Predictors of Early Death Among Infants and Toddlers Open Access

Malinowski, Renee Heather (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/rv042t57g?locale=en
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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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