摘要：Objectives. We sought to determine precise estimates of infant mortality rates and to describe overall trends in infant mortality in Greenland and Denmark from 1973 to 1997. Methods. We analyzed data from population-based registries of all live-born infants in Greenland and Denmark to calculate infant mortality rates from 1973 to 1997. Results. Between the periods of 1973–1977 and 1993–1997, neonatal mortality rates in Greenland declined from 20.9 per 1000 live-born infants to 15.7, and postneonatal mortality rates declined from 20.9 per 1000 to 5.9. Infant mortality rates were significantly higher in Greenland than in Denmark, and the excess mortality was uniformly distributed over all birthweight percentiles. In Greenland, the risk of infant death was significantly lower if the mother was born outside Greenland. Conclusions. Postneonatal mortality rates in Greenland have decreased significantly during the past 25 years, but little progress has been made in decreasing neonatal mortality rates. Disparities exist among children with different maternal origins. Infant mortality rates are an important measure of a population’s health status. Although infant mortality rates in the Arctic have decreased significantly in recent decades, mortality rates remain high as compared with those among populations in the neighboring regions. 1 This is particularly true in Greenland. 2 The population in Greenland (56 124 in 2000) is primarily composed of indigenous people of Inuit origin (85%–90%) and represents the largest Arctic Inuit population in the world. Greenland has been a colony of Denmark since 1721, but it acquired home rule within the Danish Kingdom in 1979. There is much cooperation between the health systems of Greenland and Denmark, and the Greenlandic health system is highly dependent on the employment of Danish health personnel. Primarily after World War II, Greenlandic society has undergone rapid improvements in living standards and health sector services. 3 The effect of these social changes and of Westernization in general on infant mortality rates is largely unknown, although previous reports of pronounced regional variation and a high proportion of potentially avoidable deaths indicate that medical progress in infant hospital care has not been satisfactorily implemented. 4 Previous studies of infant mortality rates in Greenland have primarily used data from death registries, hospital records, or interviews, whereas data on factors such as maternal origin and birthweight have not been generally available. 5– 7 To investigate the change in infant mortality rates among Greenlanders compared with Danes, we used population-based national registries in Greenland and Denmark. Our objective was to determine precise estimates of infant mortality rates and to assess the significance of maternal origin and birthweight distribution relative to infant mortality rates in Greenland.
