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Division of Research and Planning

Statewide Infant Mortality Review

What is infant mortality?
Infant mortality is defined as a death occurring during the first year of life. The infant mortality rate is an important health outcome measure. It is often used as a measure of the overall health status of a given population. It reflects the health status of mothers and children, and is also indicative of underlying socioeconomic and racial disparities.

Infant mortality is often subdivided neonatal mortality (death in the first 27 days of life) and post-neonatal mortality (death from 28-365 days).  These subdivisions are useful because the leading causes of neonatal deaths are often different than the leading causes of post-neonatal deaths.  The leading causes of neonatal mortality include: disorders related to short gestation and low birth weight, birth defects, and maternal complications of pregnancy.  The leading causes of post-neonatal mortality include: Sudden Infant Death Syndrome (SIDS), birth defects, and accidents.

What is the South Carolina Statewide Infant Mortality Review?
The Statewide Infant Mortality Review systematically reviews a selection of infant deaths to South Carolina residents on a quarterly basis.  Available data from birth certificates, death certificates, medical records, and coroner’s reports are abstracted, de-identified, and reviewed by a panel with clinical, public health, and data expertise.  Confidentiality of all information is strictly maintained.  This means the names of the mother, provider and institution are removed.  These reviews aim to give an overview of the circumstance surrounding each death to determine whether public health or systems’ problems contributed the death.

How does the Statewide Infant Mortality Review collect and monitor data on infant deaths in South Carolina?
First, birth and deaths certificates are matched for all infant deaths.  The Statewide Infant Mortality Review Coordinator abstracts pertinent data from the certificates onto the abstraction tool.  The case is then directed to staff at appropriate hospitals for abstracting data from medical records onto the abstraction tool.  If necessary, coroners’ reports are requested and abstracted by the Coordinator.  The information on the abstraction tool is then de-identified and summarized for review by the review panel.  The panel reviews the events surrounding every infant death abstracted and makes conclusions and recommendations as it deems appropriate.

What improvements are planned for the Statewide Infant Mortality Review?
There are two major areas of improvement that are currently being pursued.  First, a data system is under development that will streamline the data collection for the Statewide Infant Mortality Review.  Once implemented, the data system will also enable epidemiologic analysis and reporting of the abstracted infant mortality data, making the data collected by the review much more flexible.

Second, currently only selected hospitals participate in the hospital abstraction portion of the Statewide Infant Mortality Review. The needs and options for expanding this portion of the review to additional hospitals are being assessed.