Washington County Health Officer Robert Parker said if the county's rate does not show a decline when 1996 figures become available this summer, efforts will have to be made to find out why so many babies were dying.

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During the three-year period from 1991 through 1993, the county infant mortality rate was 6.9 deaths per 1,000 live births, according to state statistics.

The increase to 10.1 deaths per 1,000 live births for the 1994 and 1995 period was "the biggest jump that I've seen in the past 15 years," Parker said.

"I don't think any of us know why (the rate increased)," said Linda Humbert, the health department's director of nursing. "Hopefully, we can do some investigation and see what may be the cause."

Infant mortality refers to deaths before one year of age.

In the past 30 years, the county's infant mortality rate has declined fairly steadily, with occasional upward blips from year to year, Parker said.

Parker said it was difficult to reach any conclusions about the rate because the numbers can be skewed in any one year by a handful of deaths.

About 1,500 babies are born to county residents in any one year, he said. Fifteen infants died in 1995, according to state statistics.

"The real change seems to be a jump in deaths in the first 28 days in life," Parker said.

One possible factor in the increase could be a jump in the percentage of babies born to women under 18 years old, from 3.7 percent in 1991 through 1993 to 4.2 percent in 1994 and 1995, Parker said. Teenage mothers have a greater risk of having infants die, he said.

Preventable deaths

Obstetrician/gynecologist Dr. David Solberg at the Mid-Atlantic Women's Health Center in Hagerstown said the sad fact behind the statistics is that many infant deaths are preventable.

"Premature delivery seems to be the one nut that we have to crack," he said.

"That's the biggest hurdle that we have to lowering the infant mortality rate."

Solberg said one of the most significant ways to reduce the number of premature deliveries is early prenatal care.

Younger women and teens often delay going to a doctor, Solberg said. A doctor can help women early in a pregnancy by identifying risk factors such as smoking and can check to see that the mother-to-be is in good overall health.

"Even a urinary tract infection could cause someone to go into labor early," Solberg said.

Women also should get their bodies in shape before conceiving, he said.

"It's kind of like if you're going to go on a long trip you make sure the brakes are working. A lot of people are starting with a vessel that's not really primed for the trip."

A success story

Frederick County, Md., has cut its infant mortality rate in half in recent years. In 1994-95, 20 infants died, for a rate of 3.8 per 1,000, according to state figures. In 1991-1993, 60 infants died, for a rate of 7.9 per 1,000.

Ellen Ristorcelli, the director of nursing at the Frederick County Health Department, said the county has instituted a variety of programs aimed at promoting healthy babies.

Under the Healthy Start program, county nurses make housecalls to pregnant women who are on medical assistance or referred by doctors. The nurses check on the women before and after birth and educate them on everything from the dangers of smoking to the importance of laying babies down on their backs to sleep to prevent Sudden Infant Death Syndrome.

"We're trying to focus on people we think don't know where to get care," Ristorcelli said.

The department also strives to make sure that the women who come in for pregnancy tests are assigned to private doctors for prenatal care, she said. "We put all that in motion immediately so we don't lose them," she said.

"I think we're seeing people that are coming into prenatal care earlier," she said.

In the past, more women would not begin visits until the fourth and fifth months of the pregnancy, she said.

A new program instituted at the county hospital makes sure all infants are assigned to a pediatrician before they are discharged, she said.

Another new program gives couples a packet of information when they get their marriage licenses. The packet includes information on how to prepare a mother's body for pregnancy before conception, including what vitamins the mother should be taking and drugs she shouldn't.

Washington County also has a number of programs to help out pregnant women, including Healthy Start home visits, said program supervisor Pat Firey.

Firey said she's seen an increase in social risk factors, including broken families, single mothers and pregnant teens.

Firey said one problem is that many women don't know where to get help or don't realize how many programs are available to help them out even if they can't afford to pay.

"It's a very complex problem. I don't think there's any one solution," she said.

"All of us have a responsibility. We all just need to take interest in our children, whether they are our own children or not."

Maryland's infant mortality rate dropped from 9.6 deaths per 1,000 live births for 1991 through 1993 to 8.3 in 1994 and 1995, Parker said.

According to the National Center for Health Statististics, the national rate was 7.5 per 1,000 in 1995, down from 7.9 in 1994 and 8.3 in 1993. The national data is preliminary.

In Washington County, pregnant women who want help can call the county health department at 791-3229.

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