Community-wide approach is effective at reducing infant mortality in central Ohio

The infant mortality rate has dropped in Franklin County since 2017, a sign that hospital and agency partnerships across the community have been effective in addressing issues that put babies at risk, two physicians recently told The Ohio State University Wexner Medical Center Board.

The infant mortality rate, measuring the number of deaths per 1,000 births in the first year of life, decreased from 8.2 to 5.9 between 2017 and to date in 2019, said Mark Landon, chair of obstetrics and gynecology at Ohio State.

At Wexner Medical Center specifically, the infant mortality rate among babies from Franklin County born at Ohio State dropped from 14 to 6 deaths per 1,000 births between 2011 and 2017.

Landon and Cynthia Shellhaas, a professor of obstetrics and gynecology and specialist in maternal fetal medicine, presented to the board about Ohio State Wexner Medical Center’s role in comprehensive local efforts to reduce infant mortality.

Ohio’s infant mortality rate has historically exceeded the national average, which is higher than the rate of most industrialized countries. In 2017, the Centers for Disease Control and Prevention reported the national average at 5.8 deaths per thousand.

“Most disturbing is the two- to threefold increased rate of infant mortality in babies of African American women,” Landon said of the Ohio statistics. “It is now well accepted that this racial disparity can be largely explained by social determinants of health, including housing and food concerns as well as overall poverty and inherent stress.”

Preterm birth is the primary cause of infant mortality, accounting for almost one-third of baby deaths.

“Our efforts are in fact translating into improved outcomes, particularly with respect to preterm birth prevention and hence infant mortality,” Landon said, noting that Ohio State cares for the majority of women with at-risk pregnancies in central Ohio. “You can see the substantial decline in infant mortality at OSU over time, which follows the declining rate of preterm delivery seen in our population.”

Shellhaas said Ohio State clinician scientists, and particularly Professor Emeritus Jay Iams, have led prematurity-related research for over three decades.

“We continue to actively engage in research initiatives, looking at future solutions for prematurity,” she said. “Our clinical efforts have been central to combating prematurity and infant mortality. We have been an early adopter of new clinical strategies, converting research into practice.”

Such practices include two evidence-based prevention strategies: progesterone therapy to prevent spontaneous prematurity and cervical length screenings, which were identified as a risk assessment for prematurity. Wexner Medical Center also operates specialty programs for at-risk women and clinics emphasizing prematurity prevention and treatment for women addicted to opioids.

“Most importantly, we have standardized our approach for common clinical problems among multiple providers so that we can provide consistent evidence-based care to women,” Shellhaas said.

The medical center’s community-based initiatives include multiple clinical programs at University East Hospital, located in a high-risk neighborhood, and a planned expansion of services with the use of a mobile community care coach that will improve patient access to care. Moms2B, which educates and supports new parents, was founded and is directed by Pat Gabbe, clinical professor of pediatrics at Ohio State. The program holds weekly sessions in eight high-risk Columbus neighborhoods and has served 2,500 women to date.