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Abortion Cited for Lower Infant Mortality in Canada

Women apparently opt for procedure when prenatal diagnosis finds defects, study says

TUESDAY, March 26, 2002 (HealthDayNews) -- Aborting fetuses known to be afflicted with severe defects is apparently a major reason for the recent fall in infant mortality in Canada, according to a new study.

Severe birth defects are the leading cause of infant mortality in the industrialized world. But as parents gain access to increasingly sophisticated diagnostic tests that identify birth defects in the first months of gestation, more women seem to be opting to end those pregnancies early.

The latest study, which appears in the March 27 issue of the Journal of the American Medical Association, has found that a sharp drop in infant mortality in Canada during the mid-1990s closely tracks a rise in these kinds of abortions.

Whether the same holds true in the United States isn't clear. However, abortion is legal in this country, and prenatal screening and diagnostic testing is popular.

While the last two decades have witnessed a dramatic decline in overall infant mortality in the United States, birth defects continue to be the primary cause of death for babies less than a year old. Every year about 150,000 babies -- or one in 28 -- are born in the U.S. with a major birth defect.

These defects, which include devastating anomalies of the heart, spine, and brain, result in about 20 percent of all infant deaths each year. Sudden infant death syndrome (SIDS) is another leading cause of death in babies less than 1 year old, as are breathing disorders, infections and asphyxiation.

The latest study was led by Dr. Shiliang Liu, an epidemiologist with the Center for Healthy Human Development, a division of Health Canada in Ottawa.

Infant mortality in Canada fell from between 6.4 and 6.1 per 1,000 live births between 1991 and 1995 (the rate fluctuated in those years) to 5.5 per 1,000 in 1997. At the same time, the rate of deaths from congenital defects dropped by 21 percent, from 1.86 per 1,000 in 1995 to 1.47 per 1,000 in 1996 and 1997, the researchers said.

Fetal deaths at 20 and 21 weeks of gestation attributed to abortion jumped nearly 580 percent between 1991 and 1998, the researchers found.

The timing of these procedures suggests they were performed for pregnancies marked by congenital defects, though that couldn't be proven definitively from the available data, the researchers said.

"Many of these cases would have ended as late stillbirths or deaths in the first year of life," said Dr. I.D. Rusen, a community medicine specialist at Health Canada, and a co-author of the study.

The figures don't include pregnancies terminated prior to 20 weeks, which make up the bulk of abortions in Canada. Some prenatal tests can tell whether a child has a major congenital defect as early as 15 to 16 weeks into pregnancy.

"First trimester tests are now being piloted in Canada," Rusen added. "In the future the diagnoses will likely become available at an earlier stage of pregnancy."

Abortion foes said that while a lower infant mortality rate was good news, the price for that trend is steep.

"If you factor in the reality of abortion you have the same result: dead babies," said Carroll Rees, executive director of Action Life, an anti-abortion group in Ottawa. "We have still lost a living human being."

What to Do: For more on birth defects, try the March of Dimes. Prenatal tests, including ultrasound and amniocentesis, look for signs of defects. To find out more about these procedures, which are important elements of good prenatal care, visit About.com.

SOURCES: I.D. Rusen, M.D., M.Sc., community medicine specialist, Health Surveillance and Epidemiology Division, Center for Healthy Human Development, Health Canada, Ottawa; Carroll Rees, executive director, Action Life, Ottawa; March 27, 2002 Journal of the American Medical Association
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