Predictors of Early Death Among Infants and Toddlers Open Access
Malinowski, Renee Heather (2012)
Abstract
Background Progress made in
the reduction of infant and toddler mortality rates over the past
two decades in the U.S. has recently stalled. A reevaluation of the
data provided from birth and death certificates can lead to a
better understanding of the current epidemiologic characteristics
of children that are at the highest risk of early death.Risk
factors for premature death among children must be identified and
understood so that those at high risk for mortality can be
identified and for public health policy interventions to be
effective. The objective of this study was to identify
maternal and infant characteristics associated with early death
from SIDS and homicide in a Georgia birth cohort.
Methods Child deaths for a
1999-2003 Georgia birth cohort were linked back to birth
certificate records. Controls were selected using systematic random
sampling, and deaths were compared to survivors. Descriptive,
bivariate, and logistic regression analyses were performed on the
data to examine the associations between selected maternal and
infant characteristics and mortality from SIDS and
homicide.
Results Low maternal
educational attainment and maternal tobacco use during pregnancy
were the strongest predictors of post-neonate mortality from SIDS
across all three maternal race/ethnicity groups. Important
predictors of SIDS deaths for post-neonate non-Hispanic white
children include low maternal education attainment, young maternal
age, unmarried marital status, tobacco use during pregnancy, and
low birth weight. The most important predictors of SIDS deaths
among children of non-Hispanic black mothers include late entry
into prenatal care, young maternal age, unmarried marital status,
tobacco use during pregnancy, male gender, and low birth weight.
Important predictors of homicide deaths for non-Hispanic whites
include unmarried marital status and late entry into prenatal care.
Important predictors of homicide deaths for children of
non-Hispanic blacks include young maternal age, unmarried marital
status, tobacco use during pregnancy, and male gender.
Conclusions Intervention
programs aimed at increasing the educational attainment levels of
mothers, eliminating the use of tobacco by pregnant women, and
supporting the special care needs of low birth weight and preterm
infants are likely to have the greatest impact in reducing infant
mortality rates.
Table of Contents
Table of Contents
BACKGROUND…………….........1
METHODS..........................4
RESULTS...........................6
DISCUSSION....................11
REFERENCES....................16
TABLES............................19
APPENDIX........................36
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