3202.0: Monday, October 22, 2001 - 5:15 PM

Abstract #21533

Narrowing of sex differences in infant mortality in Massachusetts

Urmi Bhaumik, MBBS, MS, DSc, Boston Healthy Start Initiative, Boston Public Health Commission, 434 Massachusetts Avenue, 5th Floor, Boston, MA 02118, 617-534-7828, urmibhaumik@hotmail.com, Iain Aitken, MBBChir, MPH, Department of Maternal and Child Health, Harvard School of Public Health, Boston, MA 02115, Ichiro Kawachi, MD, PhD, Director, Harvard Center for Society and Health, Harvard School of Public Health, Boston, MA 02115, Steve Ringer, MD, PhD, Joint Program in Neonatalogy, Harvard Medical School, Boston, MA 02115, John Orav, PhD, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, and Ellice Lieberman, MD, DrPH, Center for Perinatal Research, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115.

Background. Male infants are known to have a higher mortality rate than female infants. There have been dramatic declines in infant mortality related to improved survival of preterm infants due to significant advances in treatment. Since male infants are at a higher risk of prematurity, we examined whether changes in infant mortality altered the male female gap in mortality.

Methods. The study was a population based vital records study using linked birth and death certificates for all 619,811 live born infants in Massachusetts between 1989 and 1995. We examined changes in infant, neonatal, and postneonatal mortality by gender during the period.

Results. Between 1989 and 1995 the male excess in infant mortality decreased from 1.6/1000 to 0.8/1000 live births. This narrowing resulted primarily from a more rapid decline in neonatal mortality among male infants (1.5/1000 live births) than among female infants (0.9/1000 live births). The largest declines in the male excess in neonatal mortality occurred among very premature infants (GA <=30 weeks) and resulted primarily from a more rapid decrease in male deaths from respiratory distress syndrome.

Conclusions. Our findings indicate that there was a decrease in the male excess in neonatal mortality between 1989 and 1995. The narrowing of the sex difference in mortality suggests that newer treatments such as antenatal steroids, and surfactants may have differentially benefited male infants.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Evaluate differential benfits of improved treatments for reducing infant mortality among different population groups. 2. Recognize the need for analying sex differences in the efficacy of various treatment procedures.

Keywords: Infant Mortality, Gender

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA