Infant Mortality: What is CDC Doing?
What is CDC Doing?
We are committed to improving birth outcomes. Public health agencies––including CDC/ATSDR, health care providers, and communities of all ethnic groups—must work together to further reduce the infant mortality rate in the United States. This joint approach can help address the social, behavioral, and health risk factors that affect birth outcomes. On this page, you can learn more about CDC’s research, programs, and efforts to better understand and reduce infant mortality.
Improvements in Perinatal Care: CDC scientists, in collaboration with our partners, are working to understand the multiple reasons for preterm births and advance new strategies for prevention. CDC provides support to state Perinatal Quality Collaborative (PQC) initiatives in California, New York, Illinois, Massachusetts, and Ohio. State Perinatal Quality Collaboratives (PQCs) are networks of perinatal care providers and public health professionals working together to implement best practices such as real-time reporting of perinatal clinical quality metrics (e.g., elective deliveries less than 39 weeks of gestation, administration of antenatal steroids [medication given before birth to speed up a baby’s lung development]) in an effort to prevent prematurity and improve outcomes for infants born too early and too small.
One of the goals of CDC’s work with PQCs is the dissemination of strategies used by high-functioning PQCs to states in various stages of development. In partnership with CDC-funded collaboratives, the Division of Reproductive Health hosts regular Webinars that allow PQCs to share strategies related to their development as well as specific perinatal quality improvement initiatives. Recordings of previous Webinars are archived and available for viewing.
Grand Rounds: Public Health Approaches to Reducing U.S.
This powerful session of Grand Rounds highlighted accomplishments and explored public health, clinical, and policy strategies to improve birth outcomes.
Improving National Reporting of SIDS: CDC is committed to monitoring and reducing SIDS and other sudden unexpected infant death (SUID). CDC activities include:
- The SUID Case Registry: The purpose of the SUID Case Registry is to improve states’ ability to monitor SUID trends using standardized definitions by improving data completeness, timeliness, and case ascertainment. A better understanding of the circumstances and events associated with SUID may help reduce future deaths.
- The Sudden Death in the Young (SDY) Case Registry: The SDY Case registry expands the population of the SUID Case Registry from infancy through adolescence. The SDY registry includes an advanced review where cases are discussed and categorized jointly by pediatric clinical specialists (e.g., cardiologists, neurologists) and forensic pathologists. A blood sample is also collected at autopsy for future etiologic research. For more information, see Frequently Asked Questions about the Sudden Death in the Young Case Registry.
- Training materials: CDC developed the Sudden Unexplained Infant Death Investigation Reporting Form and collaborated with a number of organizations and subject matter experts to develop training materials for infant death investigators and instructors.
Pregnancy Risk Assessment Monitoring System (PRAMS)
The PRAMS surveillance system collects data on maternal attitudes and experiences before, during, and shortly after pregnancy from women who recently delivered a live-born infant. Forty states and New York City participate in the system, which covers approximately 78% of all live births in the United States. PRAMS data are used by CDC and the state’s public health agencies to better understand and monitor changes in maternal and child health indicators, and inform efforts to reduce infant mortality.
PRAMS uses standardized data-collection methods, allowing data to be compared among sites. The questionnaire consists of a core component used by all participating states and a state-specific component developed to address the particular data needs of each state. The core component of PRAMS includes questions about
- Attitudes and feelings about the most recent pregnancy.
- Content and source of prenatal care.
- Maternal alcohol and tobacco consumption.
- Physical abuse before and during pregnancy.
- Pregnancy-related morbidity.
- Infant health care.
- Contraceptive use.
- Mother's knowledge of pregnancy-related health issues, such as adverse effects of tobacco and alcohol; benefits of folic acid; and risks of HIV.
Maternal and Child Health Epidemiology Program
The Maternal and Child Health Epidemiology Program (MCHEP) builds state, local, and tribal capacity to effectively use maternal and child health epidemiologic research and scientific information to affect public health policy related to women, children, and families’ health. CDC works directly with states and localities by assigning an epidemiologist as a consultant for the state’s Maternal and Child Health (MCH) programs. To better understand infant health and mortality, CDC’s MCHEP assignees conduct data analyses and recommend actions to improve birth outcomes.
The MCHEP, in partnership with the Association of Maternal and Child Health Programs, the Health Resources and Services Administration, Maternal and Child Health Bureau, and a small group of states, released an infant mortality tool kit. The purpose of the State Infant Mortality Tool Kit is to guide health care agencies and organizations to work with their maternal and child health (MCH) epidemiologists to analyze and interpret available perinatal-related data. The standardized approach to the infant mortality assessment process presented in the tool kit will help states analyze the needs of their maternal and infant populations, and assist them in their efforts to develop and evaluate programs aimed at reducing perinatal risk factors.
Tracking birth defects: CDC believes that it is important to have a system to track birth defects to see when and where they happen and who they affect. Accurately finding infants and young children with birth defects is the first step in preventing birth defects and reducing their effect. This is generally achieved through birth defects tracking systems. CDC tracks birth defects through a number of state tracking systems and regional programs, including the Metropolitan Atlanta Congenital Defects Program. We base our research studies, including investigating the causes of certain birth defects, on what we learn from tracking. In addition, our systems guide us in planning and evaluating ways to prevent birth defects.
Researching birth defects: Most birth defects are thought to be caused by a complex mix of factors. These factors include our genes, behaviors, and things in the environment. For some birth defects, we know the cause. But for most, we don't. And we don't understand all the ways factors work together to cause birth defects. Research helps us answer many of these questions. CDC has been doing research in this field for more than 40 years. We have also funded other scientists to do research in the United States and abroad.
Preventing birth defects: Although we do not know the cause of most birth defects, the good news is that we know how to prevent some birth defects. For example, researchers have learned that taking folic acid before and during the early weeks of pregnancy greatly reduces the risk of serious defects of the brain and spine, called neural tube defects or NTDs. This research finding led to the advice that all women who can become pregnant should take 400 micrograms of folic acid daily. Researchers have also learned that drinking alcohol during pregnancy can cause the baby to be born with fetal alcohol spectrum disorders (FASDs). Therefore, CDC works with partners to educate women about the risk of drinking alcohol during pregnancy.
CDC’s National Center on Birth Defects and Developmental Disabilities hopes to learn more about the potential role of environmental exposures, medications, maternal infections, maternal diabetes, obesity, and genetic risk factors in causing birth defects. Expansion of tracking and research efforts holds great promise in identifying new causes of birth defects and strengthening birth defects prevention strategies.
Tracking and researching child injuries: To better understand the problem of child injury, CDC’s National Center for Injury Prevention and Control tracks data trends and conducts research on unintentional childhood injuries and child maltreatment. Injuries to children, whether unintentional or from maltreatment are often predictable and preventable—they are not “accidents.”
Preventing Shaken Baby Syndrome (SBS): A preventable tragedy, SBS is a form of abusive head trauma and inflicted traumatic brain injury. It results from violently shaking a baby by the shoulders, arms, or legs. It may result from both shaking alone or from impact (with or without shaking). Nearly all victims of SBS suffer serious health consequences and at least one of every four babies who are violently shaken dies from this form of child maltreatment. Babies (newborn to 4 months) are at greatest risk of injury from shaking. CDC provides several educational tools and resources including a guide for health departments and community-based organizations, a journalist’s guide with video, and free downloadable PSAs (Public Service Announcements).
Raising awareness about child injury prevention: CDC is committed to preventing unintentional injuries to children and maltreatment by supporting solutions that will save lives and help children live to their fullest potential. Progress has been made in preventing child injury. Child injury death rates have decreased 29% in the last decade. Yet injury is still the leading cause of death for children and teens. More can be done to keep our children safe. Everyone—including parents, health care providers, educators, and community members—can take steps to prevent unintentional injury and violence where they live, work, and play. CDC has created helpful resources for parents and public health professionals to help prevent unintentional child injury and maltreatment from occurring in the first place:
- The National Action Plan on Child Injury Prevention was developed by CDC and more than 60 stakeholders to spark action across the nation.
- The Protect the Ones You Love initiative was created to raise parents’ awareness about the leading causes of childhood injury in the United States and how they can be prevented.
- Color Me Safe is a coloring book designed for children ages four to seven. It can help parents talk with their children about safety at home and on the go!
- Essentials for Childhood is an action guide for anyone committed to the positive development of children and families. It lays out four strategies communities can consider to promote safe, stable, and nurturing relationships between children and their caregivers, and environments that help children grow up to be healthy and productive.
Infant mortality rates are based on all resident death certificates for babies who died before their first birthday in the 50 states and the District of Columbia. In addition, as part of the Vital Statistics Cooperative Program, each state provides to CDC’s National Center for Health Statistics (NCHS) matching birth and death certificate numbers for each infant younger than 1 year of age who died in the state. NCHS uses these matches to extract final edited data from the NCHS natality (birth) and mortality (death) statistical files that are derived from the birth and death certificate data provided by the states. These data are linked to form a single statistical record, thereby establishing a national linked record file. NCHS researchers then analyze the data and report the findings.
- Secretary’s Advisory Committee on Infant Mortality
- American Academy of Family Physicians
- American Academy of Pediatrics
- American College of Obstetricians and Gynecologists
- Association of Maternal and Child Health Programs
- Association of State and Territorial Health Officials
- Healthy Mothers, Healthy Babies Coalition
- HRSA’s Maternal and Child Health Bureau
- March of Dimes
- Society for Maternal-Fetal Medicine