Dip in Infant Death Rate in ’92 Attributed to Better Medical Care : Health: Officials say more women are seeing doctors before their babies are born. Medi-Cal coverage expansion also helped.

Infant deaths in Orange County declined for the second consecutive year in 1992, according to county officials, who Monday credited the improvement to the increasing availability of medical care to poor, pregnant women and newborns.

Gerald Wagner, the county’s maternal and child health director, attributed the gains in infant survival to expansion of the state’s Medi-Cal program to provide prenatal care to the undocumented and the increased willingness of physicians to treat expectant mothers on Medi-Cal, the state’s medical program for the indigent.

“When you have better prenatal care, you have better outcomes for children not only in the immediate newborn period but throughout the first year of life,” Wagner said.

The number of children younger than one who died in the county dropped to a rate of 5.4 deaths per 1,000 live births, from a rate of 6.2 deaths per 1,000 live births in 1991. In 1992, a total of 277 infants died, down from 317 the year before.

The decline in infant mortality has continued since 1990, when 395 infants died, a rate of 7.7 deaths per 1,000 births.

The importance and availability of prenatal care are factors in the decreasing infant mortality, county officials said, while adding that not only are more pregnant women seeing doctors, but they are also seeing them earlier in the gestation period.

The percentage of women who gave birth without prenatal care declined from 2.5% in 1990 to 1.5% in 1992. And the percentage of new mothers who had started receiving medical attention in their first trimester of pregnancy grew from 74% in 1990 to 76% in 1992.

While white expectant women continue to benefit the most from early prenatal care, with 90% seeing physicians in their first trimester, Latinas are beginning to catch up, with the percent increasing from 60% in 1991 to 64% in 1992. Similarly, the percent of Southeast Asian mothers who got early prenatal care expanded from 81.5% in 1991 to 86% in 1992.

Dennis Buchanan, a Fullerton obstetrician-gynecologist, said some of the improvement in health care for poor women is because more physicians are accepting Medi-Cal patients.

Buchanan, who is on the Orange County Medical Assn.’s Access to Care Committee, said that while the newest 1992 data compiled by the Orange County Health Care Agency “sounds encouraging, it may be too early to say how much is due to improved access to prenatal care and how much is due to improvements in neonatal care.”

Others attribute the gains more directly to prenatal and postnatal care programs.

Angelo Doti, director of financial assistance for the Orange County Social Services Agency, said that since 1990 there has been “a kind of full-court press” on the part of state, federal and local agencies “to educate expectant mothers and their families and expand the scope of (Medi-Cal) coverage.”

Doti said that the improved infant survival rates also reflect federally funded nutritional programs designed to care for infants during their first year.

Buchanan, who also serves as the president of the board of Orange County’s Maternal Outreach Management System, or MOMS, expects the improvement to continue. He pointed out that the 1992 infant mortality statistics predate the founding of MOMS in January, 1993. The program links poor, expectant mothers with doctors and assists them with non-medical problems, such as lack of transportation, that keep them from prenatal care.

Dottie Andrews, executive director of MOMS, said she eagerly anticipates the next round of numbers for 1993 and 1994.

“We are headed in the right direction,” she said.

Mortality Rate The mortality rate in Orange County has decreased fro the second year in a row. The numberof infants under one year of age who die per 1,000 live births: Mortality Rate ‘92: 5.37 Health officials attribute improvement to a rise in the number of women receiving prenatal care. No Prenatal Care ‘92: 1.5 Source: Orange County Health Care Agency; Researched by Leslie Berkman / Los Angeles Times