Perinatal periods of risk: phase 2 analytic methods for further investigating feto-infant mortality.
The perinatal periods of risk (PPOR) methods provide a framework and tools to guide large urban communities in investigating their feto-infant mortality problem. The PPOR methods have 11 defined steps divided into three analytic parts: (1) Analytic Preparation; (2) Phase 1 Analysis-identifying the opportunity gaps or populations and risk periods with largest excess mortality; and (3) Phase 2 Analyses-investigating these opportunity gaps. This article focuses on the Phase 2 analytic methods, which systematically investigate the opportunity gaps to discover which risk and preventive factors are likely to have the largest effect on improving a community's feto-infant mortality rate and to provide additional information to better direct community prevention planning. This article describes the last three PPOR epidemiologic steps for investigating identified opportunity gaps: identifying the mechanism for excess mortality; estimating the prevalence of risk and preventive factors; and estimating the impact of these factors. While the three steps provide a common strategy, the specific analytic details are tailored for each of the four perinatal risk periods. This article describes the importance, prerequisites, alternative approaches, and challenges of the Phase 2 methods. Community examples of the methods also are provided.
Sappenfield
William M
WM
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. Bill_Sappenfield@doh.state.fl.us
Peck
Magda G
MG
Gilbert
Carol S
CS
Haynatzka
Vera R
VR
Bryant
Thomas
T
D001724:Birth Weight; D005260:Female; D046689:Fetal Mortality; D005431:Florida / Q000453:epidemiology; D005865:Gestational Age; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007229:Infant Welfare / Q000706:statistics & numerical data; D007231:Infant, Newborn; D008297:Male; D008429:Maternal Welfare / Q000706:statistics & numerical data; D018743:Perinatal Care / Q000379:methods* / Q000706:statistics & numerical data; D011247:Pregnancy; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D014505:Urban Population