The exclusion of any high-risk infants from the denominator or numerator in reported IMRs can be problematic for comparisons. Many countries, including the
United States,
Sweden or
Germany, count an infant exhibiting any sign of life as alive, no matter the month of gestation or the size, but according to United States
Centers for Disease Control researchers,
[6] some other countries differ in these practices. All of the countries named adopted the WHO definitions in the late 1980s or early 1990s,
[7] which are used throughout the European Union.
[8] However, in 2009, the US CDC issued a report which stated that the American rates of infant mortality were affected by the United States' high rates of premature babies compared to European countries and which outlines the differences in reporting requirements between the United States and Europe, noting that France, the Czech Republic, Ireland, the Netherlands, and Poland do not report all live births of babies under 500 g and/or 22 weeks of gestation.
[6][9][10] However, the report also concludes that the differences in reporting are unlikely to be the primary explanation for the United States’ relatively low international ranking.
[10]