Minnesota’s infant mortality rate fares better than national average, but not by much

On average, one infant dies every day in Minnesota.

This is one of many statistics the House Early Childhood Finance and Policy Division heard Thursday from Susan Castellano, maternal and child health section manager at the Department of Health.

Division members learned infant and maternal health and mortality in Minnesota is a mixed bag. There are a handful of unsettling trends as well as a few areas of improvement.

No action was taken.

The statistics

Coming in at No. 29 in a list of Organization for Economic Cooperation and Development countries, the United States has 5.9 infant deaths per 1,000 live births. Comparatively, Slovenia and Finland, in the first and second position, have 1.6 and 1.7 infant deaths per 1,000 live births, respectively.

“We’re not keeping up with the rest of the world is the takeaway,” Castellano said. “And while we’ve made some improvement in the U.S. over the last years … we’ve still got a long ways to go.”

Minnesota fares slightly better than the U.S. as a whole, with a rate of 5.1 infant deaths per 1,000 live births, according to the department’s 2016 infant mortality data. Breaking it down a little further, there were 69,835 live births in Minnesota that year, and 357 infant deaths.

This rate — and those who are more likely to experience the death of an infant — has stayed consistent over the past decade, with American Indian and African American populations disproportionately affected. The causes of death vary, with some being entirely unavoidable, and some being preventable.

Rep. Laurie Pryor (DFL-Minnetonka) asked for examples of preventable deaths and what steps or measures can be taken to reduce those types of deaths in the future.  

“Certainly one really good example is infant deaths from suffocation,” Castellano said. “It’s an education issue.”

Another is prematurity, which, in some cases can be reduced with proper prenatal care and being proactive. If a mother has had a premature birth in the past, there are steps she can take during following pregnancies to reduce the likelihood of prematurely delivering again.

Unfortunate trends

Information provided by the department points to a startling upsurge in maternal opiate use and, correspondingly, a rise in the number newborns experiencing a drug withdrawal syndrome called Neonatal Abstinence Syndrome. Nationally, the rate of maternal opiate use per 1,000 hospital births climbed progressively from 1.19 in 2000 to 5.63 in 2009. The rate of babies born with NAS per 1,000 hospital births was 1.2 in 2000 to 5.8 in 2012.

Another concerning statistic shows a resurgence of sexually transmitted diseases in Minnesota over the past decade. From 2016 to 2017, gonorrhea increased by 28 percent, syphilis by 10 percent and chlamydia by 4 percent.

“It’s important to note because it does have an impact on mothers and infants in terms of birth outcomes. We see these on the rise, rather astronomically,” Castellano explained.

Among other impacts, STDs can result in increased risk of birth defects, miscarrying, going into preterm labor and delivery, and stillbirth or death.

Finally, between 2000 and 2016, death by suicide, drugs, opioids or alcohol related issues have been on the rise. This is a nationwide trend impacting the general population and pregnant women alike.

“Pregnancy and post-partum are a very vulnerable time for depression,” Castellano said. She added that suicide is the leading cause of death for new moms, and that mothers with depression may find it difficult provide the simulation their infants need in order to develop properly.

The good news

One positive trend in Minnesota is that teen pregnancy rates have dropped significantly over the past 25 years, across all ethnicities and races. Notably, African Americans, American Indians and Hispanic populations continue to experience a disproportionately higher teenage birth rate than their white or Asian counterparts.

When looking at females ages 15-19, regardless of race or ethnicity: 59 of every 1,000 became pregnant in 1990. As of 2016 that number has dropped to 16 of every 1,000.

“One of the best strategies to promote good birth outcomes, we know, is family planning — for pregnancies to be intended in the first place,” Castellano said. “Because it means that people have the resources and decided that they have the resources to support the babies that they’re having.”