Maryland's infant mortality rate dropped to its lowest point in 2009, according to preliminary statistics, but state public health officials say there is still need for improvement.
The overall rate decreased to 7.2 infant deaths per 1,000 live births in Maryland last year, down from 8 in 2008 — a 10 percent decrease. The teen birth rate also decreased, from 2.8 births to women under 18 to 2.6, with declines recorded for black and white women.
"We are so pleased this is showing positive progress," said Frances Phillips, Maryland's deputy secretary for public health. "These numbers are slow to change, and so we're just really pleased with what these indicators are."
However, while the infant mortality rate declined among whites, from 5.1 to 4.1, the rate increased slightly among black families to 13.6 from 13.4 in 2008.
Final numbers will be released in September, Phillips said.
She cautioned that infant mortality rates can vary significantly from year to year and that more work needs to be done, but "we're confident that this reflects progress that we've been working so hard in public health to achieve," she said.
Orin S. Levine, an epidemiologist at the Johns Hopkins University's Bloomberg School of Public Health, said the data showed promise. "It's evident that when we make a concerted effort, we can do better," he said.
But the racial disparities show "we're making some progress, but the progress isn't being equally seen everywhere," he said.
Nationally, the infant mortality rate was 6.8 deaths per 1,000 births in 2007, the most recent number available, according to the National Center for Health Statistics.
Statewide, more women gave birth in 2009 with late or no prenatal care, increasing from 4.3 births per 1,000 to 4.7, according to state statistics. The number of black mothers who received late or no care increased from 6.3 per 1,000 to 7 last year.
The number of low-birthweight babies decreased slightly, from 9.3 per 1,000 to 9.2, but the rate was also down for every racial group.
Phillips said that more babies survived in Frederick, Anne Arundel and Prince George's counties, with significant reductions in the infant mortality rates. But Prince George's, along with Somerset County and Baltimore City, remains a targeted focus for interventions, she said.
Phillips said that state health officials took two public health approaches to address infant mortality. Under the Babies Born Healthy program, they worked to improve communication between doctors and nurses, she said.
They also noticed that at some hospitals, physicians were inducing labor earlier and earlier, for nonmedical reasons — sometimes before 39 weeks. "When you start shaving off days of interuterine development, it starts putting more babies into NICUs [neonatal intensive care units]," she said. "That practice has stopped."
Teams at local health departments now review system reports on every infant death to find trends, Phillips said. As a result, in some jurisdictions, parents are asked in the hospital whether they have a crib. If they don't, they are given one, Phillips said.
In Baltimore, the infant mortality rate was 13.5 for 2009, according to state statistics. More than 20 percent of the 128 infant deaths last year were caused by unsafe sleeping practices — putting children to bed on their stomachs, for example, or on a couch or something other than a crib or a bassinet, said Dr. Jacquelyn Duval-Harvey, deputy commissioner for youth and families.
Although sudden infant death syndrome represents only 8 percent of infant deaths nationally, in Baltimore it's 17 percent, Duval-Harvey said. The city health department plans to launch a "safe sleep" campaign in August to make an immediate impact on these preventable deaths, she said.