highest infant mortality rate of any region studied, with 68 deaths per 1,000 live births. Classification Infant mortality rate (IMR) is the number of deaths per 1,000 live births of children under one year of age. The rate for a given region is the number of children dying under one year of age, divided by the number of live births during the year, multiplied by 1,000. Forms of infant mortality: Perinatal mortality is late fetal death (22 weeks gestation to birth) or death of a newborn up to one week postpartum. Neonatal mortality is newborn death occurring within 28 days postpartum. Neonatal death is often attributed to inadequate access to basic medical care, during pregnancy and after delivery. This accounts for 40–60% of infant mortality in developing countries. Postneonatal mortality is the death of children aged 29 days to one year. The major contributors to postneonatal death are malnutrition, infectious disease, troubled pregnancy, sudden infant death syndrome, and problems with the home environment. Causes Causes of infant mortality directly lead to the death. Environmental and social barriers prevent access to basic medical resources and thus contribute to an increasing infant mortality rate; 99% of infant deaths occur in developing countries, and 86% of these deaths are due to infections, premature births, complications during delivery, and perinatal asphyxia and birth injuries. Greatest percentage reduction of infant mortality occurs in countries that already have low rates of infant mortality. Common causes are preventable with low-cost measures. In the United States, a primary determinant of infant mortality risk is infant birth weight with lower birth weights increasing the risk of infant mortality. The determinants of low birth weight include socioeconomic, psychological, behavioral and environmental factors. Main causes There are three main leading causes of infant mortality; namely Premature-related conditions, Congenital anomalies and Sudden Infant Death Syndrome. In North Carolina,Premature-related conditions ranked first, with a percentage of 37.5%, followed by congenital anomalies which accounted for 17.4% of the total infant deaths, while Sudden Infant Death Syndrome accounted for 12.9%. Premature birth Premature, or preterm birth (PTB) is defined as birth before 37 weeks of gestation and can be further sub-classified as extremely PTB (occurring at less than 28 weeks gestation), very preterm birth (occurring between 28 and 32 weeks gestation), and moderate to late PTB (occurring from 32 through 36 weeks gestation). Lower gestational age increases the risk of infant mortality. Over the last