FIMR findings, recommendations released

Sleep-related deaths are down across the region, but STDs, smoking, poverty and life-course issues still are impacting birth outcomes, according to the latest Fetal and Infant Mortality Review findings released at the October 18 Coalition meeting. Recommendations from FIMR include continued safe sleep education; a focus on safe sex, STDs and family planning; and bringing attention to the dangers of smoking during pregnancy.

The recommendations are based on 2011 data. The overall infant mortality rate continued to drop, although the disparity between white and nonwhite widened.  

Sudden Unexplained Infant Deaths (SUIDs), including SIDS and other sleep-related deaths, decreased in Northeast Florida to <1 per 1,000 live births in 2011, marking another year of notable improvement. Sleep-related deaths accounted for 12 percent of all infant deaths and 54 percent of deaths after the first month of life.

Within the FIMR review cases, maternal health remained a key factor in fetal and infant deaths. In 93 percent of FIMR cases from 2009-2011, mothers had medical conditions during pregnancy. Unintended pregnancy, substance abuse and late entry into prenatal care were also prevalent in the cases.

Mothers experienced life course stessors in 40 percent of the cases reviewed, including abuse, poverty and lack of support. Poverty, in particular, has been present in a higher proportion of cases over the last three years.

FIMR aims to reduce infant mortality by gathering and reviewing detailed information to gain a better understanding of fetal and infant deaths in Northeast Florida. The project examines cases with the worst outcomes to identify gaps in maternal and infant services and to promote future improvements.

FIMR’s Case Review Team (CRT) reviewed 87 cases between 2009-2011 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.

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