Early infant mortality in Canada called 2nd worst in developed world

Babies born in Canada have a surprisingly high likelihood of dying on the day of their birth, a new study suggests. 

A report from international aid organization Save the Children assessed infant mortality data from 176 countries worldwide, focusing specifically on how many newborns are able to survive beyond their first day out of the womb.

The report said Canada had the second-highest rate of first-day infant mortality in the industrialized world, with roughly 900 babies — or 2.4 per 1,000 births — ending in early tragedy.

Only the United States posted a higher number of babies who die within their first 24 hours on earth, with 11,300 or 2.6 per 1,000 births.

Switzerland rounded out the top three with 2.2 first-day deaths per 1,000 births, Save the Children said, noting the three countries fell well short of the nations that boast a first-day mortality rate of just 0.5.

Cyprus, Estonia, Iceland, Luxembourg, Singapore and Sweden all boast that distinction, the report said.

Experts said Canada's poor results come as little surprise, noting infant mortality rate has been an issue of increasing concern for the past several years.

Dr. Janet Smylie, a physician in the department of family and community medicine at Toronto's St. Michael's Hospital, said Canada's infant mortality rate — or number of babies who die within their first year of life — has averaged around five per 1,000 births for the past decade.

Smylie said that number is driven higher by the mortality rate for aboriginal infants, adding some First Nations populations register mortality rates of up to four times the national average.

"At the root of it is a distribution problem," Smylie said in a telephone interview. "We're an affluent country, but at a systems level we're still not distributing all of our health and social resources equally to all groups."

Smylie said the social imbalance that sees aboriginals struggling with higher than average levels of poverty is compounded by the country's geography. Canada's vast size ensures that people living in remote northern communities often have to travel dozens, even hundreds, of kilometres to receive proper maternity care, Smylie said.

Such factors drive up infant mortality within the first year and by extension those infants who do not survive their first 24 hours on earth, she said.

Fertility treatment advances

But Smylie said some of Canada's results may also be attributable to its scientific advancements.

Physicians in the U.S. and Canada have a wide range of technology at their disposal to bring infants into the world before they've reached full term, she said. Since all live births are counted in most countries' mortality data, she said the number of premature births — induced or otherwise — may have an impact on the overall figures for developed nations.

"Some of the technologies in advanced maternity care, particularly when you're speaking of multiples [births], you might actually have 23 or 22 weekers born alive, but their mortality rate is very high," she said.

In a 2012 report on infant mortality, the Conference Board of Canada also suggested advancements in fertility treatments that result in more multiple, high-risk births may also be driving Canada's overall numbers higher.

Still, the board report concluded Canada falls well below other comparable countries, including fellow members of the Organization for Economic Co-operation and Development.

"The fact that Canada does not seem able to break below the rate of five deaths per 1,000 live births, while 14 peer countries already have, suggests that further attention must be paid to better understanding international differences in infant mortality rates — whether they are due to methodological or socio-economic factors, or both," the report said.

While Canada's numbers may seem elevated compared to their industrialized peers, Save the Children said Tuesday they account for just a fraction of all first-day infant deaths.

Developed nations account for less than two per cent of the global total, adding most of the countries with high numbers are located in subsaharan Africa.

Somalia had the highest first-day mortality rate with 18 of every 1,000 babies dying within their first 24 hours.