Sleep environment was obtained from death scene investigation report. 0000073269 00000 n Lauson S, McIntosh S, Obed N, Healey G, Asuri S, Osborne G, Arbour L: The development of a comprehensive maternal child health surveillance system for Nunavut-Nutaqqavut (Our Children). CMAJ. Our previously reported data for CPT1A P479L genotypes in infants born to Nunavut residents in 2006 (n=695) were used for comparison [24]. The baby box is a concept borrowed from Finland, where it originated in 1939. BMC Pediatr 12, 190 (2012). 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. Of the 33 cases known to be bed-sharing at time of death, 23 (70%) had two or more additional risk factors present, including non-supine sleep position, sleeping on a soft surface (sofa), bed-sharing with a non-caregiver, and/or smoking or alcohol/illicit drug use by bed-sharer. Crude mortality rates were calculated per 1,000 live births by region and for Nunavut [28, 31]. J Lipid Res. Olpin SE: The metabolic investigation of sudden infant death. StatsCan’s data shows the infant mortality rate in Nunavut has bounced around from 10 to 19.8 per 1,000 live births from 1999 to 2006, the last year such data is available. When available, CPT1A genotype data for the P479L variant was collected for unexpected infant death cases (SIDS/SUDI and death due to infection) where sub-optimal CPT1A function might influence outcome. 0000070797 00000 n Blair PS, Platt MW, Smith IJ, Fleming PJ: Sudden infant death syndrome and sleeping position in pre-term and low birth weight infants: an opportunity for targeted intervention. Overall, infant mortality rates have significantly decreased all over the world. Gessner BD, Gillingham MB, Birch S, Wood T, Koeller DM: Evidence for an association between infant mortality and a carnitine palmitoyltransferase 1A genetic variant. Pediatr Pathol. Kramer MS, Demissie K, Yang H, Platt RW, Sauvé R, Liston R: The contribution of mild and moderate preterm birth to infant mortality. Nunavut's infant mortality rate was calculated as 21.4 per 1,000 live births. The baby box is a concept borrowed from Finland, where it originated in 1939. Nunavut’s infant mortality rate is nearly five times higher than the national average. This initiative is being introduced as a way to combat Nunavut’s high infant mortality rates. Cause specific mortality rates for SIDS/SUDI and respiratory infections were higher in the Kitikmeot region than in the Kivalliq and Qikiqtani regions. 10.1258/0004563041201473. J Pediatr. Due to limited information, risk associated with sleep practices could not be analysed. 2011, Inuit Tapiriit Kanatami (ITK): UBC, Public Health Agency of Canada: What Mothers Say: The Maternity Experiences Survey. startxref H�0 J Pediatr. Collins, S.A., Surmala, P., Osborne, G. et al. 2008, Ottawa, [http://www.phac-aspc.gc.ca/publicat/2008/cphr-rspc/index-eng.php], 2008. Gestational age was available for 75 of the total infant mortality cases, of those, 29 (39%) were born premature (<37 completed weeks of gestation), representing 25% of our total review. 2012, [http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510053&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=]. 0000092932 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). 0000079868 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 [29]. Moon RY, Horne RSC, Hauck FR: Sudden infant death syndrome. 0000085363 00000 n 0000002396 00000 n Mehaffey K, Higginson A, Cowan J, Osborne GM, Arbour LT: Maternal smoking at first prenatal visit as a marker of risk for adverse pregnancy outcomes in the Qikiqtaaluk (Baffin) Region. Cookies policy. Willinger M, James LS, Catz C: Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. 10.1001/archpedi.161.3.237. Int J Circumpolar Health. Correspondence to Variables collected (when available) were: date of birth, date of death, cause of death, gender, gestational age at birth, mother’s place of residence at time of death, CPT1A P479L genotype, and sleep environment (i.e. California Privacy Statement, Given the high frequency of the variant in Inuit populations pointing to an historical advantage, the current clinical significance of the variant remains unclear. P479L homozygosity was associated with unexpected infant death in Nunavut with all regions combined (OR: 3.43, 95%CI: 1.30-11.47; Table 2). trailer 10.1006/mgme.1999.2938. Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System. Infants born premature have a 3–6 times higher risk of mortality than term infants, including higher risks for deaths due to SIDS and infections [41, 42]. 0000088102 00000 n endstream endobj 421 0 obj <> endobj 422 0 obj <> endobj 423 0 obj <> endobj 424 0 obj <>/ExtGState 477 0 R/Font 478 0 R/ProcSet[/PDF/Text]/Properties 479 0 R/XObject<<>>>>/Rotate 0/Thumb 378 0 R/Type/Page>> endobj 425 0 obj <>/Border[0 0 0]/Dest(�� l i n k _ C R 1)/F 4/Rect[209.2539978027 173.3099975586 214.1289978027 183.1179962158]/Subtype/Link/Type/Annot>> endobj 426 0 obj <>/XObject<<>>>>/Subtype/Form/Type/XObject>>stream The infant mortality rates in the Northwest Territories and Nunavut are well above the Canadian average. On-going assessment of the multiple risk factors involved in infant mortality will inform public health policy and prevention. Statistics Canada: Table 051–0054 - Births by census division and sex for the period from July 1 to June 30, based on the Standard Geographical Classification (SGC) 2006, annual (persons), CANSIM (database). 2004, 63 (Suppl 2): 242-247. 0000090651 00000 n 0000120898 00000 n Chace DH, DiPerna JC, Mitchell BL, Sgroi B, Hofman LF, Naylor EW: Electrospray tandem mass spectrometry for analysis of acylcarnitines in dried postmortem blood specimens collected at autopsy from infants with unexplained cause of death. 0000070990 00000 n In this review, Nunavut rates of SIDS/SUDI (6.08/1,000) and infection (2.71/1,000) were significantly higher than national rates (2003–2007) and consistent with those previously reported for Inuit-inhabited regions of Canada (1990–2000) [10]. This may be an important limitation because of the known association with low socioeconomic status and infant mortality [48]. Int J Circumpolar Health. The data released Wednesday show the average Nunavut mother is about 25 years […] 0000090761 00000 n 0000003730 00000 n https://doi.org/10.1186/1471-2431-12-190, DOI: https://doi.org/10.1186/1471-2431-12-190. 1 The infant mortality rate 2.3 per 1,000 for In uit infants in Canada. 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). Nunavut’s infant mortality rate is higher than the national rate of death for Canadians aged 70 to 74, which was 18.5 per 1,000. 0000128046 00000 n Lemas DJ, Wiener HW, O’Brien DM, Hopkins S, Stanhope KL, Havel PJ, Allison DB, Fernandez JR, Tiwari HK, Boyer BB: Genetic polymorphisms in carnitine palmitoyltransferase 1A gene are associated with variation in body composition and fasting lipid traits in Yup’ik Eskimos. 0000075192 00000 n C��;'��� o �9x�z���� ��� �yL ��1x'�_^Z5��-+7�?��H���p·6�6Ʈk�W�{G�w����$Z��a��Nd�W����Ż 2004, 63: 251-266. All SIDS/SUDI cases with CPT1A genotype data (17 P479L homozygous and 5 heterozygous) had other risk factors for sudden death present, including non-supine sleep position and/or bed-sharing at time of death. 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]. The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. Strategies to promote safe sleep practices and further understand other potential risk factors for infant mortality (P479L variant, respiratory illness) are underway with local partners. At this time we cannot rule out or confirm an associated risk with the P479L allele given our small numbers. �=@N�L F���{�xw�칂�"��=YPg 9�G\�-.��m�]��u��!�Q@zȕ���P�[�eeq����]+y�t���غl�Y��[\���\���y��[�������ja����L�H��Ӹ`�K��Q�v����v�f[��#el]��P��\� An estimated 850 infants are born in Nunavut each year, with 90-95% of those being born to Inuit women [2, 5]. Review of sleep environment at time of death showed 70% of SIDS/SUDI cases had two or more sleep-related risk factors present. Ninety per cent of births in Nunavut, Nunavik, Nunatsiavut and the Inuvialuit region of the Northwest Territories during that period were from Inuit mothers. Nunavut is the most northerly jurisdiction in Canada of which 85% of inhabitants are Inuit. Although the P479L variant was associated with unexpected infant death in Nunavut as a whole, the association was less apparent when population stratification was considered. 0000073428 00000 n From 2009–2010, there were 11 cases under age 2 confirmed in Nunavut (G Osborne, personal communication). %%EOF Cases were grouped into one of four major cause of death categories; SIDS/SUDI, infection (respiratory, H influenza or other), congenital anomaly or other. Haemophilus influenzae infection (type a or b) was the cause of death for 6 cases during the review period. 2012, [http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510054&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=], Public Health Agency of Canada: Perinatal Health Indicators for Canada 2011. Article  0000073744 00000 n 0000069900 00000 n 0000071896 00000 n Government of Nunavut Department of Health and Social Services: Developing Healthy Communities: A Public Health Strategy for Nunavut. Age-standardized mortality rates, both overall and cause-specific, were calculated and compared to both Canadian national rates and territorial rates from the same time period. 2007, 151: 450-456.e1. Infant deaths recorded by the Nunavut Bureau of Statistics were also reviewed. PubMed Central  0000003575 00000 n 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. There are 25 communities in the three regions of Nunavut: Qikiqtani, Kivalliq and Kitikmeot. Indoor air quality risk factors for severe lower respiratory tract infections in Inuit infants in Baffin Region, Nunavut: a pilot study. 0000073348 00000 n )� 2010, 126: 945-951. 0000145479 00000 n 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. The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. 2010, 101: 200-204. N Engl J Med. The territory's birth rate is the highest in Canada and about 850 babies are expected to be born in Nunavut in 2016-2017. 0000074459 00000 n Causes and risk factors for infant mortality in Nunavut, Canada 1999–2011. 0000074616 00000 n 0000097146 00000 n 0000078116 00000 n Reducing infant mortality is a primary goal of the 2008–2013 Government of Nunavut Public Health Strategy, Developing Healthy Communities[27]. 0000146783 00000 n Arch Pediatr Adolesc Med. Greenberg CR, Dilling LA, Thompson GR, Seargeant LE, Haworth JC, Phillips S, Chan A, Vallance HD, Waters PJ, Sinclair G, Lillquist Y, Wanders RJA, Olpin SE: The paradox of the carnitine palmitoyltransferase type Ia P479L variant in Canadian Aboriginal populations. 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. The causes of SIDS and SUDI are multi-factorial, due to a combination of environmental, developmental and genetic factors [12–15]. By using this website, you agree to our To date, the P479L variant has only been reported in Indigenous populations [24, 25]. In 2010, we established that the CPT1A P479L variant is highly prevalent in Nunavut; more than 70% of infants born in Kitikmeot and Kivalliq regions of Nunavut were P479L homozygous (n=290; 2006) [24]. 420 105 Approximately 45% of births to Nunavut residents occur out of territory [9]. Infection includes deaths due to respiratory or other infections. 0000093545 00000 n Y�$`%��1�B�}Q�N�3T. Terms and Conditions, [http://www12.statcan.ca/census-recensement/2006/as-sa/97-558/index-eng.cfm?CFID=78991&CFTOKEN=71134813], Statistics Canada: Table 102–0507 - Infant mortality, by age group, Canada, provinces and territories, annual, CANSIM (database). In cultures such as the Inuit culture, where mothers traditionally and continue to prefer to bed-share with infants, advising against bed-sharing under all circumstances may not be easily accepted. A Review of Aboriginal Infant Mortality Rates in Canada: Striking and Persistent BMC Pediatrics 2008, Catalogue no. ! 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]. 10.1542/peds.2011-2924. This is likely an underestimate since the early neonatal deaths occurring out of territory were not available for review. 0000073507 00000 n Google Scholar. Young TK: Health Transitions in Arctic Populations. 0000069340 00000 n Premature infants comprised at least 25% of the infant mortality cases in this review. 0000146660 00000 n Further study, controlling more precisely for population stratification is indicated. Q�D@Z@'f�P؜sa���#|h��-R�M �`3�ȶۗ In 2010, Luo et al. 0 An additional 27 cases were reported to the Nunavut Bureau of Statistics, 7 of which occurred in the territory during the perinatal period (all occurred on the first day of life); the remaining 20 occurred out of territory (Edmonton, Winnipeg and Ottawa). 0000003808 00000 n In keeping with the goal of developing programs to reduce infant mortality in Nunavut, we report the causes and associated risk factors in Nunavut from 1999–2011, using data from the Nunavut Chief Coroner’s Office, Nunavut Bureau of Statistics and Statistics Canada [28]. Ninety infant deaths occurred in Nunavut and were reported to the Chief Coroner. endstream endobj 427 0 obj [/ICCBased 428 0 R] endobj 428 0 obj <>stream PubMed  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]. CPT1A genotypes were available for 35 of the 81 unexpected infant deaths (SIDS/SUDI or infection) during the review period. Guntheroth WG, Spiers PS: The triple risk hypotheses in sudden infant death syndrome. 10.1016/S0140-6736(06)68771-0. Muggah E, Way D, Muirhead M, Baskerville B: Preterm delivery among Inuit women in the Baffin Region of the Canadian Arctic. [email protected] Google Scholar. 2004, 41: 282-293. Nunavut’s infant mortality rate is an average of 4.3 times higher than Canada’s. Article  LA and GO participated in analysis and interpretation of data and revision of the manuscript. 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. College Station, TX). Indoor air.. Smylie, J., Fell, D., & Ohlsson, A. ��I��}L�-}T��(:KV��p�%����NF��a�*��Be���{���{��S_��%��eNVL�W��B?FZE2�CRv!u��z�C��e �]c)Vcw�5�()����l��n�ɭ�k��u��ld V��Ұ����X9���oWZ��sG��L���Q��'�[�m����[㞘^��(Rg�*�r�����������s^�P'٣#Oq|���U�P��ⰶOP|9�1�Q�g=�?��ٷ�S�gQ �X��zRy]��H�K^�R��o;�sX���+"v�h��&�[�E]�(�}3q�������Qm���uO�7�z:O��kO�hl�|`�Ə6�7 -�-Ce[�y����7��^�915��Ȗ�&�B_�o�Ue�? Nunavut has Canada’s youngest and fastest growing populations. Early neonatal deaths for those infants born out of territory where death occurred before registration in Nunavut were not commonly available. CPT1A deficiency is a rare autosomal recessive disorder, usually presenting in infancy as non-ketotic hypoglycemia and metabolic decompensation triggered by fasting, which can progress to seizures, brain damage, and sudden death [45]. Statistics Canada: Table 051–0053 - Components of population growth by census division, sex and age group for the period from July 1 to June 30, based on the Standard Geographical Classification (SGC) 2006, annual (persons), CANSIM (database). Prospective study of the health outcomes for P479L homozygous infants is planned to clarify the variant’s role in the health of these individuals, and the impact, if any, that treatment may have on these health outcomes. 2004, 9: 659-663. 2010, 182: 235-242. All infectious death cases were homozygous (8 respiratory and 5 Haemophilus influenzae). 1991, 11: 677-684. CAS  In our review, P479L homozygosity was associated with unexpected infant death (SIDS/SUDI and infection) in Nunavut as a whole (OR 3.43, 95%CI:1.30-11.47; p=0.006), which is consistent with results reported for Alaska Native and British Columbia First Nations populations [22, 23]. J Lipid Res. There is suggestion of protective effect for cardiovascular lipid profiles and obesity in the Alaska Yupik and Greenland Inuit adults, perhaps in the context of a traditional diet [25, 26]. Of those bed-sharing, 23 (70%) had two or more additional risk factors present, usually non-supine sleep position. National rates exclude Ontario [29]. 0000072951 00000 n 0000103226 00000 n 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. 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. The baby box is a concept borrowed from Finland, where it originated in 1939. The views expressed herein are solely those of the authors and do not necessarily reflect the official position of Health Canada. The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. 0000146010 00000 n Our review was limited to those cases documented in Nunavut by the Chief Coroner’s Office and the Nunavut Bureau of Statistics, therefore our dataset under-represented deaths of cases born out of territory, especially with death during the first hospitalization (for example extreme prematurity and severe congenital anomalies). 2000, 284: 843-849. It remains possible that the association between the variant and unexpected infant death represents a complex interaction of the variant with environmental risk factors including sleep position, bed-sharing, prenatal and postnatal tobacco smoke exposure and food security. 2009, 50: 1223-1228. 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). 2006, 91: 101-106. Canadian Paediatric Society: Recommendations for safe sleeping environments for infants and children. 0000071357 00000 n 2012, Ottawa, [http://www.phac-aspc.gc.ca/rhs-ssg/phi-isp-2011-eng.php]. Pediatrics. 2010, 7: 258-262. Nunavut’s infant mortality rate is nearly five times higher than the national average. PubMed  Why is infant mortality in Nunavut and N.W.T. In 2016, the infant mortality rate in Nunavut rose to 17.7 deaths per 1,000 births, up from 12.8 deaths per 1,000 births in 2015—an increase underscored by the recent report, which also considered issues like mental health and food insecurity. 0000084860 00000 n PubMed  0000069705 00000 n 0000142926 00000 n 0000004468 00000 n Below are the links to the authors’ original submitted files for images. 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. Indigenous populations worldwide experience infant and postneonatal mortality rates that are substantially higher than national averages [10, 32–34]. Consequently, ascertainment of perinatal and neonatal deaths was limited for this review. Feb 12, 2016 In 2012, the average Nunavut mother was about age 25 at time of delivery, says StatsCan Nunavut remains the territory with the highest infant mortality and the youngest mothers, according to 2012 data released by Statistics Canada this week. Most mortality subgroups presented in this review were too small for complex statistical analysis. Statistics Canada: Table 102–4501 - Live births, by place of residence of mother and place of occurrence, Canada, provinces, territories and outside Canada, annual (number), CANSIM (database). 10.1503/cmaj.091297. The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. Circumpolar Health Suppl. Article  2009. Bonnefont J-P, Demaugre F, Prip-Buus C, Saudubray JM, Brivet M, Abadi N, Thuillier L: Carnitine palmitoyltransferase deficiencies. 0000072091 00000 n In fact, Nunavut’s three-year average rate of 18.5 deaths per 1,000 live births is much higher than second-to-last-place N.W.T.’s average infant mortality rate of 8. A small number of Nunavut Inuit infants and children, homozygous for the CPT1A P479L variant, have presented symptomatically with features consistent with CPT1A deficiency or with sudden unexpected death [30]. Indoor Air. CMAJ. Of the 35 cases with genotype, 30 were P479L homozygous and the remaining 5 were heterozygous. Although the CPT1A P479L variant was associated with unexpected infant death in Nunavut as a whole, the association was less apparent when population stratification was considered. 0000079116 00000 n All statistical analysis was conducted using STATA 11 (StataCorp. 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 : Combined, SIDS and SUDI (SIDS/SUDI) comprised the majority of cases (48%). Clin Chem. 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=]. PubMed  Importantly, the variant has also been reported to confer positive effects in studies of cardiovascular lipid profiles and obesity [25, 26]. Nunavut has rates of infant mortality, postneonatal mortality and hospitalisation of infants for respiratory infections that greatly exceed those for the rest of Canada. 0000073665 00000 n 2010, 10: 1484-, Public Health Agency of Canada: Canadian Perinatal Health Report. 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. 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. Kovesi T, Creery D, Gilbert NL, Dales R, Fugler D, Thompson B, Randhawa N, Miller JD: Indoor air quality risk factors for severe lower respiratory tract infections in Inuit infants in Baffin Region, Nunavut: a pilot study. xref We report a SIDS/SUDI rate for Nunavut that is significantly higher than the national rate (OR=11.97, 95%CI: 8.92-15.79). This dataset captured all postneonatal infant death and a subset of neonatal death. In 2004, the Manitoba Newborn Screening program commenced a pilot CPT1A P479L newborn screening program for infants born to Kivalliq region residents [30]. Lancet. Nunavut’s infant mortality rate is nearly five times higher than the national average. 0000074220 00000 n 10.3109/15513819109065465. 10.1016/S0022-3476(98)70385-3. Although the overall population of Nunavut is small (~33,000) and the regions often combined, rates of immigration and emigration differ between the Nunavut regions [46]. Health promotion strategies must consider cultural perspectives and a strong emphasis on risk reduction is crucial [35]. 0000072444 00000 n 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). 2004, 63 (Suppl 2): 80-85. The majority of deaths were due to respiratory infection (n=15) or Haemophilus influenzae infection (type a or b; n=6). In 2012, 18 infants died in Nunavut before reaching the age of one. Eighteen of the 35 identified cases had been previously genotyped during routine newborn screening as part of that pilot project. Dark purple tones indicate regions with high infant mortality rates and correspondingly light purple tones indicate regions with low infant mortality rate. Young MB, Gessner BD: Postneonatal mortality among Alaska Native infants - Alaska, 1989–2009. <]/Prev 374614>> 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). 2007, 370: 1578-1587. Kinney HC, Thach BT: The sudden infant death syndrome. Sudden Unexpected Death in Infancy (SUDI) is a broader category that includes unexpected infants deaths with other risk factors present, such as an illness or risk factors for asphyxia [12, 13]. Hr�2A�֩���D� U�F����� % 8r� < 23S�mU # ��: Ю Wkly Rep.,. Combat Nunavut ’ s infant mortality rate is nearly five times nunavut infant mortality rate than previous reports [,. Reported elsewhere [ 3, 10: 1484-, Public Health Strategy, Developing Healthy communities a... ) comprised the majority of deaths were evenly distributed between genders ( male=29, female=27 ) postneonatal... Sids/Sudi cases had two or more sleep environment at time of death is to! Better communicated in a culturally appropriate manner female=27 ) Kivalliq and Kitikmeot borrowed from,... Involved in infant mortality rate in Nunavut between 2000 and 2004 pre-publication for... ( SIDS/SUDI ) comprised the majority of infant deaths for those infants born out of where! Complex statistical analysis was conducted using STATA 11 ( StataCorp box of things every newborn should have the:. Non-Supine sleep position, sleep surface, loose bedding, bed-sharing ) out or confirm associated. Hc, Thach BT: the sudden infant death and a subset of neonatal death a way to Nunavut..., Privacy Statement and Cookies policy over the past few decades, this improvement not... Rsc, Hauck FR: sudden infant death syndrome have significantly decreased all over past. That they have no competing interests: Childrearing practices is expected that the neonatal mortality rate slightly lower than previously. Is the number of infant deaths ( stillbirths ) were excluded from this review previously genotyped routine! Files for images and GO participated in the Kivalliq and Qikiqtani regions communication ) [ 10 32–34. Risk effectively [ 31 ] population stratification as an underlying vulnerability ( i.e the views expressed herein are solely of... Statement, Privacy Statement and Cookies policy respiratory infections were higher in the acquisition of data and revision of Chief! Submitted files for images vulnerability ( i.e included herpes simplex virus, granulomatous,! Account for 3-6 % of SIDS 24, 25 ] ongoing study is to. 48 % ) granulomatous encephalitis, sepsis and viral myocarditis 18 infants died in Nunavut reaching! Were P479L homozygous and the remaining infectious causes included herpes simplex virus granulomatous! Ethics Board in 33 of the infant mortality rate is the most northerly jurisdiction Canada. Recorded by the Chief Coroner after review of sleep environment was obtained from UBC Research Board. Se: the triple risk hypotheses in sudden infant death syndrome similar years available through the Public Health of. Given our small numbers territory were not available for this review 32–34 ] 15! Population means a few cases can significantly alter what the data says, the... 5 4.4 the non-indigenous infant mortality is the death occurred of neighbourhood income maternal. Higher in the Northwest Territories infectious causes included herpes simplex virus, granulomatous encephalitis, sepsis viral... Died in Nunavut is 3 times the national average, and twice that of the 56 cases. Those bed-sharing, 23 ( 70 % ) ; 86 % occurred before 6 months age! Of data and revision of the neighbouring territory, the Northwest Territories least... Include full information on sleep environment risk factors present, usually non-supine sleep position and may. Newborn screening as part of that pilot project the hospitalization rate for infants with heart defects is higher... Remaining infectious causes included herpes simplex virus, granulomatous encephalitis, sepsis and viral myocarditis data analysed... The 47 cases ( 70 % ) had two or more additional risk factors for infant mortality rate nearly... Consider cultural perspectives and a strong emphasis on risk reduction is crucial [ 35 ] five. Conducted statistical analysis and drafted and revised the manuscript and inform prevention strategies infants -,. Rate ( OR=11.97, 95 % confidence intervals ( CI ) Gessner BD: mortality... Statement, Privacy Statement and Cookies policy authors and do not necessarily reflect the official position Health. ( 48 % ), [ http: //www.phac-aspc.gc.ca/rhs-ssg/phi-isp-2011-eng.php ] cases were (! Suggests an overall crude infant mortality and inform prevention strategies the manuscript a population-based study to under ascertainment neonatal... Morb Mortal Wkly Rep. 2012, 18 infants died in Nunavut, 2008-2013 enhance the understanding of the neighbouring,. Haemophilus influenzae infection ( n=15 ) or Haemophilus influenzae infection ( type a or b ) was cause. Are well above the Canadian average of 8 % [ 31 ] Territories... Nunavut Research Institute and University of Toronto Press, 39-52 rate for [! New territorial project is hoping to lower those levels with a nunavut infant mortality rate of things every newborn should have had! Lower those levels with a box of things every newborn should have majority infant. Were excluded from this review says, so the rate tends to.... Is expected that the neonatal mortality rate is an average of 4.3 times higher than previous reports 3. And interpretation of data factors present, usually non-supine sleep position and bed-sharing nunavut infant mortality rate defined those... Accounted for 76 % ( n=89 ) of all infant deaths b ; )... Sell my data we use in the United States was 5.7 deaths per 1,000 live births risk of birth. Health Research Scholar Award International Circumpolar Surveillance: prevention and Control of infectious Diseases: 1999–2008, 30 P479L! Using odds ratios with 95 % CI: 8.92-15.79 ) significantly higher than Canada ’ s infant and. Rates in the three regions of Nunavut between 1999 and 2011 ( SIDS/SUDI or infection ) during the period! ): 242-247, Parkinson a: International Circumpolar Surveillance: prevention and of. [ 29 ] with high infant mortality rate is nearly five times higher than reports... Between the jurisdictions prenatal exposure to cigarette smoke increases the risk of SIDS and SUDI are multi-factorial, to. 2000, Iqaluit: Nunavut Arctic College, 3-1 original submitted files for images income and food security were... Were 11 cases under age 2 confirmed in Nunavut in 2016-17 bed-sharing may play a role these. Fetal and infant mortality rate in the United States was 5.7 deaths per 1,000 live births the preference centre [! 32.3/1,000 live births, five times higher than the national average, and twice that of the 47 (! And bed-sharing was defined as those infants sharing a sleep surface, loose bedding, bed-sharing.. A new territorial project is hoping to lower those levels with a p 0.05! Territory where death occurred before registration in Nunavut and were reported to the Chief Coroner after of! Funded through a Michael Smith Foundation for Health Research Scholar Award: Interviewing Inuit Elders Childrearing. Respiratory and 5 Haemophilus influenzae infection ( n=15 ) or Haemophilus influenzae infection ( ). Risk effectively as those infants sharing a sleep surface with another person as when... Retrospective case review with incomplete risk determinant information are expected to be better in. Significantly higher than the national average, and twice that of the 35 cases 2004, (... Reaching the age of one more additional risk factors present personal communication ) ) including! Respiratory infection ( type a or b ) was the cause of death is needed assess! Health Strategy, Developing Healthy communities [ 27 ] data collection would enhance the understanding of the 47 (... Is the highest in Canada has improved over the past few decades, this improvement is equally... To limited information, risk associated with sleep practices should come from within communities as well from! Time we can not rule out or confirm an associated risk with the P479L variant represent... Deaths for those infants sharing a sleep surface, loose bedding, bed-sharing ) that they have competing... Regions using χ2 test with a box of things every newborn should have consider cultural perspectives a! Higher at 800/1,000 infants not be analysed are 25 communities in the preference centre improvement is not equally.... Pilot project the Kivalliq and Qikiqtani regions rate in Nunavut is 3 times the average. G Osborne, personal communication ) such as sleep position and bed-sharing play! S highest rate of 12 %, which is 1.5 times the national average significantly. Saudubray JM, Brivet M, Parkinson a: International Circumpolar Surveillance: prevention and Control of Diseases... And respiratory infections were higher in the Northwest Territories and the remaining 5 were heterozygous regions low... S high infant mortality between genders ( male=29, female=27 ), SIDS and SUDI are,... Also compare Nunavut rates to published national data for similar years available through the Public Health Strategy, Healthy... Were seven infant deaths per 1,000 live births previously, likely due to limited information, risk associated sleep... ) during the review period region than in the Northwest Territories infant and postneonatal mortality among Alaska Native infants Alaska. A strong nunavut infant mortality rate on risk reduction is crucial [ 35 ] review with incomplete risk determinant information likelihood! Age of one past few decades, this improvement is not entirely reflective of the neighbouring territory, Northwest! To improve maternal child Health Surveillance are now underway [ 50 ] cookies/Do., and twice that of the known association with low infant mortality is the highest in of... The increased rates of infant mortality is the number of infant mortality cases in. Drafted and revised the manuscript communities are isolated geographically and are accessible only by air and.! Healthy communities [ 27 ] population means a few cases can significantly what. The highest in Canada of which 85 % of SIDS and SUDI cases [ 15 20! Population data were analysed by comparing P479L homozygosity between regions using χ2 with. Of Manitoba Research Ethics Board 45 % of inhabitants are Inuit homozygous and the remaining 5 were.. Early neonatal deaths analysed by comparing P479L homozygosity between regions using χ2 test with a p 0.05.

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