About the Program
Infant Mortality in Alaska
What is the AMIMR?
The State of Alaska, Division of Public Health, Section of
Maternal, Child and Family Health established the Alaska Maternal
and Infant Mortality Review (AMIMR) in 1989. At the time, Alaska’s
infant mortality was 1.2 times greater than reported in the
United States. A collective concern by state and private health
practitioners established the AMIMR to reduce this high infant
mortality rate in Alaska. The AMIMR was formed under the guidelines
of Alaska Statutes Section 18.23.010-18.23.070 as a medical
review organization to retroactively evaluate the circumstances
surrounding infant death and make recommendations for reducing
Alaska’s high infant mortality rate. Over the last decade,
the infant mortality in Alaska declined from 9.6 (1989-1991)
per 1,000 to 6.1 (1998-2000) per 1,000 live births. The AMIMR
scope has also been expanded to review fetal and maternal deaths
as well. The AMIMR systematically collects medical and socioeconomic
data on all fetal, infant, and maternal deaths in Alaska to
better understand the circumstances contributing to these deaths.
The AMIMR is one of 28 state fetal and infant mortality programs
in the nation.
What is the purpose of the AMIMR?
The purpose of the AMIMR is to provide reliable and timely
information on fetal, infant, and maternal deaths in Alaska.
Accurate information on these types of deaths is important in
evaluating current health initiatives and to make recommendations
for future health initiatives to reduce these untimely deaths.
What are the goals and objectives of the AMIMR?
The goal of AMIMR is to reduce fetal, infant and maternal mortality
in Alaska through a committee review process of all fetal, infant,
and maternal death records. AMIMR goal has these specific objectives:
- To perform statewide epidemiological surveillance concerning
fetal, infant and maternal deaths in Alaska.
- To review all fetal, infant and maternal deaths in Alaska.
- To conduct annual comprehensive analyses.
- To translate results from analyses of AMIMR committee findings
for the purpose of public policy planning and evaluation of
established public health initiatives and programs.
- To document patterns of fetal, infant and maternal morbidity
in Alaska that result in mortality to detect changing etiologies
that may be preventable.
- To educate health care providers regarding diagnostic, therapeutic,
and preventative strategies to reduce fetal, infant, and maternal
mortality in Alaska.
Who are the partners in the AMIMR?
Agencies represented on the AMIMR committee are: Alaska Native
Tribal Health Consortium (ANTHC); Alaska Neonatology Associates;
Alaska State Troopers; Cook Inlet Tribal Council; Department
of Air Force; Department of Army; Kodiak Area Native Association;
Southeast Alaska Regional Health Corporation (SEARHC); State
Bureau of Vital Statistics; State Division of Family and Youth
Services; State Medical Examiner’s Office; Tribal Law
& Policy Institute; and other private physicians/health
practitioners of various specialties throughout the State of
Other AMIMR partners are:
How are data collected?
The Alaska Bureau of Vital Statistics generates a monthly report
of fetal, infant and maternal deaths for the AMIMR project.
Birth and death certificates are provided for each death. These
certificates provide the vital information necessary for collecting
medical information about the case. The Alaska State Troopers
or municipal police departments, and State Medical Examiner’s
Office may be requested to provide further information. A home
interview may also be required. If so, a public health nurse
from the appropriate region is requested to do the interview.
Upon receipt of all medical and related documentation, the death
record is abstracted for particular autopsy and medical data.
The death record is then brought before the AMIMR monthly meeting
to be reviewed by the presiding committee members. A consensus
form is completed recording the committee’s findings for
each death record. Abstracted and consensus information is then
entered into a database for the purpose of completing the annual
analysis. Confidentiality of records is maintained at all levels.
What information does the AMIMR collect?
The AMIMR abstraction and consensus forms collect the following:
- Birth/death information.
- Reproductive history
- Prenatal history/procedures
- Medications prescribed/taken during pregnancy
- Neonatal/infant health history
- Medical history
- External exam/general appearance
- Evidence of trauma/surgical intervention
- Congenital anomalies
- Organ weights/systems descriptive status
- Ancillary/special studies
- Most probable/contributing causes of death
How can data from the AMIMR be used?
Every year data are aggregated and an analysis is performed.
Findings of the annual analysis can be used:
- To monitor progress towards the attainment of local, state
and national health goals.
- To be utilized as the standard of public health decisions
regarding public policy health improvements.
- To be utilized by the State of Alaska to evaluate the success
of such campaigns as Back to Sleep and Never Shake a Baby.
- To identify potential areas of needed services.
- To detect and monitor changing etiologies for fetal, infant
and maternal mortality in Alaska that may be preventable.
- To educate health professionals and the general public on
the status of maternal and infant mortality issues in the
state and ways to potentially prevent these deaths.