Project Impact, the Fetal and Infant Mortality Review Project (FIMR), endeavors to gather detailed information to better understand fetal and infant deaths. This project was developed by the Northeast Florida Healthy Start Coalition with funding from the Florida Department of Health. From 2011 to 2013, 81 cases have been selected to be reviewed by using the American College of Obstetrics and Gynecology’s (ACOG), approach. A multidisciplinary Case Review Team (CRT) is in place to review non-identifying summaries derived from birth, death, medical, hospital and autopsy records. Information from family interviews is also included when appropriate.
In the Five counties that make up northeast Florida (Baker, Clay, Duval, Nassau and St. Johns) the infant mortality rate–when a baby dies before the first birthday–continues to increase. The regional rate of infant mortality, 8 deaths per 1,000 live births, remains higher than the state rate of 6.1 deaths per 1,000 live births in 2013. There were 256 losses in Northeast Florida in 2015–15 fetal deaths or stillbirths and 141 infant deaths.
Among the 81 cases reviewed by the FIMR Case Review Team, maternal health prior and during pregnancy was most frequently identified as a contributing factor. In 93 percent of cases reviewed, medical conditions during pregnancy like STDs, maternal infections, and placental abruption were present. The medical history of the mother was a contributing factor in 79 percent of the cases. Other prevalent contributing factors include family planning issues, inadequate prenatal care, preterm labor, prematurity, maternal infections other than STDs and fetal/infant infection, obesity, life course issues, poverty and substance abuse.
Two community action recommendations have resulted from the work of Project Impact. The first is to continue to focus on preventing sleep-related deaths. The nationwide decline in sleep-related deaths, largely due to educational efforts, is reversing. Locally, twenty-six babies died of Sudden Infant Death Syndrome (SIDS) and suffocation and strangulation both in the bed and in other locations. Statewide, unexplained infant deaths (SUIDs) accounted for 16.3 percent of infant deaths in 2013. That same year Northeast Florida SUIDs accounted for 18.4 of infant deaths. Education that focuses on babies sleeping alone on a safe sleep surface needs to continue. The second recommendation is to communicate the dangers of smoking during pregnancy. Self-reported tobacco use rose from 12 percent in 2012 to 15 percent in 2013. Among the moms that self-reported substance abuse, 90% reported tobacco use. The “Don’t Blow Smoke” campaign, which is focused on Health Zone 1 and zip codes 32218 and 32244, has been implemented and is now in the second phase.
Project Impact’s 2013-2014 Community Report, a publication of the Northeast Florida Healthy Start Coalition, can be found at this link: http://nefhealthystart.org/wordpress/wp-content/uploads/2011/02/Project_Impact_2013-2014.pdf
For more information contact:
Megan Denk, Director, THE PLAYERS Center for Child Health, Wolfson Children's Hospital