title: The contribution of infectious diseases to infant mortality in Alaska.
abstract: BACKGROUND
  Based on death certificates to determine cause of death, current research suggests that infectious diseases are less important causes of infant mortality than in the past.
  
  
  METHODS
  To determine the contribution of infectious diseases to infant mortality and the sensitivity of death certificates for identifying infectious disease causes of death, we examined information from multiple sources for a population-based sample of infant deaths that occurred in Alaska during 1992 through 1994.
  
  
  RESULTS
  We collected information for 181 of 272 reported infant deaths and identified 48 infants for whom an infection was a primary (n = 15), contributing (n = 12) or suspected (n = 21) cause of death (infectious disease-related infant mortality rate, 2.2/1000 live births). Of these 48 deaths 27 were associated with a maternal peripartum infection and 15 were associated with a postneonatal respiratory tract infection. A specific organism was identified for 15 of 29 infants who died during the neonatal period and for 5 of 19 infants who died during the postneonatal period (including 2 with coagulase-negative Staphylococcus and the rest with a variety of other organisms). Death certificates identified an infectious disease as a primary or contributing cause of death for 19 infants (sensitivity, 40%) and reported a specific organism for 4 infants.
  
  
  CONCLUSIONS
  Infectious diseases caused or contributed to a high proportion of infant mortality in Alaska during 1992 through 1994. Death certificates had poor sensitivity for identifying infectious disease-related infant deaths.
authors.affiliation: Alaska Division of Public Health, Section of Maternal, Child, and Family Health, Epidemiology and Evaluation Unit, Anchorage, USA.
authors.forename: B D
authors.initials: BD
authors.lastname: Gessner
authors.forename: T M
authors.initials: TM
authors.lastname: Wickizer
mesh_terms: D000413:Alaska; D003644:Death Certificates; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007239:Infections / Q000401:mortality*