09/05/08 - Smoking while pregnant addressed.
Smoking while pregnant addressed.
Jule Hubbard
Wilkes Journal Patriot
9-5-08
A $27,000 grant has been awarded to the Wilkes Health Department to help reduce infant mortality by addressing the high percentage of Wilkes County women who smoke while pregnant.
The grant will fund efforts to help pregnant women stop smoking over the next three years, said Josh Swift, health promotion coordinator for the health department. It's from the N.C. Health and Wellness Trust Fund, created by the N.C. General Assembly to invest part of North Carolina's share of funds received through settlement of court cases with tobacco industries.
Swift said Wilkes is among four of the state's 100 counties that received the grant, with selection based on the high percentage of women smoking during pregnancy in each county.
Smoking during pregnancy increases risks of pregnancy complications, decreased birth weight and Sudden Infant Death Syndrome. Swift said 167 (or 20 percent) of the 838
Wilkes babies born live in 2007 were to mothers who reported that they smoked while pregnant. Statewide, 12 percent of mothers with live births in 2007 said they smoked while pregnant.
Of the 167 Wilkes women with live births who smoked while pregnant in 2007, 97 percent were white and 3 percent were minorities. That compares to 74 percent white and 26 percent minority statewide, but minorities make up a larger percentage of the total statewide population.
Swift said much of the health department's anti-smoking efforts funded by the grant will be through offices of private physicians because most women in Wilkes get prenatal care there instead of at the health department.
"One of the reasons Wilkes was selected for this pilot project was because the health department has maternal care coordinators (social workers) integrated in the private physician offices," he added. The 838 live births in 2007 in Wilkes were near the annual average of 834 for 2000 to 2007. The highest in that period was 927 in 2007 and the lowest was 758 in 2004.
Wilkes County's infant mortality rate dropped from 8.8 deaths per 1,000 live births in 2006 to 7.2 deaths per 1,000 live births in 2007. The statewide rate was 8.5 deaths per 1,000 live births in 2007, up from a state record low of 8.1 in 2006.
Wilkes had an average of 7.7 deaths per 1,000 live births from 2003 to 2007, compared to 8.4 for the entire state. Average infant mortality rates in adjoining counties for that period included: Yadkin, 9; Watauga, 10.2; Surry, 8; Ashe, 5.8; Alleghany, 12; Iredell, 6.9; and Caldwell, 7.5.
The 130,886 live births in North Carolina in 2007 were the most ever in the state. Of these, 72,359 (55.3 percent) were white non-Hispanic; 30,575 (23.4 percent) were black non-Hispanic; 1,757 (1.3 percent) were American Indian non-Hispanic; 22,104 (16.9 percent) were Hispanic; and 4,091 births (3.1 percent) were among other races/ethnicities.
There were 13.9 minority infant deaths per 1,000 live births statewide in 2007, up from an all time low of 13.6 in 2006. The 2007 white infant mortality rate was 6.3 in 2007 and 6 in 2006.
In 2005-2007, black non-Hispanics had the highest statewide average infant mortality rate at 15 deaths per 1,000 live births, followed by American Indian non-Hispanics (12.3), Hispanics (6.3), and white non-Hispanics (6.2). Other non-Hispanic minorities, as a group, had the lowest overall infant mortality rate (5.9) during that time.
In 2007, prematurity and low birth weight accounted for 18.6 percent of deaths of infants under 1 year old statewide, and for 27.3 percent of the neonatal deaths (infants under 28 days old).
Birth defects were the cause of 18.2 percent of the deaths, and Sudden Infant Death Syndrome (SIDS), accounted for 8.9 percent.
Other causes of death included respiratory problems and other medical conditions, diseases, infections and accidents. Homicide or assault were blamed for 1.1 percent of the deaths.
"Many women of childbearing age in North Carolina are entering pregnancy with risk factors that affect their health as well as the health of their baby," said State Health Director Leah Devlin. "One-fourth of North Carolina women in this age group are obese, almost half don't get the physical activity they need, and another one-fourth use tobacco," said Mrs. Devlin.
"Some women are also affected by high blood pressure, diabetes, mental health issues, or misuse of alcohol or drugs," she said.
"African American women in North Carolina are disproportionately affected by poor health, lack of health insurance, and high rates of poverty," Mrs. Devlin added.
"Unfortunately, one out of four of women of childbearing age in North Carolina does not have health insurance, making access to health care difficult at this important time in their lives," she said. "Without continued care, women who have chronic health problems may not be able to stay healthy. That's not good for their babies, either, and can put their future pregnancies at risk," she said.
"If North Carolina is to reduce infant mortality, we must improve the health and wellbeing of all women of reproductive age," she emphasized.
The Division of Public Health and N.C. Healthy Start Foundation, in partnership with a number of organizations including the March of Dimes, are encouraging women to take advantage of opportunities to improve their health not only during, but also prior to and after pregnancy. The Division is also seeking to expand access to health care and family planning services for women of childbearing age. More information about these efforts can be found at www.mombaby.org.
September is Infant Mortality Awareness Month. Among activities planned to bring attention to this important issue is "Families Focused, Families Empowered...A Healthy Baby Begins With You" on Saturday, Sept. 20, at Halifax Community College in Weldon, which will give area families an opportunity to learn more about the resources in their community, with a specific focus on family wellness.
Overall, infant mortality rates have improved dramatically over the past 30 years in North Carolina, declining 48.8 percent since 1978, when 16.6 out of 1,000 babies died. The rate reached an all-time low of 8.1 infant deaths per 1,000 live births in 2007. However, North Carolina still has one of the nation's higher infant mortality rates. Based on provisional 2004 and 2005 data, the Centers for Disease Control and Prevention (CDC) ranked the state 44th in infant mortality.