Risk Factors for Pneumonia-Associated Infant Death in the United States, 2007-2010 Open Access

Ramakrishnan, Sharada (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/vq27zn57c?locale=en
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Abstract

Abstract

Risk Factors for Pneumonia-Associated Infant Death in the United States, 2007-2010

By: Sharada Ramakrishnan

PURPOSE: The objective of this study was to determine maternal and infant risk factors associated with pneumonia-associated infant death in the United States.

METHODS:
Using the United States Period Linked Birth/Infant Death data for 2007-2010, a retrospective case-control study was conducted to determine infant and maternal risk factors for pneumonia-associated infant death among singleton infants born in the United States. A pneumonia-associated death was defined by the presence of an International Classification of Diseases, Tenth Revision (ICD-10) code for pneumonia (J12 - J18). Infants who survived their first year were randomly selected as controls to obtain a 1 to 4 ratio of cases to controls. Risk factors for pneumonia-associated infant death were determined using multivariable logistic regression modeling.

RESULTS: The infant mortality rate for pneumonia-associated infant death during 2007-2010 in the United States was 10.7. Male sex was associated with higher odds of pneumonia-associated death (OR 1.45, 95% CI 1.28-1.64) compared to females, infants with a 5-minute Apgar score <7 had higher odds (OR 7.41, 95% CI 5.53-10.01) of pneumonia-associated death compared to infants with a score ≥7. The American Indian/Alaska Native race group had the highest odds of pneumonia-associated death (OR 2.23, 95% CI 1.48-3.31) compared to the White race group. Among both low and normal birth weight infants, those born first in live birth order had lower odds of pneumonia-associated death compared to those born second in live birth order. Among low birth weight infants, the maternal age category of 20-24 years had a higher odds of pneumonia-associated death, whereas for normal birth weight, those with maternal age ≤19 had a higher odds.

DISCUSSION: Pneumonia is one of the top ten leading causes of death in the United States. The findings in this study are relevant for reducing the impact of pneumonia-associated death in the United States. Health care providers and mothers will be able to identify methods for prevention of pneumonia during prenatal care, and awareness of risk factors will lead to an overall decrease in the rate of pneumonia-associated death.

Table of Contents

TABLE OF CONTENTS

1. Introduction..........1

1.1. Disease Definition..........1

1.2. Symptoms and Treatment/Management..........2

1.3. Prevention and Immunization..........3

1.4. Causes and Known Risk Factors..........4

2. Methods..........5

2.1. Epidemiological Methods and Analyses..........5

2.2. Maternal and Infant Risks and Model Selection..........7

3. Results..........8

3.1. Infant Mortality Rates..........8

3.2. Risk Factors..........9

4. Discussion..........10

5. Tables..........13

1. Summary of ICD-10 Codes..........13

2. Proportion of Selected Maternal and Infant Characteristics by Cases and Controls..........14

3. Deaths and Infant Mortality Rates (IMRs) for Select Infant and Maternal Characteristics..........15

4. Summary of Multivariable Logistic Regression Analysis of Select Risk Factors..........16

6. Figures..........17

1. Distribution of Infant Age at Death..........17

7. References..........18

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