Excess Hispanic Fetal-Infant Mortality in a Midwestern Community

Hoff, Gerald L.; Cai, Jing; Okah, Felix A.; Dew, Paul C.

doi:10.1177/003335490912400513

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…In the total sample, 50% of excess fetoinfant deaths were associated with the MHP category and 28% of fetoinfant deaths were associated with the IH category. While all previous studies have identified MHP as the major contributor to excess fetoinfant deaths, the second highest contributor varies between maternal care and infant health, depending on community [ 6 – 9 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Very Low Birth Weight and Perinatal Periods of Risk: Disparities in St. Louis

Xaverius

Salas

Kiel

et al. 2014

BioMed Research International

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Objective. Very low birth weight (VLBW) is a significant issue in St. Louis, Missouri. Our study evaluated risk factors associated with VLBW in this predominantly urban community. Methods. From 2000 to 2009, birth and fetal death certificates were evaluated (n = 160, 189), and mortality rates were calculated for perinatal periods of risk. The Kitagawa method was used to explore fetoinfant mortality rates (FIMR) in terms of birth weight distribution and birthweight specific mortality. Multivariable logistic regression was used to assess the magnitude of association of selected risk factors with VLBW. Results. VLBW contributes to 50% of the excess FIMR in St. Louis City and County. The highest proportion of VLBW can be attributed to black maternal race (40.6%) in St. Louis City, inadequate prenatal care (19.8%), and gestational hypertension (12.0%) among black women. Medicaid was found to have a protective effect for VLBW among black women (population attributable risk (PAR) = −14.5). Discussion. Interventions targeting the health of women before and during conception may be most successful at reducing the disparities in VLBW in this population. Interventions geared towards smoking cessation and improvements in Medicaid and prenatal care access for black mothers and St. Louis City residents can greatly reduce VLBW rates.

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Section: Discussionmentioning

confidence: 99%

Very Low Birth Weight and Perinatal Periods of Risk: Disparities in St. Louis

Xaverius

Salas

Kiel

et al. 2014

BioMed Research International

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Perinatal Periods of Risk Analysis: Disentangling Race and Socioeconomic Status to Inform a Black Infant Mortality Community Action Initiative

Kothari

Romph

Bautista³

et al. 2017

Matern Child Health J

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Objectives The goal of this study is to use Perinatal Periods of Risk (PPOR) analysis to differentiate broad areas of risk (Maternal-Health/Prematurity, Maternal Care, Newborn Care, and Infant Health) associated with being Black from those associated with being poor. Methods Phase I PPOR compared two target populations (Black women/infants and poor women/infants) against a gold standard reference group (White, non-Hispanic women, aged 20+ years with 13+ years of education), then against each other. Phase II PPOR further partitioned excess risk into (1) Very-low-birthweight-risk and (2) Birthweight-specific-mortality-risk and identified individual-level risk factors. Results Phase I PPOR revealed Black excess mortality within the Maternal-Health/Prematurity category (67% of total excess mortality). Phase II PPOR revealed that Black excess mortality within this category was primarily due to premature deliveries of very-low-birthweight infants. In a unique extension of the PPOR methodology, a poverty-excess-PPOR was subtracted from the Black-excess-PPOR, and showed that Black women have substantial excess mortality above and beyond that associated with poverty. Subsequent analyses to identify Black-specific risks, controlling for poverty, found that vaginal bleeding, premature rupture of membranes, history of preterm delivery, and having no prenatal care significantly predicted preterm delivery. Conclusions This study demonstrated the utility of PPOR, a standardized risk assessment approach for focusing health promotion efforts. In the study community, PPOR identified that maternal preconception and prenatal factors contributed the greatest risk for Black infants due to prematurity and low birthweight. Higher socioeconomic status did little to mitigate this risk. These findings informed a community-wide plan that integrated evidence-based strategies for addressing systematic racial inequity with strategies for addressing systematic socioeconomic disadvantage.

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Excess Hispanic Fetal-Infant Mortality in a Midwestern Community

Cited by 2 publications

References 23 publications

Very Low Birth Weight and Perinatal Periods of Risk: Disparities in St. Louis

Very Low Birth Weight and Perinatal Periods of Risk: Disparities in St. Louis

Perinatal Periods of Risk Analysis: Disentangling Race and Socioeconomic Status to Inform a Black Infant Mortality Community Action Initiative

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