The majority of deaths were due to respiratory infection (n=15) or Haemophilus influenzae infection (type a or b; n=6). N Engl J Med. 2004, 63: 251-266. At this time we cannot rule out or confirm an associated risk with the P479L allele given our small numbers. On-going research will address this limitation. endstream endobj 427 0 obj [/ICCBased 428 0 R] endobj 428 0 obj <>stream Muggah E, Way D, Muirhead M, Baskerville B: Preterm delivery among Inuit women in the Baffin Region of the Canadian Arctic. © 2021 BioMed Central Ltd unless otherwise stated. BMC Pediatrics Google Scholar. Collins, S.A., Surmala, P., Osborne, G. et al. SIDS is a diagnosis of exclusion where the cause of death remains unexplained after a thorough investigation, including a complete autopsy, examination of the death scene, and review of clinical history . Crude national infant and postneonatal mortality rates were calculated with available 1998–2007 data, and crude national cause-specific mortality rates were calculated with available 2003–2007 data. Nunavut has the largest Inuit population in Canada, a population which has been identified as having high rates of Sudden Infant Death Syndrome (SIDS) and infant deaths due to infections. Our review suggests an overall crude infant mortality rate slightly lower than reported previously, likely due to under ascertainment of neonatal deaths. Indigenous populations worldwide experience infant and postneonatal mortality rates that are substantially higher than national averages [10, 32–34]. On-going assessment of the multiple risk factors involved in infant mortality will inform public health policy and prevention. 0000073269 00000 n Infection was the second leading cause of infant mortality during the review period, and had a cause specific mortality rate of 2.71/1,000 live births. Eighteen of the 35 identified cases had been previously genotyped during routine newborn screening as part of that pilot project. 2010, 126: 945-951. Google Scholar. CAS Gestational age at birth was available for 41 cases, 14 (25%) were born premature (<37 completed weeks of gestation). Article U�F�����%8r�<23S�mU#��:Ю! Given the high frequency of the variant in Inuit populations pointing to an historical advantage, the current clinical significance of the variant remains unclear. PubMed At 15.1 deaths per 1,000 live births, Nunavut's infant mortality rate is double Greenland's - and nearly four times the Canadian average. Although our data are limited, our results are consistent with other studies that suggest bed-sharing with additional risk factors present increases risk for SIDS/SUDI [18, 19]. 2009, 50: 1223-1228. The baby box is a concept borrowed from Finland, where it originated in 1939. PubMed 2007, 151: 450-456.e1. 0000004296 00000 n RESULTS: The infant mortality rate was 32.3/1,000 live births, five times Canada's rate. Infants in Nunavut have the highest reported rate of hospitalisation for lower respiratory tract infections worldwide, with an average of 306-484/1,000 infants [36, 37]. Bonnefont J-P, Demaugre F, Prip-Buus C, Saudubray JM, Brivet M, Abadi N, Thuillier L: Carnitine palmitoyltransferase deficiencies. Pediatrics. Arbour L, Gilpin C, Millor-Roy V, Platt R, Pekeles G, Egeland GM, Hodgins S, Eydoux P: Heart defects and other malformations in the Inuit in Canada: a baseline study. 0000075349 00000 n Int J Circumpolar Health. All authors read and approved the final manuscript. 10.1016/j.ymgme.2010.07.013. CPT1A P479L homozygosity, which has been previously associated with infant mortality in Alaska Native and British Columbia First Nations populations, was associated with unexpected infant death (SIDS/SUDI, infection) throughout Nunavut (OR:3.43, 95% CI:1.30-11.47). Objectives. A new territorial project is hoping to lower those levels with a box of things every newborn should have.  reported that Sudden Infant Death Syndrome (SIDS) and infection were the leading causes of infant death in Inuit-inhabited regions of Canada between 1990 and 2000. In 2004, the Manitoba Newborn Screening program commenced a pilot CPT1A P479L newborn screening program for infants born to Kivalliq region residents . Why is infant mortality in Nunavut and N.W.T. Although tobacco smoke exposure data were limited in this review, environmental tobacco smoke is reported to be present in ~90% of Nunavut homes, which are small, overcrowded and have low air change rates . Although most infants are born healthy, Nunavut leads the country for adverse early child health outcomes such as infant mortality, rates of birth defects, prematurity and low birth weight. 0000074299 00000 n 0000003808 00000 n Nunavut’s infant mortality rate is nearly five times higher than the national average. Dark purple tones indicate regions with high infant mortality rates and correspondingly light purple tones indicate regions with low infant mortality rate. Peters S, Cowan J, Osborne G, Sobol I, Arbour L: Rates of hospitalization for lung infection of Inuit infants from the Baffin Region and association with heart defects 2000–2005. Infant mortality is strongly associated with socioeconomic status in Canada: Infant mortality rate by income Footnote * By income Rate per 1 000 live births (birth weight 500+ g) Lowest income: 4.7 : 0000074459 00000 n To determine the causes and potential risk factors of infant mortality in Nunavut, we reviewed all infant deaths (<1yr) documented by the Nunavut Chief Coroner’s Office and the Nunavut Bureau of Statistics (n=117; 1999–2011). In Chukotka (Russian Federation) and Nunavut (Canada) the infant mortality was notably higher than the overall Arctic average: about 20 infant deaths per 1 000 live births. Carnitine palmitoyltransferase 1 deficiency, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510001&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www12.statcan.ca/census-recensement/2006/as-sa/97-558/index-eng.cfm?CFID=78991&CFTOKEN=71134813, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1020507&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024304&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024501&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.phac-aspc.gc.ca/rhs-ssg/survey-eng.php, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510054&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.phac-aspc.gc.ca/rhs-ssg/phi-isp-2011-eng.php, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024512&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.phac-aspc.gc.ca/publicat/2008/cphr-rspc/index-eng.php, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510053&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.biomedcentral.com/1471-2431/12/190/prepub. Finland’s infant mortality rate was 90 in 1,000 live births, and has seen a dramatic drop to less than two in 1,000 births due to its famous Finnish Maternity Package (baby boxes). 0000069169 00000 n To study the Inuit infant mortality rate, University of Montreal researcher Dr. Zhong-Cheng Luo looked at all four million births in Canada between 1990 and 2000. %%EOF 0000070265 00000 n While the infant mortality rate in Canada has improved over the past few decades, this improvement is not equally distributed. Kovesi TA, Cao Z, Osborne G, Egeland GM: Severe early lower respiratory tract infection is associated with subsequent respiratory morbidity in preschool Inuit children in Nunavut, Canada. Clin Chem. Google Scholar, Statistics Canada: Table 102–4304 - Birth-related indicators (low and high birth weight, small and large for gestational age, pre-term births), by sex, three-year average, Canada, provinces, territories, census metropolitan areas and metropolitan influence zones, occasional (number unless otherwise noted), CANSIM (database). Some information on sleep environment at time of death was available for 52 of the 56 SIDS/SUDI cases. PubMed Central 0000070797 00000 n 0000069340 00000 n Information on maternal and household characteristics, including parity, maternal age, maternal education, household income and food security, were very limited or not available for this review. Of SIDS/SUDI cases with information on sleep position (n=42) and bed-sharing (n=47), 29 (69%) were sleeping non-supine and 33 (70%) were bed-sharing. However, postneonatal mortality rates were consistent with or higher than previous reports [3, 10]. J Pediatr. Nunavut’s infant mortality rate is nearly five times higher than the national average. 2008, Toronto: University of Toronto Press, 39-52. Reducing infant mortality is a primary goal of the 2008–2013 Government of Nunavut Public Health Strategy, Developing Healthy Communities. Reducing the risk from one factor may decrease the overall risk of SIDS. The northern territory Nunavut has Canada’s largest jurisdictional land mass with 33,322 inhabitants, of which 85% self-identify as Inuit. Although prenatal maternal smoking was not well documented in the data available for this review, in other studies 60-80% of Nunavut women self-reported smoking during pregnancy, almost 5 times the national average of 13% [43, 44]. The baby box is a concept borrowed from Finland, where it originated in 1939. A Review of Aboriginal Infant Mortality Rates in Canada: Striking and Persistent 0000146010 00000 n Two-tailed p values <0.05 were considered significant. Two Haemophilus influenzae cases had a respiratory component. Mol Genet Metab. 2012, 53: 175-184. 2008, Iqaluit,Nunavut: Government of Nunavut, 2008-2013. Nunavut’s infant mortality rate is nearly five times higher than the national average. 0000088102 00000 n The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. The significantly lower P479L homozygosity in the Qikiqtani region may be due to admixture and/or a higher rate of non-Inuit immigration from other regions and provinces. 0000003772 00000 n National comparison data for infant deaths (1998–2007) were obtained from the Public Health Agency of Canada 2011 Perinatal Health Indicators for Canada report . † 6 of Inuit adults in Inuit 3% Nun angat smoke daily 6 1 of all adults in Canada 6% smo ke daily 2 the growth rate of the Inuit 9% populat ion in Canada from 2006 to 20161 1 the growth rate of the total 1% Nunavut is the most northerly jurisdiction in Canada of which 85% of inhabitants are Inuit. Cases were grouped into one of four major cause of death categories; SIDS/SUDI, infection (respiratory, H influenza or other), congenital anomaly or other. Cause of death was documented for 95 cases. Placing infants to sleep on their backs (supine) has substantially reduced SIDS worldwide, apparently over-riding inherent risk factors and reducing risk of asphyxia [13, 14]. J Asthma. The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. 10.1001/archpedi.161.3.237. Terms and Conditions, Premature infants comprised at least 25% of the infant mortality cases in this review. 10.1194/jlr.P900001-JLR200. 0000072444 00000 n 2012, [http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024512&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=]. This initiative is being introduced as a way to combat Nunavut’s high infant mortality rates. J Lipid Res. https://doi.org/10.1186/1471-2431-12-190, DOI: https://doi.org/10.1186/1471-2431-12-190. Egeland GM, Pacey A, Cao Z, Sobol I: Food insecurity among Inuit preschoolers: Nunavut Inuit child health survey, 2007–2008. Combined, SIDS and SUDI (SIDS/SUDI) comprised the majority of cases (48%). 10.3109/02770903.2011.560320. CMAJ. 0000074220 00000 n 0000080847 00000 n 2004, 63 (Suppl 2): 242-247. Unexpected infant deaths comprise the majority of infant deaths in Nunavut. 2011, [http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024501&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=]. Nunavut’s infant mortality rate is nearly five times higher than the national average. Although most infants are born healthy, Nunavut leads the country for adverse early child health outcomes such as infant mortality, rates of birth defects, prematurity and low birth weight.
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