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Infant mortality is the death of young children under the age of 1. This death toll is measured by the infant mortality rate (IMR), which is the probability of deaths of children under one year of age per 1000 live births. The under-five mortality rate, which is referred to as the child mortality rate, is also an important statistic, considering the infant mortality rate focuses only on children under one year of age.2013, the leading cause of infant mortality in the United States was birth defects. Other leading causes of infant mortality include birth pneumonia, congenital malformations, term birth complications such as abnormal presentation of the fetus umbilical cord prolapse, or prolonged labor, neonatal infection, diarrhea, malaria, measles and malnutrition. One of the most common preventable causes of infant mortality is smoking during pregnancy. Lack of prenatal care, alcohol consumption during pregnancy, and drug use also cause complications which may result in infant mortality. Many environmental factors contribute to infant mortality, such as the mother’s level of education, environmental conditions, and political and medical infrastructure. Improving sanitation, access to clean drinking water, immunization against infectious diseases, and other public health measures can help reduce high rates of infant mortality.

In 1990, 8.8 million infants younger than 1 year died globally. Until 2015, this number has almost halved to 4.6 million infant deaths. Over the same period, the infant mortality rate declined from 65 deaths per 1,000 live births to 29 deaths per 1,000. Globally, 5.4 million children died before their fifth birthday in 2017. In 1990, the number of child deaths was 12.6 million. More than 60% of these deaths are seen as being avoidable with low-cost measures such as continuous breast-feeding, vaccinations and improved nutrition.

Throughout the world, infant mortality rate (IMR) fluctuates drastically, and according to Biotechnology and Health Sciences, education and life expectancy in the country is the leading indicator of IMR. Infant mortality rate (IMR) is the number of deaths per 1,000 live births of children under one year of age. The rate for a given region is the number of children dying under one year of age, divided by the number of live births during the year, multiplied by 1,000.

Environmental and social barriers prevent access to basic medical resources and thus contribute to an increasing infant mortality rate; 99% of infant deaths occur in developing countries, and 86% of these deaths are due to infections, premature births, complications during delivery, and perinatal asphyxia and birth injuries. Greatest percentage reduction of infant mortality occurs in countries that already have low rates of infant mortality. Common causes are preventable with low-cost measures. In the United States, a primary determinant of infant mortality risk is infant birth weight with lower birth weights increasing the risk of infant mortality. The determinants of low birth weight include socio-economic, psychological, behavioral and environmental factors.

Causes of infant mortality and deaths that are related to medical conditions include: low birth weight, sudden infant death syndrome, malnutrition, congenital malformations, and infectious diseases, low income for health care including neglected tropical diseases. Obese women are at an increased risk of developing complications during pregnancy, including gestational diabetes or pre-eclampsia. Additionally, they are more likely to experience a pre-term birth or have a child with birth defects

People who live in areas where particular matter (PM) air pollution is higher tend to have more health problems across the board. Short-term and long-term effects of ambient air pollution are associated with an increased mortality rate, including infant mortality. Air pollution is consistently associated with post neonatal mortality due to respiratory effects and sudden infant death syndrome. Specifically, air pollution is highly associated with STDs in the United States during the post-neonatal stage. High infant mortality is exacerbated because newborns are a vulnerable subgroup that is affected by air pollution. Newborns who were born into these environments are no exception. Women who are exposed to greater air pollution on a daily basis who are pregnant should be closely watched by their doctors, as well as after the baby is born. Babies who live in areas with less air pollution have a greater chance of living until their first birthday. As expected, babies who live in environments with more air pollution are at greater risk for infant mortality. Areas that have higher air pollution also have a greater chance of having a higher population density, higher crime rates and lower income levels, all of which can lead to higher infant mortality rates

The key pollutant for infant mortality rates is carbon monoxide. Carbon monoxide is a colorless, odorless gas that does great harm especially to infants because of their immature respiratory system. Another major pollutant is second-hand smoke, which is a pollutant that can have detrimental effects on a fetus. According to the American Journal of Public Health, “in 2006, more than 42 000 Americans died of second hand smoke-attributable diseases, including more than 41 000 adults and nearly 900 infants … fully 36% of the infants who died of low birth weight caused by exposure to maternal smoking in utero were Blacks, as were 28% of those dying of respiratory distress syndrome, 25% dying of other respiratory conditions, and 24% dying of sudden infant death syndrome.” The American Journal of Epidemiology also stated that “Compared with nonsmoking women having their first birth, women who smoked less than one pack of cigarettes per day had a 25% greater risk of mortality, and those who smoked one or more packs per day had a 56% greater risk. Among women having their second or higher birth, smokers experienced 30% greater mortality than nonsmokers.” Stress is a lead factor in inducing labor in pregnant women, and therefore high levels of stress during pregnancy could lead to premature births that have the potential to be fatal for the infant.

It was in the early 1900s that countries around the world started to notice that there was a need for better child health care services. Europe started this rally, the United States fell behind them by creating a campaign to decrease the infant mortality rate. With this program, they were able to lower the IMR to 10 deaths rather than 100 deaths per every 1000 births. Infant mortality was also seen as a social problem when it was being noticed as a national problem. American women who had middle class standing with an educational background started to create a movement that provided housing for families of a lower class. By starting this, they were able to establish public health care and government agencies that were able to make more sanitary and healthier environments for infants. Medical professionals helped further the cause for infant health by creating a pediatrics field that was experienced in medicine for children

When a woman becomes pregnant, certain steps can help to reduce the chance of complications during the pregnancy. Attending regular prenatal care check-ups will help improve the baby’s chances of being delivered in safer conditions and surviving. Additionally, taking supplementation, including folic acid, can help reduce the chances of birth defects, a leading cause of infant mortality. Many countries have instituted mandatory folic acid supplementation in their food supply, which has significantly reduced the occurrence of spina bifida, a birth defect, in newborns. Similarly, the fortification of salt with iodine, salt iodization, has helped reduce adverse birth outcomes associated with low iodine levels during pregnancy.

Abstinence from alcohol can also decrease the chances of harm to the fetus during pregnancy. Drinking any amount of alcohol during pregnancy may lead to fetal alcohol spectrum disorders (FASD) or alcohol related birth defects (ARBD). Tobacco use during pregnancy has also been shown to significantly increase the risk of a preterm or low birth weight birth, both of which are leading causes of infant mortality. Pregnant women should consult with their doctors to best manage any existing health conditions that they have to avoid complications of both their health as well as the fetus.