Predictors of infant mortality among college-educated black and white women, Davidson County, Tennessee, 1990-1994.
Strategies to reduce US infant mortality rates often focus on the black-white disparity in rates. Linked Infant Birth and Death Files for Davidson County, Tennessee, from 1990 through 1994 were used to determine infant outcomes for infants born to college-educated white and black women. Risks for adverse outcomes were identified by comparing infant deaths to live births using logistic regression analyses. The following variables entered the logistic model process: maternal and paternal age; race and education; nativity status; maternal risk factors; interpregnancy interval; parity; infant gender; tobacco or alcohol use; number of prenatal visits; trimester in which prenatal care began; marital status; gestational age; and birthweight. After adjustment for the effects of the other variables, a gestational age < 28 completed weeks of gestation was the most significant independent predictor of infant death. Black race was not identified as a significant predictor of infant mortality. Regardless of race, a decrease in infant mortality rates among college-educated women in this country depends on the prevention of preterm births. Strategies to diagnose early preterm labor must proceed from a comprehensive maternal care program for all women. Open channels of communication between patient and provider will form the cornerstone for preterm prevention-intervention programs. Analysis of state and local infant mortality data may identify regional differences in infant mortality rates and differences in risk factors associated with adverse infant outcomes.
Scott-Wright
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Department of Family and Preventive Medicine, Meharry Medical College, Nashville, Tennessee, USA.
Wrona
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Flanagan
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D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001724:Birth Weight; D004522:Educational Status; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009035:Mothers; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D011247:Pregnancy; D011295:Prenatal Care; D012307:Risk Factors; D013714:Tennessee; D044465:White People / Q000706:statistics & numerical data