FIMR Report: Sleep-related deaths, substance abuse and preconception health impact infant deaths

shutterstock_68501338Although the infant and fetal mortality rates declined in Northeast Florida in 2015, a review of the deaths in the region found that too many of our babies die from preventable causes like bedsharing, parental/caregiver substance use and being born too small and too soon. These findings and more from the 2015-2016 Fetal and Infant Mortality Review process were released at the October 20 Coalition community meeting.

Click here for the full presentation on the FIMR results. Also released was the 2015-16 Project IMPACT report, which looks at the status of maternal and child health in Baker, Clay, Duval, Nassau and St. Johns counties.

FIMR’s Case Review Team (CRT) reviewed 28 cases in 2015-16 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.

For the first time in eight years, the team reviewed sleep-related deaths. Of the nine abstracted deaths (of 26 total sleep-related deaths in the region), the majority took place at home, while the baby slept with others, in an unsafe sleep location, on soft bedding and with unsafe items in the bed.

A mother’s health prior to pregnancy continued to have a major impact on birth outcomes. Unmanaged medical conditions and high BMIs can lead to maternal complications and prematurity. Substance use before, during and after pregnancy also impacts preconception health; can lead to fetal deaths and babies born with withdrawal issues; and is a factor in a number of sleep-related deaths.

Based on the infant mortality statistics and the FIMR cases, the Case Review Team developed the following recommendations:

  1. Safe sleep education will continued to be a recommendation. More specifically, a Public Service Announcement to include information about bedding, bedsharing and additional teaching regarding skin-to-skin contact while “alert and awake.” We will collaborate with a number of local agencies who partake in the Child Abuse Death Review team.
  2. Address late entry or second trimester entry into care. Referral time for women on Medicaid from the assinged medical home to the obstetrician is causing women to enter into prenatal care late. Work with the four managed care organizations in the region to smooth this transition and avoid causing late entry to OB while the pregnant woman waits for a referral from her medical home, whom she may never visited before.
  3. Centralized location for all obstetrician-related activities in Northeast Florida. Possibly Facebook, but a website is preferred. Links to classes, connections to resources, fast facts, service announcements.