Major Causes Of Early Childhood Death From Injury Identified

"This important study examines some major causes of death for smallchildren," said NICHD Director Duane Alexander, MD. "The study provides vitalinformation for planning interventions that can help prevent this needless,tragic loss of life."

The investigators were led by Ruth Brenner, MD, MPH, of NICHD's Divisionof Epidemiology, Statistics, and Prevention Research. They began by analyzing aset of linked infant birth and death certificates, compiled by the NationalCenter for Health Statistics, for the years 1983 through 1991. Homicidesclaimed the greatest number of lives. A listing of deaths by all categoriesfollows.

The study found that infants were more likely to die from injuries iftheir mothers were young, unmarried, had lower levels of education, had moreolder children, had received prenatal care either late or not at all, or wereNative American or African American. Infants who died from an injury were morelikely to be of low birth weight, premature, and male. In addition, theresearchers found that specific injuries corresponded with specific riskfactors. For example, children born to mothers who were younger or had givenbirth previously were at twice the risk for suffocation. Infants born to NativeAmerican mothers were at greatest risk for motor vehicle-related deaths anddrownings, while the rate of death from choking was highest among low-birthweight infants.

Dr. Brenner cautioned that the study was limited to information that waslisted consistently on birth and death certificates, such as birth weight onbirth certificates, and cause of death on death certificates. This limitationprevented the researchers from examining the influence of paternalcharacteristics and other important factors, such as household income.

Dr. Brenner added that efforts to prevent childhood injuries andinjury-related deaths should continue to focus on such general strategies as theuse of car safety seats for infants and visiting home nurse programs for young,unmarried mothers. She pointed out, however, that there is also a need todevelop specific intervention strategies for children at particularly high riskof death.

"Our study identified groups of infants at increased risk of death dueto injury," she said. "This will help in the design of more focusedinterventions to prevent injuries in high risk groups of children."