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The Perinatal Periods of Risk Phase 2 Analytic Methods—Case Study Exercise William M. Sappenfield, MD, MPH 2015 HRSA MCH EPI Course.

Published byDaisy Preston Modified over 8 years ago

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Presentation on theme: "The Perinatal Periods of Risk Phase 2 Analytic Methods—Case Study Exercise William M. Sappenfield, MD, MPH 2015 HRSA MCH EPI Course."— Presentation transcript:

1 The Perinatal Periods of Risk Phase 2 Analytic Methods—Case Study Exercise William M. Sappenfield, MD, MPH 2015 HRSA MCH EPI Course

2 Alaska Infant Mortality Rates, 1990-2012

3 Feto-Infant Mortality Rates Racial/Ethnic subgroups of Alaska, 2007-2009 (external reference group) Racial Groups Maternal Health/ Prematurity Maternal Care Newborn Care Infant Health Overall Feto- Infant Mortality All Races 1.91.71.33.17.9 White 1.51.10.91.65.2 Alaska Native 2.1 1.97.113.2 External Reference Group 2.01.30.90.85.0

4 Excess Excess Feto-Infant Mortality Rates Racial/Ethnic subgroups of Alaska, 2007-2009 (external reference group) Racial /Ethnic Groups Maternal Health/ Prematurity Maternal Care Newborn Care Infant Health Feto-Infant Mortality All Races -0.10.50.32.32.9 White -0.5-0.10.00.80.2 Alaska Native 0.10.81.06.38.2

5 Racial /Ethnic Groups Maternal Health/ Prematurity Maternal Care Newborn Care Infant Health Feto-Infant Mortality White -10-20163 Alaska Native 1785470 Other/ Missing 5104524 All -415127598 Excess Number Excess Number Feto-Infant Deaths Racial/Ethnic subgroups of Alaska, 2007-2009 (external reference group)

6 Phase 2 Analysis—Infant health period Identify causal pathways or biologic mechanisms for excess mortality Infant Health SIDS Injury Infection Anomalies Each cause category has its own set of Risk Factors Perinatal

7 Example Total Excess Mortality in the Infant Health Period is 0.712 Per 1000 live births over 1500 g

8 Passive smoke Sleep position Breast-feeding Bedding Co-sleep Maternal age Death scene investigation Folic acid intake Alpha-feto protein Alcohol Drug abuse Diabetes Ultrasound Delivery site Phase 2 Analysis—Infant health period Estimate prevalence of risk and preventive factors by type of mechanism SIDS/SUIDAnomalies

9 Medical home Immunizations Breast-feeding Passive smoke Prenatal care Maternal age Infection type Bedding Supervision Environment Injury type InjuryInfection Phase 2 Analysis—Infant health period Estimate prevalence of risk and preventive factors by type of mechanism

10 Feto-Infant Mortality Rates Racial/Ethnic subgroups of Alaska, 2004-2011 Racial Groups2004- 2006 2007- 2009 2010- 2011 Urban White6.24.95.0 Rural White5.16.04.9 Urban Alaska Native8.98.65.1 Rural Alaska Native13.015.77.2

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