Causes of Native American infant mortality.

This study was conducted to verify the rates, causality, and associated risk factors for American Indian and Alaska Native (AI/AN) infant deaths in 10 states. A retrospective descriptive study was carried out for the 3-year period 1986-1988 by matching copies of death and birth certificates, expanding the data base with medical and social information about the infants and their families, and analyzing contributing factors through a panel of pediatric specialists. Families were not interviewed. Comparison of the cohort of deceased infants in the 10 states with national Indian and all races infants dying in the same period revealed several important factors. Sudden infant death syndrome was 4 times higher than the U.S. all races rate and 3 times higher than the national rate for all Indians. Deaths from combined effects of prematurity were 4 times greater than the national Indian rate, the latter being comparable to the U.S. white rate. Infant deaths due to congenial anomalies were not significantly higher than the U.S. Indian rate or than the U. S. all races rate. Regional differences in the health of AI/AN infants exist. Infant deaths appear to be associated with high maternal behavioral risk factors. Monitoring of infant health must be a collaborative effort between IHS and the states. Special attention should be given to family planning and birth spacing