The annual Fetal and Infant Mortality Review identified reducing sleep-related deaths and smoking during pregnancy as key approaches to improving birth outcomes in Northeast Florida. The findings from the 2011-2013 FIMR reviews were released at the October 16 Coalition community meeting along with the 2013-14 Project IMPACT report.
FIMR’s Case Review Team (CRT) reviewed 81 cases between January 2011 and December 2013 utilizing an approach developed by the American College of Obstetrics and Gynecology (ACOG) that pulls information from birth, death, medical, hospital and autopsy records and maternal interviews. Efforts are also made to interview the family. No information that identifies the family or medical providers is included on the abstraction form.
A mother’s general health, life course stressors and family planning issues continue to be main contributing factors to fetal and infant deaths in the five-county area.
A mother’s health prior to and during pregnancy was the most frequently identified contributing factor in the 81 fetal and infant death cases. Pre-pregnancy conditions like diabetes, hypertension and asthma were identified in more than half of the cases (56 percent) while 93 percent of the cases included medical conditions during pregnancy, like STDs and other infections, placental abruption and premature rupture of membranes. Life course issues like poverty, abuse and lack of support, that can impact a pregnancy were found in a third of the cases.
FIMR’s 2013-2014 recommendations are:
- Continue to focus on preventing sleep-related deaths. The number of sleep-related deaths has increased over the last three years. The number of deaths for years 2011, 2012 and 2013 were 14, 21 and 26 respectively. When compared to all causes of death in infants for years 2011, 2012 and 2013, this represents 13 percent, 16.5 percent and 18.4 percent, respectively. Education should focus on babies sleeping alone on a safe sleep surface.
- Continue to focus on dangers of smoking during pregnancy. The Community Action Team’s “Don’t Blow Smoke” campaign is gaining momentum. Phase I (target area-Health Zone 1) and Phase 2 (social media and expansion outside the target area to include the 32218 and 32244 zip codes) have been implemented. The percentage of moms in the death cohort that self-reported tobacco use was 12 percent in 2012. It rose to 15 percent in 2013. Self-reported tobacco use in the 2013 birth cohort is 6.9 percent.
The Community Action Team (CAT) works to implement the FIMR recommendations. The Team held an anti-smoking video contest as part of the second phase of their “Don’t Blow Smoke” campaign, which was developed from the FIMR recommendations. Teens submitted their entries and a winner was selected in March 2014. Other activities from the past year include a focus on long-acting reversible contraception (LARC) at the Magnolia Project, the Coalition’s federal Healthy Start program.
In addition to the two FIMR recommendations, the Coalition also chose to continue and expand LARC promotion and education due to the high rate of unplanned pregnancies. A subcommittee of Coalition members was formed to work in conjunction with the CAT team.