Abstract
Infant mortality has decreased nationwide; however, our national rates still log behind those of other industrialized countries, especially the rates for minority groups. This study evaluates the effect of prenatal care and risk factors on infant mortality rates in Chicago. Using linked infant birth and death certificates of Chicago residents for 1989-1995, a total of 5838 deaths occurring during the first year of life were identified. Birth certificate variables, especially prenatal care, were reviewed. Variables were compared by stratified analysis. Pearson chi 2 analysis and odd ratios (ORs) were computed. Infant mortality rate (IMR) in Chicago decreased from 17 in 1989 to 12.6 in 1995 (P < .0001). Some factors increased IMR several fold: prematurity (OR 17.43), no prenatal care (OR 4.07), inadequate weight gain (OR 2.95), African-American ethnicity (OR 2.55), and inadequate prenatal care (OR 2.03). Compared with no care, prenatal care was associated with lower IMR; however, early care was associated with higher IMR and ORs than later care. These results demonstrate prenatal care is associated with lower IMR; however, compared with late prenatal care, early care does not improve IMR. Further studies should evaluate whether improving the quality of care improves IMRs.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Curry M. A., Perrin N., Wall E. Effects of abuse on maternal complications and birth weight in adult and adolescent women. Obstet Gynecol. 1998 Oct;92(4 Pt 1):530–534. doi: 10.1016/s0029-7844(98)00258-0. [DOI] [PubMed] [Google Scholar]
- Fiscella K. Does prenatal care improve birth outcomes? A critical review. Obstet Gynecol. 1995 Mar;85(3):468–479. doi: 10.1016/0029-7844(94)00408-6. [DOI] [PubMed] [Google Scholar]
- Guyer B., Martin J. A., MacDorman M. F., Anderson R. N., Strobino D. M. Annual summary of vital statistics--1996. Pediatrics. 1997 Dec;100(6):905–918. doi: 10.1542/peds.100.6.905. [DOI] [PubMed] [Google Scholar]
- Huntington J., Connell F. A. For every dollar spent--the cost-savings argument for prenatal care. N Engl J Med. 1994 Nov 10;331(19):1303–1307. doi: 10.1056/NEJM199411103311910. [DOI] [PubMed] [Google Scholar]
- Kogan M. D., Alexander G. R., Kotelchuck M., Nagey D. A., Jack B. W. Comparing mothers' reports on the content of prenatal care received with recommended national guidelines for care. Public Health Rep. 1994 Sep-Oct;109(5):637–646. [PMC free article] [PubMed] [Google Scholar]
- Kogan M. D., Martin J. A., Alexander G. R., Kotelchuck M., Ventura S. J., Frigoletto F. D. The changing pattern of prenatal care utilization in the United States, 1981-1995, using different prenatal care indices. JAMA. 1998 May 27;279(20):1623–1628. doi: 10.1001/jama.279.20.1623. [DOI] [PubMed] [Google Scholar]
- Kotelchuck M. An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index. Am J Public Health. 1994 Sep;84(9):1414–1420. doi: 10.2105/ajph.84.9.1414. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mayer L., Liebschutz J. Domestic violence in the pregnant patient: obstetric and behavioral interventions. Obstet Gynecol Surv. 1998 Oct;53(10):627–635. doi: 10.1097/00006254-199810000-00021. [DOI] [PubMed] [Google Scholar]
- Poma P. A., Poma A. E. Influence of maternal ethnicity on infant mortality in Chicago, 1989-1996. J Natl Med Assoc. 1999 Feb;91(2):87–90. [PMC free article] [PubMed] [Google Scholar]