Annual FIMR recommendations focus on safe sleep, smoking and family planning

FIMR Coordinator Laurie Lee presents the annual findings

Smoking, safe sleep and family planning were the main focus of the 2013 Fetal and Infant Mortality Review findings and recommendations that were released at the October 17 Coalition meeting. The recommendations closely mirror those of the previous few years, as these continue to be significant issues leading to poor birth outcomes in the region.

FIMR’s Case Review Team (CRT) reviewed 81 cases between January 2010 and December 2012 utilizing an approach developed by the American College of Obstetrics and Gynecology (ACOG) that pulls information from birth, death, medical, hospital and autopsy records and maternal interviews. Efforts are also made to interview the family. No information that identifies the family or medical providers is included on the abstraction form.

A mother’s general health, life course stressors and family planning issues continue to be main contributing factors to fetal and infant deaths in the five-county area. Other frequently identified contributing factors include: Late or no prenatal care (60 percent of cases); Maternal infections other than STDs (56 percent of cases); Preterm Labor (48 percent of cases); and Prematurity (48 percent of cases).

The following recommendations were made:

  • Continue to focus on preventing sleep related deaths. Of the 127 infant deaths in Northeast Florida in 2012, 21 were sleep related. This represents 17% of all deaths as opposed to 13% in 2011.
  • Focus on safe sex, STD prevention and family planning. Duval County ranks 5th in the state based on 2012 data in STD rates. STD protection education should be separate from family planning as the contraceptive methods that are most effective do not protect against STD’s; Decisions should be made about each one individually.
  • Continue to focus on dangers of smoking during pregnancy. Over the last 3 years, the percentage of moms in the death cohort that self-reported some type of substance abuse has gone from 17% in 2010, to 11% in 2011 to 12% in 2012; 90% were tobacco smokers. The Healthy Start program in St. Johns County is piloted SCRIPT (evidence-based smoking cessation program for pregnant women) based on last year’s recommendations. The pilot went well and is now expanding into all five counties in the region.

The Community Action Team (CAT) then works to implement the FIMR recommendations.