Risk Factors for Diarrhea-associated Infant Mortality in the United States, 2005-2007
The Pediatric Infectious Disease Journal, 06/28/2012
Mehal JM et al. – Efforts to reduce diarrhea–associated morality should focus on understanding and improving management of diarrhea in vulnerable LBW infants. For prevention of diarrhea–associated deaths in normal birth weight (NBW) infants, educating mothers who fit the high–risk profile regarding home hydration therapy and timely access to medical treatment is important.
Methods- Records of singleton infants with diarrhea listed anywhere on the death certificate were selected from the US Linked Birth/Infant Death data for the period, 2005 to 2007; characteristics of these infants were compared with those of infants who survived their first year.
- During 2005 to 2007, 1087 diarrhea-associated infant deaths were reported; 86% occurred among low birth weight (LBW, <2500 g) infants.
- Compared with normal birth weight infants, LBW infants had a greater mortality rate and younger median age at death (7 versus 15 weeks, P < 0.0001).
- The most common codiagnoses for diarrhea-associated death among LBW and NBW infants were sepsis (26%) and volume depletion (20%), respectively.
- Among LBW infants, 97% of diarrhea-associated deaths occurred in inpatient settings, whereas 27% of NBW infant deaths occurred in outpatient settings and 5.3% in the decedent’s home.
- Male sex, black race, unmarried status and low 5-minute Apgar score (<7) increased mortality odds among LBW infants whereas, among NBW infants, low 5-minute Apgar score, black race, young maternal age (<25 years) and high birth order (third or more) increased mortality odds.
