Premature birth and the changing composition of newborn infectious disease mortality: reconsidering "exogenous" mortality.
Linked death and birth records from San Antonio, Texas revealed that infectious infant mortality is increasingly a function of premature birth and low birth weight. Between 1935 and 1944, 4% of infectious infant deaths had associated causes involving prematurity and related conditions; by 1980, 25% of infectious infant deaths involved prematurity and more than 40% of those infants weighed less than 2,500 grams. The shift in birth-weight composition results almost entirely from an increase in very low-weight births. Under conditions of advanced perinatal technology, infectious infant mortality should no longer be viewed as wholly exogenous. These findings further undermine the contemporary relevance of the exogenous-endogenous distinction.
Sowards
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Department of Sociology, Washington State University, Pullman 99164-4020, USA. sowardsk@vancouver.wsu.edu
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001724:Birth Weight; D002423:Cause of Death; D002648:Child; D003141:Communicable Diseases / Q000401:mortality*; D005260:Female; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007234:Infant, Premature; D008875:Middle Aged; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology