FRANKFORT — The number of Kentucky infants who died last year declined to its lowest rate ever, and officials cite better prenatal care as one reason.

        The infant mortality rate has dropped over the past decade from an average of 9.2 deaths per 1,000 births in 1991 to 6.9 last year, according to preliminary numbers from the state Department for Public Health.

        The rate is the lowest since Kentucky began collecting infant mortality data in 1978.

        At the same time, however, health officials said the rate would be lower if they could reduce the number of babies born at what's considered a low birth weight — 5.5 pounds or less. Such babies are at greater risk of dying or having health or developmental problems.

        The lower infant mortality rating puts Kentucky — which typically has ranked in the bottom half of the states — at the national average, according to preliminary figures released in October by the federal Centers for Disease Control and Prevention. Last year, 54,723 babies were born in Ken tucky and 375 died at birth or in their first year compared with 1991, when 472 of 51,243 babies died.

        Public health officials consider infant mortality to be a key indicator of how well a state is doing in caring for pregnant women and babies.

        “We've got some very good things to report on infant mortality,” said Dr. Steve Davis, director of adult and child health for the state Health Department. “But that's not to leave the message there's not still work to be done.”

        Though the state's overall low-birth-weight rate decreased slightly last year — dropping from 82.3 per 1,000 births in 1999 to 81.8 in 2000 — the rate increased for babies who were not born prematurely.

        That's a concern, Dr. Davis said, because underweight, full-term babies often result from a mother's poor health or behavior — such as use of tobacco, alcohol or other drugs.

        “We have to continue to improve on getting pregnant moms to stop the use of tobacco and alcohol,” said Dr. Davis.

        Dr. Tom Young, a Lexington pediatrician active in children's health issues, said he's heartened by the decrease in infant deaths.

        “Obviously, that's a good sign,” he said. Dr. Young said he thinks it's because Kentucky has made great strides in providing prenatal care.

        But Dr. Young said he, too, is concerned about the rate of low-birth-weight babies.

        “Until we get that down we are going to have a hard time making a major impact on the infant mortality rate,” he said.

        Dr. Davis said he thinks educational efforts will help improve the health of mothers and babies.

        New mother Renee Halsell, 19, of Louisville, said she learned important information from a Jefferson County Health Department nurse who visited her. The nurse was provided through Passport, which oversees health care for Medicaid recipients in that region.

        “At first I was a little dubious about someone coming to my house,” Ms. Halsell said. Ms. Hal sell said she didn't smoke or drink alcohol but had one vice — soft drinks.

        “I'm a pop addict,” she said.

        But, based on nutritional information her nurse provided, Ms. Halsell cut back on soft drinks and the “little goodies” such as snack foods,and adopted a more balanced diet.

        And on Sept. 9, her healthy, 6-pound, 14-ounce son, Camren, was born.

        Passport, which oversees Medicaid care in Jefferson and 15 surrounding counties, also has seen a decline in infant mortality in its region.

        The 16 counties accounted for nearly 30 percent of the state's births last year.

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