Drugs, Prenatal Neglect Blamed for Rise in L.A. County’s Infant Deaths

Infant deaths and the number of babies born underweight in Los Angeles County are rising dramatically, according to the latest county statistics. Experts trace the trend--which is most striking among blacks--to increasing drug use and shortages of obstetric and prenatal care.

The infant mortality rate among blacks and Latinos rose 17% in 1988 over 1987, while dropping 12% among Anglos. The percentage of babies born weighing less than 5 1/2 pounds--a key predictor of mortality and disability--rose 17% overall and 32% among blacks.

By contrast, Orange County’s infant mortality rate actually decreased from 7.6 deaths per 1,000 live births in 1987 to 6.8 deaths in 1988, according to Dottie Andrews, director of Community Services for county chapter of the March of Dimes.

The rate has fluctuated between 6 and 7 deaths per thousand births for the last several years, she said.

Medi-Cal patients have trouble gaining access to prenatal and perinatal services at UCI Medical Center, yet the county’s rate--better than both state and national averages--is credited to prenatal care that is better overall than in Los Angeles County, said Roberta Maxwell, senior research analyst at the Orange County Health Care Agency.

Los Angeles’ numbers represent “a turn for the worse” after several decades of improvement, a top county health official said Friday. In the previous year’s statistics, the infant mortality rate had dropped below the statewide average for the first time in 20 years.

“It’s very disappointing to see things turn around like this,” said Dr. Irwin Silberman, director of maternal health and family planning programs for the county. “And I think it’s going to be worse in 1989.”

Experts attributed the shift to several factors: the rise of crack cocaine addiction among child-bearing women, the county’s syphilis outbreak, difficulties in getting prenatal care and, among some women, ignorance of the need for that care.

In hope of addressing those problems, the March of Dimes Birth Defects Foundation announced in Los Angeles on Friday a national campaign aimed at preventing infant mortality and so-called low-birth-weight births through public education and changes in public policy.

“It’s our belief that the most important thing is to get people motivated to get prenatal care,” said Jennifer Howse, president of the foundation. “. . . Then we can point to the lack of capacity” in prenatal care programs.

In 1988, Orange County’s death rate for white babies was the highest, at 7.9 per 1,000, followed by 5.9 for Latinos, 5.4 for blacks, 5.0 for Southeast Asians and 4.1 for other Asians.

Of the 15,610 births to Latino women, nearly 5,000 had inadequate prenatal care, she said.

However, mortality among Latino babies is not high, Maxwell said: “We’ve postulated there is perhaps an informal kind of prenatal care, a network of family and community that is not classified in our traditional sense but may in fact be enough to direct people with problems into the care system.”

Los Angeles County’s preliminary 1988 statistics, released Friday, include the following:

The overall infant mortality rate in the county rose from 8.2 deaths per 1,000 live births in 1987 to 9.6 in 1988. Among blacks, the rate rose from 16.3 to 21.1; among Latinos, from 5.8 to 7.5.

The percentage of babies born weighing less than 2,500 grams, or 5 1/2 pounds, rose from 5.3 to 6.2. Among blacks, the percentage rose from 10.4 to 13.7--”a dismaying 32% increase for black babies,” Silberman said.

One in four pregnant women in Los Angeles County did not begin prenatal care in the crucial first trimester of pregnancy. The rate is more striking among minorities--37% for Latino women and 32% for black women.

Babies born to mothers who receive no prenatal care are four times as likely as others to die during the first year of life, specialists say. The infants are three times as likely as others to be born weighing less than 2,500 grams.

“I think we have two challenges here,” said Wendy Lazarus of Children Now, a statewide advocacy and policy group. “One is to make sure there are open doors for those women who want to get prenatal care. . . . The second is to really reach out in those communities.”

Staff writer Lynn Smith contributed to this story.