Premature births, especially among African-Americans, are the biggest cause of higher-than-average infant mortality rates in Hamilton County, according to a study of child fatalities released Thursday.

        Experts are struggling to explain why the rates are so high.

CHILD DEATHS

Leading causes of childhood deaths in Hamilton County:     Natural causes* ....... 95     Unintended injury ....... 13     Homicide ....... 10     SIDS ....... 5     Unknown cause ....... 2     Suicide ....... 1     Total ....... 126     *Includes premature birth, birth defects and other medical conditions. Breakdown of natural causes:     Premature birth ....... 58     Birth defects ....... 15     Medical disorders ....... 11     Other medical ....... 5     Infection ....... 4     Cancer ....... 1     Genetic disorders ....... 1     Total ....... 95     Source: Hamilton County Child Fatality Review Team

        Last year, 126 childrendied in Hamilton County, down 13 percent from 2000 and the lowest number of deaths since the report began six years ago, according to the Hamilton County Child Fatality Review Team.

        However, the county infant and child death rates still eclipse state averages. Almost 55 percent of the child deaths in 2001 occurred among African-Americans, a rate that remains at a six-year high.

        “These alarming statistics continue to puzzle and confound social service and health care agencies who have provided a variety of programs over the years to impact this serious public health problem to little avail,” the report states.

        The report states that 95 of the 126 deaths, about 75 percent, were from “natural causes,” including premature births, birth defects, infections and disease.

        Of the rest, 13 died from unintended injuries, 10 were victims of homicide, five died of Sudden Infant Death Syndrome, two died of unknown causes and one committed suicide.

        Of the 95 “natural” deaths, 58 were babies who died from prematurity — the babies typically weighed less than two pounds. nderdevel The sheer number of premature baby deaths strongly influences the county's childhood death report.

        For example, in Hamilton County, 10.8 of every 1,000 babies per year die within 27 days of birth. That's nearly twice as high as the statewide death rate of 5.6 deaths per 1,000 births.

        Experts believe many premature births can be prevented, but there isn't a clear consensus about how, said Judith Daniels, medical director of the Cincinnati Health Department and a member of the county child fatality review team.

        “For so long now, we tied the risk of low-birth-weight babies to teen pregnancy and lack of prenatal care. Now, we're finding that may not be the case,” Dr. Daniels said.

        Young mothers in Hamilton County were the least likely to have babies dying from prematurity. In fact, the highest death rates from prematurity occurred among babies born to mothers above age 30, the report states.

        Regardless of the age of the mother, 55 percent of premature infant deaths occurred among African-Americans.

        Several factors appear to be at work, Dr. Daniels said. Much of the premature birth risk may be tied to unhealthy conditions and personal behaviors that can occur among poor people — poor nutrition, drug, alcohol and tobacco use, domestic violence.

        Some of the risk of premature birth may be attributed to women choosing to delay childbirth. Women in their mid-30s are more likely to suffer miscarriages or deliver unhealthy babies, Dr. Daniels said.
       

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