Table 2.
Bivariate and multivariate logistic regression estimation of odds of term infant mortality by contextual county characteristics and individual maternal sociodemographic, health and obstetric characteristics in the US, 2013
| Model 1 | Model 2 | Model 3 | Model 4 | |||||
|---|---|---|---|---|---|---|---|---|
| Bivariate | County variables | Individual variables | County + individual variables | |||||
| OR | 95%CI | aOR | 95%CI | aOR | 95%CI | aOR | 95%CI | |
| Contextual County Characteristics | ||||||||
| Poverty≠ | ||||||||
| Low | Referent | Referent | Referent | |||||
| Medium | 1.41*** | (1.19, 1.66) | 1.39** | (1.17, 1.64) | – | – | 1.16 | (0.99, 1.36) |
| High | 1.84*** | (1.56, 2.18) | 1.90*** | (1.60, 2.27) | – | – | 1.31*** | (1.11, 1.54) |
| County Urban/Rural Scheme | ||||||||
| Large central metro | 1.07 | (0.93, 1.22) | 0.85* | (0.75, 0.96) | – | – | 0.98 | (0.9, 1.1) |
| Large fringe metro | Referent | Referent | Referent | |||||
| Medium metro | 1.30*** | (1.18, 1.46) | 1.02 | (0.91, 1.15) | – | – | 1.05 | (0.95, 1.17) |
| Small metro | 1.23*** | (1.08, 1.41) | 0.97 | (0.84, 1.10) | – | – | 0.95 | (0.83, 1.08) |
| Micropolitan (non-metro) metro | 1.55*** | (1.37, 1.76) | 1.19** | (1.04, 1.35) | – | – | 1.10 | (0.97, 1.24) |
| Non-core (non-metro) | 1.72*** | (1.51, 1.97) | 1.31*** | (1.14, 1.50) | – | – | 1.16* | (1.02, 1.33) |
| Maternal Individual Characteristics | ||||||||
| Gestational age (weeks) | ||||||||
| 37 | 2.30*** | (2.13, 2.48) | – | – | 2.12*** | (1.95, 2.31) | 2.12*** | (1.95, 2.31) |
| 38 | 1.43*** | (1.33, 1.53) | – | – | 1.38*** | (1.28,1.49) | 1.38*** | (1.28, 1.49) |
| 39 | Referent | Referent | Referent | |||||
| 40 | 0.82*** | (0.76, 0.88) | – | – | 0.85*** | (0.78, 0.92) | 0.86*** | (0.79, 0.93) |
| ≥ 41 | 0.86** | (0.77, 0.96) | – | – | 0.92 | (0.81, 1.04) | 0.93 | (0.82, 1.05) |
| Maternal age (years) | ||||||||
| 15–19 | 1.62*** | (1.48, 1.77) | – | – | 1.50*** | (1.34, 1.68) | 1.47*** | (1.31, 1.65) |
| 20–24 | 1.39*** | (1.30, 1.48) | – | – | 1.19*** | (1.10, 1.29) | 1.18*** | (1.09, 1.27) |
| 25–29 | Referent | Referent | Referent | |||||
| 30–34 | 0.74*** | (0.69, 0.80) | – | – | 0.78*** | (0.71, 0.85) | 0.79*** | (0.72, 0.86) |
| 35–39 | 0.76*** | (0.69, 0.84) | – | – | 0.83*** | (0.74, 0.92) | 0.84** | (0.75, 0.94) |
| ≥ 40 | 1.25** | (1.08, 1.44) | – | – | 1.29** | (1.10, 1.52) | 1.33** | (1.12, 1.56) |
| Maternal education | ||||||||
| High school or less | 2.47*** | (2.31, 2.65) | – | – | 1.30*** | (1.18, 1.44) | 1.27*** | (1.15, 1.40) |
| Some college/AA | 1.81*** | (1.68, 1.96) | – | – | 1.19*** | (1.08, 1.31) | 1.17** | (1.06, 1.28) |
| Bachelor’s or more | Referent | Referent | Referent | |||||
| Maternal race/ethnicity | – | – | ||||||
| Non-Hispanic White | Referent | Referent | Referent | |||||
| Non-Hispanic Black | 1.63*** | (1.53, 1.74) | – | – | 1.19*** | (1.10, 1.29) | 1.20*** | (1.11, 1.31) |
| Hispanic | 0.84*** | (0.78, 0.89) | – | – | 0.68*** | (0.62, 0.73) | 0.68*** | (0.63, 0.74) |
| Non-Hispanic Other | 0.75*** | (0.67, 0.84) | – | – | 0.87* | (0.76, 0.99) | 0.89 | (0.78, 1.01) |
| Marital status | ||||||||
| No | Referent | Referent | Referent | |||||
| Yes | 0.53*** | (0.51, 0.56) | – | – | 0.83*** | (0.78, 0.89) | 0.83*** | (0.78, 0.89) |
| Number of previous live births | ||||||||
| 0 | Referent | Referent | Referent | |||||
| 1–2 | 1.22*** | (1.15, 1.29) | – | – | 1.32*** | (1.24, 1.42) | 1.31*** | (1.23, 1.41) |
| ≥ 3 | 1.83*** | (1.70, 1.97) | – | – | 1.81*** | (1.65, 2.00) | 1.78*** | (1.61, 1.96) |
| Infant sex | ||||||||
| Male | Referent | Referent | Referent | |||||
| Female | 0.84*** | (0.80, 0.88) | – | – | 0.84*** | (0.80, 0.89) | 0.84*** | (0.80, 0.89) |
| Month prenatal care began | ||||||||
| First trimester | Referent | Referent | Referent | |||||
| Second trimester | 1.55*** | (1.46, 1.65) | – | – | 1.25*** | (1.16, 1.34) | 1.24*** | (1.16, 1.33) |
| Third trimester | 2.23*** | (2.04, 2.44) | – | – | 1.71*** | (1.55, 1.90) | 1.70*** | (1.54, 1.89) |
| No prenatal care | 3.71*** | (3.25, 4.23) | – | – | 2.12*** | (1.80, 2.53) | 2.09*** | (1.76, 2.49) |
| Tobacco use during pregnancy | ||||||||
| No | Referent | Referent | Referent | |||||
| Yes | 2.59*** | (2.43, 2.76) | – | – | 1.79*** | (1.65, 1.94) | 1.77*** | (1.63, 1.91) |
| Chronic hypertension | ||||||||
| No | Referent | Referent | Referent | |||||
| Yes | 1.64*** | (1.38, 1.94) | – | – | 1.32** | (1.07, 1.62) | 1.30* | (1.06, 1.60) |
| Chronic diabetes | ||||||||
| No | Referent | Referent | Referent | |||||
| Yes | 1.06 | (0.95, 1.18) | – | – | 1.02 | (0.90, 1.15) | 1.02 | (0 .90, 1.15) |
| Pregnancy associated hypertension | ||||||||
| No | Referent | Referent | Referent | |||||
| Yes | 1.18** | (1.05, 1.32) | – | – | 1.04 | (0.91, 1.19) | 1.03 | (0.90, 1.18) |
| Medicaid | ||||||||
| No | Referent | Referent | Referent | |||||
| Yes | 1.95*** | (1.85, 2.06) | – | – | 1.20*** | (1.11, 1.28) | 1.18*** | (1.10, 1.27) |
| N | – | 2,551,828 | 2,551,828 | 2,551,828 | ||||
| ICC | – | 0.015*** | – | 0.006*** | ||||
* p < 0.05, ** p < 0.01, *** p < 0.001, ≠low poverty (< 10%), medium poverty (10.0–19.9%), high poverty (≥20%)