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Categories of Infant Mortality

1. Perinatal mortality is late fetal death 22 weeks after pregnancy, or death of a newborn up to one week postpartum.

2. Neonatal mortality is newborn death occurring within 28 days postpartum. Neonatal death is often attributed to inadequate access to basic medical care during pregnancy and after delivery.

3. Post neonatal mortality is the death of children aged 29 days to one year. The major contributors to postneonatal death are malnutrition, infectious disease, and poor environment. The leading causes of infant mortality in Canada are congenital malformations, chromosomal malformations, low birth weight and maternal complications during pregnancy.

While these types of infant mortality are more rare in Canada, levels of education, isolation, and medical infrastructure are all contributors to infant mortality. Throughout the 20th century,the Canadian infant mortality rate has consistently dropped. The decline in infant mortality is due to more advanced medical facilities, access to education, as well as better medical treatment and technology for infants. .

Infant Mortality in Canada

Although Canada is considered an industrialized nation, it has a higher infant mortality rate compared to its peer nations. Countries such as Japan, Sweden, Finland, and Norway all have three-year average infant mortality rates of under 3 deaths per 1,000 live births, significantly better than Canada. Moreover, within Canada, not all Provinces scored equally. British Columbia and Prince Edward Island scored the highest with a “B” grade while Alberta and Saskatchewan scored lowest with a D and D-. P.E.I. and B.C. are the only provinces that rank on par with most of Canada’s international peers, as average infant mortality rates in both provinces are 3.7 deaths per 1,000 live births. Both provinces score “B” grades. Overall, Canada’s average infant mortality rate of 4.9 is significantly higher than the three-year average of other industrialized countries. Canada earns a “C” as a whole on this indicator. N.W.T. and Nunavut scored “D-” grades for infant mortality. A significant reason for Canada's infant mortality is how good Canada's medical facilities are. Infants born underweight often perish. However, the majority are brought to term, but some die due to health complications.

First Nations and Infant Mortality

Canada's First Nations population, particularly the Inuit, have a higher infant mortality rate than the rest of the population.The discrepancy is well known, though little has been done about it. These studies do not distinguish First Nations who live on on reserves. It is important to identify those who live on reservations, as their socioeconomic situation is often significantly worse. In addition, they are managed under a different healthcare system from the rest of the population. Health Canada manages and provides funding for reserves around the country while the rest of Canada’s healthcare is handled provincially. Studies done by Health Canada have shown that infant mortality rates were 1.47 to 1.8 times higher in First Nations communities, resulting in 10.1 and 7.3 infant deaths per 1000 live births. The numbers were even greater for the Inuit at 2.37 and 4.46 times higher--16.3 and 18.1 per 1000 relative to non first nations. births. Compared to non-Aboriginal births, preterm birth rates were consistently 1.7–1.8 times higher in Inuit, large-for-gestational-age birth rates were consistently 2.7–3.0 times higher in First Nations births during the same time period. Between 1996–2000 and 2006–2010, as compared to non-Aboriginal infants, the risk disparities increased for infant mortality from 4.10 to 5.19 times for the Inuit, and for post neonatal mortality in Inuit from 6.97 to 12.33 times or First Nations from 3.76 to 4.25 times infants. Adjusting for maternal socioeconomic status, age, marital status, parity, education and rural vs urban residence helps quantify the risk differences. Regardless, significantly greater infant mortality rates remain for both Inuit and First Nations to this day. Nunavut, Canada’s most isolated province primarily made up of Inuit people has the highest infant mortality rate of any province by far at 16.1 per thousand births in 2008. By 2011, that number had grown to 28.7 per thousand births. This means that Nunavut has consistently had at least four times the infant mortality rate of the rest of Canada. The isolation of Nunavut is one of the biggest reasons for this, as it is difficult to maintain sufficient medical facilities. Of course socioeconomic status, age and other variables are still factors

Causes of Infant Mortality

Perinatal Mortality

Perinatal mortality refers to the death of a fetus of neonate and is the bases to calculate the perinatal mortality rate, or PNM. Variations in the precise definition of the perinatal mortality exist specifically concerning the issue of inclusion or exclusion of early fetal and late neonatal fatalities. The World Health Organization defines perinatal mortality as the "number of stillbirths and deaths in the first week of life per 1,000 live births, the perinatal period commences at 22 completed weeks 154 days of gestation and ends seven completed days after birth" In Canada, this is the primary cause of infant mortality. It killed 292.7 children per 100,000 births in 2008 in Canada.

Congenital Anomalies

The second largest cause of infant mortality are congenital anomalies. Summary results of the report show that approximately 1 in 25 babies born in Canada is diagnosed with one or more congenital anomalies every year. Their overall national birth prevalence rate between 1998 and 2009 has decreased from 451 to 385 per 10,000 births. This is likely due to a number of factors involving: increased prenatal diagnosis and subsequent pregnancy termination; implemented measures such as mandatory stomach acid fortification in food; and changes in health behaviors and practices to reduce the risk for some congenital anomalies such as tobacco smoking and multivitamin use. Despite children dying from these conditions, it is still treated often. However, it kills 111 children per 100,000 live births in Canada.

Sudden Infant Death Syndrome

Sudden infant death syndrome (SIDS) is the 3rd largest cause of infant mortality in Canada. SIDS (also known as cot death or crib death) is the sudden unexplained death of a child less than one year of age. Diagnosis requires that the death remains unexplained even after a thorough autopsy and detailed death scene investigation. SIDS usually occurs during sleep. Typically, death occurs between the hours of 00:00 and 09:00. There is usually no evidence of struggle and no noise produced. In Canada, it killed 107 children per every 100,000 live births.

The cause of SIDS is unknown. The requirement of a combination of factors including a specific susceptibility, a specific time in development and an environmental stress have been proposed. While nobody knows what specifically causes SIDS, there is some evidence that cigarette smoke or other environmental factors may play a role. with other causes including infections, genetic disorders, and heart problems. While child abuse in the form of intentional suffocation may be misdiagnosed as SIDS, this is believed to make up less than 5% of cases

Other causes prevalent in Canada include nervous system diseases at 41 per 100,000 live births. Circulatory system diseases that kills around 36 children per 100,000 live births and infectious/ parasitic disease that kill 32 children per every 100,000 live births. However, these are significantly smaller in number compared to the first three