By Fallan Patterson

Staff Writer

A lower percentage of infants died before their first birthday in Osceola County in 2009 than in any of the past five years, according to the latest data released by the Florida Department of Health and the Healthy Start Coalition of Osceola County.

The county’s infant mortality rate has dropped to 6.2, its lowest rate in five years. The rate is slightly lower than the state’s rate of 6.9. The numbers are determined by the deaths of infants before their first birthday and infant deaths per 1,000 births.

The county’s fetal deaths (stillbirths) also declined to a 5.7 rate, which is lower than the state rate of seven fetal deaths per 1,000 live births.

Although infant deaths as a whole have decreased, African-American infant deaths have increased. The African-American infant mortality rate for Osceola County was 16.7; more than the 12.1 rate throughout the state.

While every woman, infant and birth is different, the Florida Department of Health outlines several risk factors that may contribute to the high infant mortality rate among African-American babies.

These factors include African-American women who enter into prenatal care later than women of other races; a lack of transportation to prenatal doctor appointments; poor nutrition; a lack of a support system in family and friends; and a higher likelihood of having a poor birth experience.

However, despite ongoing national research, Linda Clarke, registered nurse and infant mortality rate facilitator at the Health Department, said some factors of fetal deaths in African-American infants remain unknown.

“There isn’t any data that supports any one factor,” she said “According to ongoing research by (the University of California Los Angeles), even after accounting for multiple risk factors such as genetics, behavior, access to prenatal care, socioeconomic issues, stress and infection, still 90 percent of the racial and ethnic disparities is unexplained.”

According to Patty McWhirter, executive director of the coalition, infant deaths are mostly caused by maternal health before pregnancy, including lifestyle choices, such as smoking.

“It is a challenge to influence the mother’s health since we do not see a woman until she is pregnant,” she said. “That is why our continuing education and connection to timely health care and other resources for residents is very important.”

Other factors that can cause infant death are birth defects, lack of prenatal and infant care, infections and premature birth, according to Dr. Mercedes Rodriguez, medical executive director for the Heath Department.

According to the data released, nearly 73 percent of Osceola County infants who died were born at less than 29 weeks gestation (full term is 40 weeks) and weighed less than 3.3 pounds. Premature birth is considered any baby born before 37 weeks gestation, defined by the U.S. National Library of Medicine.

Clarke stated premature birth can be caused by a variety of factors including tobacco and drug use, being very overweight or underweight, having poor dental heath or untreated health issues, such as sexually transmitted disease, asthma, diabetes and high blood pressure.

Clarke is part of the Fetal and Infant Mortality Review team at the Health Department, which formed in 2008 after a spike in infant deaths in the county. The team looks at each infant death closely to determine the cause.

“Prematurity is the major contributing factor to infant deaths in our county,” Clarke said. “Our task as a community is to make women aware how vitally important it is to adopt a healthy lifestyle and make sure any chronic medical conditions are under control before becoming pregnant.”

More than 1,600 mothers were served by the Healthy Start Coalition of Osceola County for prenatal care in 2009. Momcare, a division of the coalition that helps working pregnant mothers without health insurance who qualify for Medicaid, aided nearly 4,000 women that year.

McWhirter said more than 50 percent of pregnancies are unplanned.

The coalition already does educational outreach at county health fairs and at the county jail; it plans to step up its efforts to also include substance abuse treatment centers.