1. Unit 2: Infant Mortality: Leading Causes

2. 2011: Infant mortality 6.05/1000 births 2006: Infant mortality rate: 6.69/1000 births The good news: Infant mortality rates are improving

3. Recent Trend in Infant Mortality, United States

5. Source: State Center for Health Statistics

6. In 2005, the US ranked 30 th in infant mortality.

7. DISPARITY: (dis-par-i-ty) literally means inequality. In health, for example, it can refer to an inequality of access to and quality of health care among people of different races or ethnicities or people living in different geographical areas.

8. There are two major DISPARITIES recognized in Infant Mortality Geographical Race/Ethnicity The two often co-occur Look at the maps and charts that follow to better understand disparities in infant mortality.

9. Recent Trend in Infant Mortality, United States 2011

10. Recent Trend in Infant Mortality, U.S. Percent Change 2005 - 2010

11. Infant Mortality Rates by race and ethnicity

12. Infant Mortality Rates by race and ethnicity % change 2005 - 2011

13. Top 5 causes of infant mortality

14. Low Birth Weight Defined Low Birth Weight - infants completing 37 weeks gestation and weighing less than 2500 grams at birth. Very Low Birth Weight - infants completing 37 weeks gestation and weighing less than 1500 grams at birth.

15. Low Birth Weight, U. S less than 2500 grams (5 1/2 pounds).

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17. Preterm Birth Rates as a Function of Maternal Age

18. Preterm Birth Rates as a Function of Race of Mother

20. Birth Defect An abnormality of structure, function or body chemistry, whether genetically determined or the result of environmental interference. It may to present at birth or appear later in life.

21. Overview of birth defects 1 in 33 babies are born with birth defects Malformations or genetic abnormalities cause 7-20% of stillbirths Chromosomal abnormalities cause up to 70% of first-trimester miscarriages and 20% of second-trimester miscarriages 10,500 deaths per year 30% of all pediatric admissions

22. Major factors responsible for birth defects Chromosomal abnormalities - either number or alignment Abnormalities of individual genes - truly inherited, includes blood disorders and in-born errors of metabolism Intrauterine injury - caused by a teratogenic agent, naturally occurring or environmentally induced Multifactorial circumstances - environmental factors acting on a genetically predisposed embryo

23. What are chromosomes? Chromosomes are tiny string-like structures in cells of the body. Composed of coiled DNA that contains the estimated 20,000 to 25,000 human gene pairs that determine traits like eye and hair color, as well as direct the growth and development of every part of our physical and biochemical systems. Each person normally has 23 pairs of chromosomes, or 46 in all. We normally inherit one chromosome per pair from our mother and one from our father.

24. Where are Genes?

25. What are genes? A sequence of nitrogen bases within the DNA strands. Basic unit of inheritance. Determines both the structure and function of the organism.

26. Allele: one member of a pair of genes (small pieces of DNA) located at a specific spot on a chromosome. We inherit two alleles for each gene: one from each parent The expression of traits is associated with alleles GENES

27. Protein Construction Four nitrogen bases code for the construction of all proteins in the cytoplasm of the cell. In order for the codes to be made operational, several steps occur: 1.Transcription of mRNA by DNA in cell nucleus 2.mRNA moves to cytoplasm to direct protein synthesis 3.tRNA brings AA’s for placement in protein chain (Translation) Four nitrogen bases code for the construction of all proteins in the cytoplasm of the cell. In order for the codes to be made operational, several steps occur: 1.Transcription of mRNA by DNA in cell nucleus 2.mRNA moves to cytoplasm to direct protein synthesis 3.tRNA brings AA’s for placement in protein chain (Translation)

28. Dominant: Recessive Co-dominate Sex-linked Some genetic disorders caused by genetic mutations One mutated copy of gene is all that is needed to affect someone. Two mutated copies of gene needed to affect someone X-linked: genes on X chromosome Two different versions of gene expressed as in the AB blood type (this is not a disorder)