How to Curb Neonatal Mortality Rates

April 8, 2021
April 8, 2021

According to the Centers for Disease Control’s (CDC) data brief from December of 2020, 21,467 infants die each year in the U.S. The CDC has identified the top 10 contributing factors, but the top four contribute to more than 10,000 of those deaths. The number becomes more disappointing when it is understood that many of these deaths are likely preventable. 

Neonatal Mortality – Understanding the Leading Causes

By far, the most significant number of neonatal deaths (the death of an infant before his or her first birthday) are attributed to congenital malformations, deformations, and chromosomal abnormalities.

The second largest contributor is disorders related to short gestation and low birth weight. In third place is accidents or unintentional injuries. Sudden infant death syndrome is the fourth largest contributor and is nearly tied with maternal complications of pregnancy.  

Solutions that Work – Educating for Healthier Pregnancies

The good news is that there are some fairly straightforward solutions to many of the factors that contribute to neonatal mortality. Healthcare providers and public health organizations can help with education that helps pregnant women and those planning to become pregnant understand how to minimize their risks, protect their pregnancies and the health of their newborns. Perhaps the most effective strategies are those that equip pregnant women and new mothers with information on how to protect their pregnancies, themselves, and their babies.

  • Help women plan for a healthy pregnancy. Women who have sufficient levels of folic acid at least one month before and throughout their pregnancies can help protect their babies from major brain and spine defects such as spina bifida and anencephaly. Regular doctor visits should also be encouraged.
  • Counsel new and expectant mothers that a healthy lifestyle can help reduce the possibility of neonatal death. Managing the increasing population of maternity patients presenting with obesity and diabetes and their complications can help minimize unnecessary risks for mother and baby.
  • Give new and expectant mothers the education and the tools to help them avoid dangerous substances. Substances that are dangerous for the mother are likely to represent danger to her pregnancy and her baby. The complete avoidance of alcohol is essential as there is no known safe amount of alcohol consumption for pregnant women. Fetal Alcohol Spectrum Disorders (FASDs) can result in lifelong intellectual, behavioral, and physical disabilities, and in some cases, death.

    Pregnant women should also be encouraged to avoid smoking of any kind before and during pregnancy. This will help to minimize the risk of pre-term birth, cleft palette and lip, low birth weight and even death. Women who use marijuana for medical reasons should consult their doctors for alternative and safer therapies during their pregnancy.

  • Encourage vigilance about protecting from infections. Infections are dangerous for the mother, but also for the developing fetus. Careful handwashing, the avoidance of areas where the Zika virus may still be present, and the avoidance of people who may be ill are just some of the recommendations that may help pregnant women avoid infections and the associated dangers to their pregnancies and their infants.
  • Pregnant women should also be encouraged to control fevers and to avoid becoming overheated to minimize the risk of neural tube defects.

Solutions that Work – Preventing Accidents and Sudden Infant Death Syndrome

Healthcare providers have an important role in keeping infants safe. New parents receive an abundance of information before bringing their infant home including essential information on infant safety. Significant improvements in Sudden Infant Death Syndrome have been realized since the 1990s, but there are still about 3,500 infant sleep-related deaths each year. This number would seem to indicate that there is still a need to educate caregivers on the importance of placing infants on their backs on firm surfaces for sleep. It is also important to emphasize the importance of removing other hazards such as pillows, bumpers, and soft toys from the crib. While room-sharing is recommended, bed sharing is not and can represent a danger to infants.

Solutions that Work – Improving Healthcare Providers’ Neonatal Care Quality

A previous HealthStream blog post about neonatal mortality offered the following solutions for improving providers’ care quality in this area:

  1. Continue to study and share the data. Maternal mortality reviews help us better understand the causes of maternal deaths. Understanding the cause of death is critically important, but sharing is also critical as it facilitates learning from one another. We should use data to raise awareness of these clinical issues so that successful interventions from one unit in one hospital can be shared and lead to more significant changes nationally.
  2. Use existing tools. Numerous organizations use robust bundles and toolkits that have been created specifically to address unique OB clinical issues.
  3. Remember to address communication when planning education for providers. Learning that simply addresses clinical skills is missing a critical component. Providers can make the biggest improvements when they learn how to communicate effectively in an emergency.
  4. Maintain a focus on critical thinking. This includes helping providers feel comfortable enough to do a brief timeout to think through and discuss complicated clinical issues.
  5. Help providers and patients understand and embrace shared decision-making. This is specifically defined as, “healthcare teams and patients discussing care options, the consequences of those options, other available options, and then making the decision about care together – the healthcare team, the patient and the patient’s family.”
  6. Be mindful of the damaging effects of hierarchies in healthcare organizations. Everyone on the team should be encouraged to speak up regarding safety issues without fear of personal or professional repercussions.
  7. Improve provider preparation for neonatal transport. Training healthcare providers about the risks and best practices involved in moving infants experiencing a healthcare crisis is another way to improve care quality

HealthStream and our partner S.T.A.B.L.E. have recently partnered to deliver the dynamic S.T.A.B.L.E. program in an online format for the first time ever. The self-paced, online S.T.A.B.L.E. program takes 5.5 to 6 hours to complete and offers e-learners the ability to build their confidence through interactive activities, audio and video presentations, and PDF resources from the S.T.A.B.L.E. manual that can be downloaded or printed.

Everyday hundreds of newly born infants become ill and require specialized care, yet many caregivers lack the knowledge, skills, and confidence in their ability to provide the necessary care. With the goal to improve the quality of care of sick infants and increase the confidence of those who care for them, HealthStream and S.T.A.B.L.E. have partnered to offer the dynamic S.T.A.B.L.E. program in an online format for the first time ever.