Infectious disease mortality among infants in the United States, 1983 through 1987

Objectives. The purpose of this study was to determine the relative importance of infectious disease as a cause of infant mortality in the United States and to identify characteristics at birth associated with subsequent infectious disease mortality. Methods. Birth and infant death certificate data from the National Center for Health Statistics (NCHS) 1983 through 1987 Linked Birth/Infant Death Data Sets were analyzed. Results. Infection was the underlying cause of death for over 16 000 infants, representing the fourth leading cause of mortality in this cohort. Almost 90% of infectious disease deaths during infancy were due to noncongenital infections, and the majority of these deaths occurred during the postneonatal period. Low birthweight, preterm birth, and male gender were independently associated with postneonatal mortality due to noncongenital infection. Conclusions. NCHS should revise its classification system for causes of infant mortality to incorporate an 'Infectious Diseases' category. Future research should be directed toward clarifying the low birthweight-infectious disease mortality relationship and determining the degree to which infection-related infant deaths might be prevented by existing vaccines or improved access to health care.