The primary goal of the proposed study is to examine the relationship between race and infant mortality in the context of a general model of risk factors for infant mortality. Data on births and deaths will be obtained from a 20 county region in North Carolina (Perinatal Care Region Two) for 1984-1987. The model will include demographic characteristics, medical and behavioral factors, and characteristics of the mother and infant previously found to be related to low birth weight and infant mortality. Analyses that focus specifically on low birth weight births also will include a risk factor defined as medical etiology that identifies the proximal processes and events judged directly responsible for a preterm birth, and incorporates them into a more detailed categorization of the traditional dichotomization of term vs. preterm birth. Detailed preliminary analyses will be conducted between race and medical etiology and the manner in which they related to infant mortality. Data on medical etiology will be obtained from records of hospitals in Perinatal Care Region Two, and from a small number of hospitals peripheral to the region where residents may go to give birth. These data will be merged with computerized information from the North Carolina vital statistics birth/fetal death and birth/infant death files, and with data from the prevention of prematurity program currently being conducted in Perinatal Care Region Two. Data from the prevention of prematurity program will provide an expanded set of risk factors generally not available in studies of risk for infant mortality. As the initial step in the development of multivariate models of risk for infant mortality, all risk factors hypothesized to impact on infant mortality will be identified as exogenous and intervening. Intervening variables will be further delineated in terms of their type and temporal proximity to the outcome variable. Multivariate analyses will examine the appropriateness of a single model of risk for infant mortality as opposed to separate models for specific subgroups of women. Analyses will be conducted separately for neonatal and postneonatal deaths.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD024159-03
Application #
3324599
Study Section
Special Emphasis Panel (SRC)
Project Start
1988-07-01
Project End
1991-12-31
Budget Start
1990-07-01
Budget End
1991-12-31
Support Year
3
Fiscal Year
1990
Total Cost
Indirect Cost
Name
Wake Forest University Health Sciences
Department
Type
Schools of Medicine
DUNS #
041418799
City
Winston-Salem
State
NC
Country
United States
Zip Code
27106
Michielutte, R; Moore, M L; Meis, P J et al. (1994) Race differences in infant mortality from endogenous causes: a population-based study in North Carolina. J Clin Epidemiol 47:119-30
Moore, M L; Michielutte, R; Meis, P J et al. (1994) Etiology of low-birthweight birth: a population-based study. Prev Med 23:793-9
Michielutte, R; Ernest, J M; Moore, M L et al. (1992) A comparison of risk assessment models for term and preterm low birthweight. Prev Med 21:98-109