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PubMedDate not supplied

Prenatal outreach: an approach to reduce infant mortality of African American infants.

Infant mortality is a pernicious and disturbing problem in the African American community. Research and public health reports clearly demonstrate the importance of early and ongoing prenatal care in reducing the incidence of low birth weight (LBW) infants, especially for indigent and racial/ethnic minority groups (American Nurses Association 1987, Hogue & Yip, 1989; McCormick, 1985, National Commission to Prevent Infant Mortality 1988, Institute of Medicine 1985, 1989; United States Department of Health and Human Services [USDHHS], 1990). LBW is a known risk factor for perinatal morbidity and mortality in the first year of life (USDHHS, 1993). Prenatal outreach and home visiting programs have shown effectiveness in assisting African American pregnant women and other racial/ethnic minority groups to access and participate in needed prenatal care. Brooten, Gennaro, Knapp, Jovene, Brown, and York's (1991) research also confirmed the importance of early discharge and home followup of very low birthweight infants. Nurses are challenged to participate in grass-roots initiatives and community-based approaches to improve the prenatal outcomes of African American teens.

Adolescent↗
PubMed1988

Characteristics of infant mortality in the RSA 1929-1983. Part I. Components of the white and coloured infant mortality rate.

Secular trends in white and coloured neonatal, post-neonatal and infant mortality rates are presented for the period 1929-1983. More detailed information is given for deaths in the first month of life. During this 54-year period the infant mortality rate for whites has declined from 64.2/1,000 to 13.5/1,000, whereas the rate for coloureds fell from 158.8 (1938) to 55.0/1,000. The greater part of the latter decline occurred after 1970. Since 1945 the neonatal mortality rate (NMR) for whites has exceeded the post-neonatal mortality rate (PNMR) but among coloureds the PNMR still exceeds the NMR.

Black or African American↗
PubMed1993

[Decrease and inequalities of infant mortality in Salvador, 1980-1988].

This study sought to describe the changes in mortality among infants under one year of age in different areas of the city of Salvador, Bahia, during the period 1980-1988. This was done using estimates of variation in two indicators: proportional infant mortality and the coefficient of infant mortality. Values for the first indicator were separated into low, intermediate, high, and very high quartiles for 1980 and then calculated again using 1988 data. The second indicator was derived from the estimated number of live births using the rate of 33.4/1,000 inhabitants for 1980 and 31.4/1,000 for the years thereafter. The results showed that infant mortality in that age group had declined over the period, but that at the end of the period inequalities persisted in the distribution of infant deaths, which confirmed that conditions remained adverse for certain segments of the population.

Brazil↗
PubMed2000

[Birth rate, stillbirth rate and infant mortality of legitimate and illegitimate newborn infants in Austria 1987-1996: an ecological study].

BACKGROUND: The infant mortality in babies of single mothers in Great Britain is 33% higher than in babies of married mothers. There exists hardly any recent publication on infant mortality and stillbirth rate in association with the marital state of the mother from other European countries. METHODS: From 1987 to 1996 birth weight, stillbirth rate and infant mortality of all Austrian legitimate and illegitimate births were registered by the Austrian Central Statistical Office. Differences between the legitimate and illegitimate newborns were analysed. RESULTS: Within the observation period there was a clear overall reduction (48%) of infant mortality from 9.8 to 5.1 per 1000. Overall stillbirth rate remained stable at 3.7 per 1000 births. The birth weight of illegitimate infants was significantly lower and their weighted average stillbirth rate was 20.4% higher (range -10% to +48%) over the ten year observation period. The weighted average infant mortality during the observation period was 24% higher (range 0% to +44%) for illegitimate infants. CONCLUSION: In Austria illegitimate birth was associated with lower birth weight, higher stillbirth rate and increased infant mortality between 1986 and 1997.

Austria↗
PubMed1971

[Infant mortality].

Explore the source record for details and available documents.

Infant Mortality↗
PubMed1986

Infant mortality among subsequent siblings of infants who died of sudden infant death syndrome.

A specially designed method for measuring infant mortality among families with subsequent siblings of sudden infant death syndrome (SIDS) victims in the state of Washington, 1969 to 1984, yielded results similar to those from an earlier study in Norway. In both studies the SIDS rates among siblings were substantially lower than prior estimates. The rate of SIDS in siblings of infants who died of SIDS did not differ significantly from the SIDS rate among control infants matched for maternal age and birth order. Total infant mortality rates in the two groups were virtually identical. From the data at hand, it appears that earlier estimates of the risk of SIDS in siblings were inflated and that parents of SIDS victims can be counseled accordingly.

Birth Order↗
PubMed2002

Registration artifacts in international comparisons of infant mortality.

Large differences in infant mortality are reported among and within industrialised countries. We hypothesised that these differences are at least partly the result of intercountry differences in registration of infants near the borderline of viability (<750 g birthweight) and/or their classification as stillbirths vs. live births. We used the database of the International Collaborative Effort (ICE) on Perinatal and Infant Mortality to compare infant mortality rates and registration practices in Norway (n = 112484), Sweden (n = 215 908), Israeli Jews (n = 148123), Israeli non-Jews (n = 52 606), US Whites (n = 6 074 222) and US Blacks (n = 1328332). To avoid confounding by strong secular trends in these outcomes, we restricted our analysis to 1987-88, the most recent years for which data are available in the ICE database for all six groups. Compared with Norway (with an infant mortality rate of 8.5 per 1000), the crude relative risks [95% confidence intervals] were 0.75 [0.69,0.81] in Sweden, 0.97 [0.90,1.06] in Israeli Jews, 1.98 [1.81,2.17] in Israeli non-Jews, 0.95 [0.89,1.01] in US Whites and 2.05 [1.95,2.19] in US Blacks. For borderline-viable infants, fetal deaths varied twofold as a proportion of perinatal deaths, with Norway reporting the highest (83.9% for births <500 g and 61.8% for births 500-749 g) and US Blacks the lowest (40.3% and 37.6% respectively) proportions. Reported proportions of live births <500 g varied 50-fold from 0.6 and 0.7 per 10000 in Sweden and Israeli Jews and non-Jews to 9.1 and 33.8 per 10000 in US Whites and Blacks respectively. Reported proportions 500-749 g varied sevenfold from 7.5 per 10000 in Sweden to 16.2 and 55.4 in US Whites and Blacks respectively. After eliminating births <750 g, the relative risks (again with Norway as the reference) of infant mortality changed drastically for US Whites and Blacks: 0.82 [0.76,0.87] and 1.42 [1.33,1.53] respectively. The huge disparities in the ratio of fetal to infant deaths <750 g and in the proportion of live births <750 g among these developed countries probably result from differences in birth and death registration practices. International comparisons and rankings of infant mortality should be interpreted with caution.

Adult↗
PubMed2000

Gestational age- and birthweight-specific declines in infant mortality in Canada, 1985-94. Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System.

We studied infant mortality rates in Canada within specific gestational age and birthweight categories after using probabilistic techniques to link information in Statistics Canada's live births data base (1985-94) with that in the death data base (1985-95). Gestational age- and birthweight-specific mortality rates in 1992-94 were contrasted with those in 1985-87 with changes expressed in terms of relative risks with 95% confidence intervals [CI]. Statistically significant reductions in infant mortality were observed beginning at 24-25 weeks of gestation and extended across the gestational age range to post-term births. Crude infant mortality rates, infant mortality rates among those > or = 500 g and among those > or = 1000 g decreased by 22%, 25% and 26%, respectively, from 1985-87 to 1992-94. The magnitude of the reductions in infant mortality rates ranged from 14% [95% CI 7, 21%] at 24-25 weeks of gestation to 40% [95% CI 31, 47%] at 28-31 weeks. Almost all reductions in gestational age- and birthweight-specific infant mortality between 1985-87 and 1992-94 were due to approximately equal reductions in neonatal and post-neonatal mortality. Live births > or = 42 weeks of gestation did not follow this rule; post-neonatal mortality rates among such live births decreased significantly by 51% [95% CI 26, 68%], although neonatal mortality rates showed no significant change. The mortality reductions observed across the gestational age and birthweight range are probably a consequence of specific clinical interventions complementing improvements in fetal growth. Temporal changes in the outcome of post-term pregnancies need to be carefully examined, especially in relation to recent changes in the obstetric management of such pregnancies.

Adult↗
PubMed1998

Recent declines in New York City infant mortality rates.

BACKGROUND: Although infant mortality rates have declined gradually in New York City for many years, the rate of that decline began to accelerate dramatically at the end of the 1980s. OBJECTIVE: To analyze the recent accelerated decline in infant mortality for three race/ethnicity designations in New York City and to investigate whether shifts in birth weight distribution or changes in birth weight-specific death rates were more important in determining these declines between 1988 to 1989 and 1992 to 1993. METHODS: Two complete cohorts of linked birth-death certificate files consisting of all live births in New York City in 1988 to 1989 and 1992 to 1993 were examined. For each cohort, separate multinomial logistic regressions were estimated by race/ethnicity to analyze the probability of a neonatal or postneonatal death relative to survival as a function of a spectrum of covariates. The coefficients from these regressions were used to construct direct and indirect standardization exercises to predict changes in infant mortality holding characteristics of the cohort, including birth weight distribution, constant over time, or holding the influence of determinants, including birth weight-specific death rates, constant over time. RESULTS: For whites, Hispanics, and blacks, infant mortality rates declined by 27.4%, 24.8%, and 22.7%, respectively, between 1988 to 1989 and 1992 to 1993. For whites and blacks, the largest decreases occurred for neonatal mortality rates, whereas for Hispanics, postneonatal rates fell the greatest. Although infant mortality rates among very low birth weight infants (<1500 g) fell by 27.8%, 19.3%, and 16.6% for whites, Hispanics, and blacks, the greatest decreases in rates were seen among normal birth weight infants (>2500 g). Infant mortality rate declines for this category of infants reached 31%, 31.7%, and 31.3%, respectively, for whites, Hispanics, and blacks. Direct and indirect standardization exercises indicated that the most important factor in determining these declines were decreases in birth weight-specific death rates, not improvements in the birth weight distribution over time. CONCLUSIONS: We conclude that the large decreases in infant mortality rates witnessed in New York City between 1988 to 1989 and 1992 to 1993 were attributable not to improvements in birth weight distribution of the population but to declines in birth weight-specific death rates and that normal birth weight infants showed the greatest improvement.

Black or African American↗
PubMed2006

Infant mortality trends and differences between American Indian/Alaska Native infants and white infants in the United States, 1989-1991 and 1998-2000.

OBJECTIVES: To describe changes in infant mortality rates, including birthweight-specific rates and rates by age at death and cause. METHODS: We analyzed US linked birth/infant-death data for 1989-1991 and 1998-2000 for American Indians/Alaska Native (AIAN) and White singleton infants at > or =20 weeks' gestation born to US residents. We calculated birthweight-specific infant mortality rates (deaths in each birthweight category per 1000 live births in that category), and overall and cause-specific infant mortality rates (deaths per 100000 live births) in infancy (0-364 days) and in the neonatal (0-27 days) and postneonatal (28-364 days) periods. RESULTS: Birthweight-specific infant mortality rates declined among AIAN and White infants across all birthweight categories, but AIAN infants generally had higher birthweight-specific infant mortality rates. Infant mortality rates declined for both groups, yet in 1998-2000, AIAN infants were still 1.7 times more likely to die than White infants. Most of the disparity was because of elevated post-neonatal mortality, especially from sudden infant death syndrome, accidents, and pneumonia and influenza. CONCLUSIONS: Although birthweight-specific infant mortality rates and infant mortality rates declined among both AIAN and White infants, disparities in infant mortality persist. Preventable causes of infant mortality identified in this analysis should be targeted to reduce excess deaths among AIAN communities.

Accidents↗
PubMed1988

Perinatal health in the peri-urban township of Khayelitsha, Cape Town. Part II. Infant mortality.

Estimates of infant mortality suggest that the rate during the past 14 years for families living in Khayelitsha at present was approximately 130-160/1,000. In contrast, the infant mortality rate for infants born in Khayelitsha during 1986 was 50.3/1,000. The highest rates occurred in the post-neonatal period in 'squatter' families, infection being a common cause of death. Mortality rates should fall further with improved housing.

Black or African American↗
PubMedDate not supplied

The use of logit models to investigate social and biological factors in infant mortality. I: Methodology.

Infant mortality data for England and Wales, cross classified by mother's age, parity and social class, have been published on two occasions, the first giving the relevant data for 1949/50, the second for 1975, some 25 years later. Published analyses of these separate data sets have been based on graphical and tabular methods. This paper describes the statistical methodology appropriate to the use of logit models to investigate these data sets and shows how such models may be used to supplement the more informal approach. The stillbirth data for 1975 are used for illustration. Paper II, which follows, explores the stillbirth data in greater detail, with emphasis on the changes between 1949/50 and 1975. Subsequent papers describe neonatal and post-neonatal deaths using the same framework. A final paper summarizes the overall changes in infant mortality by means of a multilogit model.

Adolescent↗