A woman’s health prior to pregnancy and unsafe sleep practices are two of the leading factors in the region’s high fetal and infant death rates. These findings and more from the 2014-2015 Fetal and Infant Mortality Review process were released at the October 15 Coalition community meeting.

Also released was the 2014-15 Project IMPACT report, which looks at the status of maternal and child health in Baker, Clay, Duval, Nassau and St. Johns counties.

FIMR’s Case Review Team (CRT) reviewed 28 cases in 2014-15 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.

Maternal conditions prior to pregnancy — like hypertension, diabetes and more — were a contributing factor in nearly 80 percent of the FIMR cases. Obesity was present in nearly 40 percent of the cases, while inadequate nutrition was present in 29 percent of cases.

Maintaining a healthy weight, having a healthy blood pressure and managing or controlling medical conditions are all important for women, whether they are planning on getting pregnant or not. This is especially important, since about half of all pregnancies are not planned. Increasing the use of Long Acting Reversible Contraception (LARC) like the IUD or implant is recommended by the Case Review Team, as these contraceptives are highly effective and can last from three to 10 years.

Sleep-related deaths are a leading cause of postneonatal deaths (from 28 to 364 days of age). These largely preventable deaths account for 16.8 percent  of all infant deaths. Of 24 sudden unexplained infant deaths in 2014, 20 were classified as Sudden Infant Death Syndrome (SIDS). Unsafe sleeping surfaces were found in 13 of those cases.

Based on the infant mortality statistics and the FIMR cases, the Case Review Team developed the following recommendations:

1. Sleep-related deaths declined in 2014, however safe sleep will remain a focus in the upcoming year. A specific focus will be placed on baby sleeping in his or her own bed as well as a sleep environment that is free of hazards such as plush toys, pillows, bumper pads, blankets or comforters.
2. Maternal pre-existing conditions continue to be a factor evident in the reviews. A recommendation is made to approach providers who have contact with women of childbearing age and engage them to participate in a preconception health program to optimize a woman’s health before she comes pregnant. Continue the Preconception Health Care Initiative that the Magnolia Project piloted; use this model to educate providers on the importance of preconception health.

After the recommendations are released, the Community Action Team (CAT) works to implement them. Over the past year, the CAT has implemented a survey are infant sleep practices; began a community LARC discussion group and produced a “Thank my lucky LARCs” educational card; brought the Life Course game into the community to educate on the social determinants of health; and continued an anti-smoking campaign with youth.