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APHA Scientific Session and Event Listing

Diana E. Ramos, MD, MPH¹, Margaret Chao, PhD, MPH¹, Joanne Roberts, RN, BS¹, Angel Hopson, RN, MSN, MPH¹, Deborah Davenport, RN, MS², and Cynthia Harding, MPH³. (1) Maternal, Child, & Adolescent Health, Los Angeles County-Department of Health Services, 600 South Commonwealth, Suite 800, Los Angeles, CA 90005, 3232514444, dramos@ladhs.org, (2) Public Health - CHS SPA 1&2, Los Angeles County Department of Health Services, 5300 Tujunga Ave, North Hollywood, CA 91601, (3) Maternal, Child and Adolescent Health, Los Angeles County Department of Health, 600 Commonwealth, 8th Floor, Los Angeles, CA 90005

OBJECTIVE: To assess the psychosocial referrals provided to women who have experienced an infant death.

METHODS: A retrospective study of infant deaths occurring during 2002 in a suburb of Los Angeles County was performed. National Fetal Infant Mortality Review (NFIMR) data forms and patient medical records were used for data capture and analysis. Descriptive statistics were performed. An assessment of local resources providing support to women with an infant loss was also undertaken.

RESULTS: A total of 53 infant deaths occurred in 2002. Among them, 43% (23/53) were African Americans, 21% (11/53) were to teens, and 68% (36/53) of infants died in the first 28 days of life. A detailed review of psychosocial factors revealed the following: 54.9% (29/53) of women had a history of a previous fetal and infant death, 47.1% (25/53) were single parents, 39.2% (21/53) started prenatal care in the second trimester or later, 25.5% (14/53) had a history of depression and mental problems, and 21.6%(11/53) had no documented bereavement support. In this suburb, only 2 local agencies offered bereavement support.

CONCLUSION: Women with a history infant loss are not receiving the necessary and appropriate psychosocial and bereavement counseling. When perinatal bereavement is not resolved, 25% to 30% of mothers may develop clinical depression. Often, a new layer of grief surfaces when parents become pregnant again which can lead to pathology if not recognized by others. Collaboration between community organizations and health care providers is needed to meet the psychosocial demands on women with an infant death.

Learning Objectives:

• Describe the ethnic variations in infant deaths in Los Angeles County.
• List the most common causes of infant deaths in Los Angeles County compared with the rest of the U.S.
• Recognize that grief and bereavement counseling is an important missing component in the care of a mother with an infant death.

Keywords: Infant Mortality, Caregivers

Presenting author's disclosure statement:

Not Answered