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September 24, 1982

Infant Mortality

JAMA. 1982;248(12):1451. doi:10.1001/jama.1982.03330120021017

To the Editor.—  In a recent editorial about infant mortality (1982;247: 1027), Paneth warns about the hazards of comparing infant mortality rates between countries; he notes how irregularly birth weights are recorded throughout the world, and states that "crude mortality rates are, more often than not, profoundly misleading."Paying little heed to his own warnings, he proceeds to place the United States back into an international infant mortality race where it ties for 16th place. To complete the invidious comparison, he cites a relatively high rate of infant mortality in the United States and the superior size and gestational age of European and Japanese counterparts.These attempts to use crude birth weights and birth-weight-specific mortality rates are misleading and inappropriate. Many countries report incomplete or provisional data for mortality of infants weighing less than 1,000 g, the weight group in which the largest number of deaths occurs. And skepticism shades