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Infant mortality rate in St. Louis stagnant despite improvements across state, US

According to the new study, a woman's weight before her first pregnancy may have long-term effects.
National Institute of Diabetes and Digestive and Kidney Diseases | National Institutes of Health

The number of infants in Missouri who die in their first year is slowly dropping alongside national numbers, but St. Louis’ infant mortality rate has remained nearly stagnant, according to the Missouri Department of Health and Senior Services.

Between 2005 and 2014, St. Louis County saw a 30 percent reduction in its infant mortality rate, reaching six deaths per 1,000 live births. In St. Louis, the rate was 10.5 deaths per 1,000 live births each year.

A stark disparity emerges in St. Louis when taking into account race and ethnicity: Black infants are almost three times as likely as white infants to never see their first birthday. Statewide, the disparity is 2-1.

“We’re putting the resources and emphasis where they need to be, but we’re nowhere near where we want to be as a region,” said Kendra Copanas, the executive director of a St. Louis initiative to reduce infant mortality called Generate Health.

So, what’s the fix? According to medical providers, it’d be improving the health of women before a pregnancy, as well as prenatal care and contraception.

“I mean it’s a little bit, on the surface, counterintuitive, that access to contraception would improve pregnancy outcomes,” said Dr. Eric Strand, president of the St. Louis Obstetrical and Gynecological Society.

“But if you think about it … they can have good prenatal planning, so they can get pregnant when they want to get pregnant,” he added. “And if they have a medical condition, that we optimize that medical condition before they get pregnant.”


Credit provided by Generate Health
Infant mortality rates in St. Louis, based on data from the Missouri Department of Health and Senior Services.

Generate Health is advocating for the state to extend Medicaid eligibility for pregnant women to up to a year after they give birth. Coverage currently ends at 60 days postpartum, so women with delivery complications may be stuck with high medical bills when they lose coverage.

It’s nowhere near expanding Medicaid through the federal Affordable Care Act, as Copanas had once hoped, but it’s a start.

“We want to see more attention on the health of women, because it does directly contribute to prematurity, low birth weight and infant mortality,” Copanas said. “As well as a woman’s health and wellness throughout the rest of her life.”

The majority of deaths in Missouri were due to rising rates of preterm births and congenital anomalies, while deaths due to Sudden Infant Death Syndrome declined.

The U.S. infant mortality rate is about six deaths per 1,000 live births, according to the U.S. Centers for Disease Control and Prevention. That number places the nation on par with Serbia and the Cayman Islands.

“When you look at our country compared to others, it is woeful,” said Dr. Strand. “And that is really disappointing, for the amount of money that we spend, per capita, on health care.”

Follow Durrie on Twitter: @durrieB.