Reducing Infant Mortality Rates Using the Perinatal Periods of Risk Model

Abstract

Despite decreases in the last 50 years, infant mortality rates in the United States remain higher than in other industrialized countries. Using overall infant mortality rates to determine the effectiveness of interventions does not help communities focus on particular underlying factors contributing to static, and sometimes increasing, community rates. This study was designed to determine and rank contributing factors to fetal-infant mortality in a specific community using the Perinatal Periods of Risk (PPOR) model. The PPOR model was used to map fetal-infant mortality for 1995 to 1998 in the Tulsa, Oklahoma, Healthy Start Program as compared to traditional calculation methods. The overall fetal-infant mortality rate using the PPOR model was 12.7 compared to 7.11 calculated using the traditional method. The maternal health cell rate was 5.4, maternal care cell rate was 2.9, newborn care cell was 1.9 compared to a 4.1 neonatal death rate calculated using the traditional method, and the infant health cell was 2.4 compared to a 2.9 postneonatal rate calculated using the traditional method. Because the highest infant mortality was in the maternal health cell, intervention strategies were designed to promote the health of women prior to and between pregnancies. The PPOR model was helpful in targeting interventions to reduce fetal-infant mortality based on the prioritization of contributing factors.

Disparities in Infant Mortality and Effective, Equitable Care: Are Infants Suffering from Benign Neglect?

“…To understand the limitations of prenatal care and programs linked to it, a review of the Perinatal Periods of Risk (PPOR)-an analytic strategy developed by the Atlanta-based World Health Organization Collaborating Center for Reproductive Health and applied nationally by CityMATCH-demonstrates the need to consider broader systems of care for different population groups (12). PPOR raises questions about the ability of prenatal care to intervene on risks for extremely early delivery given the short window of opportunity.…”

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

“…Previous PPOR analyses have found that the maternal health/prematurity category, which by definition consists of all VLBW births and fetal deaths, is often the greatest contributor to excess infant mortality [6–12]. A PPOR analysis in Kansas City found that deaths due VLBW were a significant issue among African Americans [7].…”

Risk of Very Low Birth Weight Based on Perinatal Periods of Risk

“…Studies have recently been published on the importance of improving preconception care in order to improve birth outcomes (Atrash et al., ). Other researchers utilizing the PPOR approach have recommended preconception care as an intervention to reduce infant mortality rates (Besculides & Laraque, ; Burns, ; Cai, Hoff, Dew, Guillory, & Manning, ).…”