title: Excess Hispanic fetal-infant mortality in a midwestern community.
abstract: OBJECTIVE
  We assessed excess fetal-infant mortality for Hispanic, non-Hispanic white, and non-Hispanic black populations in five contiguous counties of Missouri and Kansas.
  
  
  METHODS
  We conducted a perinatal periods of risk (PPOR) assessment of fetal-infant mortality using electronic linked birth-death record files from 2001 through 2005. We generated an internal reference group in accordance with established PPOR protocol. We used Kitagawa analysis to determine whether excess deaths were due to birthweight distribution (a higher frequency of prematurity or growth retardation) or to higher mortality rates once born at that birthweight (birthweight-specific mortality).
  
  
  RESULTS
  We found the excess fetal-infant death rates for Hispanic and non-Hispanic white populations to be similar and considerably lower than that for non-Hispanic black populations. Among Hispanic children, we judged 21.6% of fetal-infant mortality to be excess in relation to the reference population. Within the PPOR matrix, Hispanic excess mortality rates were distributed differently from those of non-Hispanic white and non-Hispanic black populations. Among Hispanic children, 93.6% of the excess mortality could be explained by low birthweight and birthweight-specific mortality, with the greatest contribution attributable to low birthweight.
  
  
  CONCLUSIONS
  The excess fetal-infant mortality experience of Hispanic people in the five-county region was similar to that of the non-Hispanic white population, but was distributed differently in the PPOR model, which has significance regarding interventions targeting reductions in fetal-infant mortality.
authors.affiliation: Kansas City Health Department, Office of Epidemiology and Community Health Monitoring, Kansas City, MO 64108, USA. Gerald_hoff@kcmo.org
authors.forename: Gerald L
authors.initials: GL
authors.lastname: Hoff
authors.forename: Jinwen
authors.initials: J
authors.lastname: Cai
authors.forename: Felix A
authors.initials: FA
authors.lastname: Okah
authors.forename: Paul C
authors.initials: PC
authors.lastname: Dew
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D005260:Female; D046689:Fetal Mortality / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000208:ethnology*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007615:Kansas / Q000453:epidemiology; D008429:Maternal Welfare / Q000706:statistics & numerical data; D008498:Medical Record Linkage; D008923:Missouri / Q000453:epidemiology; D018743:Perinatal Care; D011247:Pregnancy; D044465:White People / Q000706:statistics & numerical data