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Postneonatal deaths from infections and injuries: race, maternal risk, and age at death
M M Adams1, P H Rhodes, B J McCarthy
1Pregnancy and Infant Health Branch, Centers for Disease Control, Atlanta, Georgia 30333.
Insights
Maternal attributes influence infant mortality risk, particularly for preventable causes like infections and injuries. This study reveals specific risks related to postneonatal age at death, highlighting the need for targeted prevention strategies.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Infant mortality remains a concern, with infections and injuries being preventable causes of death.
- While maternal factors influencing infant mortality are known, their impact on postneonatal age at death requires further investigation.
Purpose of the Study:
- To investigate the relationship between maternal attributes and postneonatal age at death from infections and injuries.
- To identify demographic and risk factors associated with infant mortality in the postneonatal period.
Main Methods:
- Analysis of postneonatal deaths from infections and injuries among white and black infants with birthweights >= 2,500 g.
- Categorization of infants based on maternal race and risk status (prenatal care initiation and maternal age).
Main Results:
- Maternal race and risk status did not correlate with age at death for infection-related deaths or most injury-related deaths (motor vehicle, fire, homicide).
- Deaths from choking, drowning, or suffocation occurred at younger ages among black infants, irrespective of maternal risk status.
Conclusions:
- Prevention efforts for choking, drowning, and suffocation deaths in black infants should target early infancy.
- Understanding maternal attributes' role in postneonatal mortality is crucial for developing effective public health interventions.
Abstract:
Most infants with birthweights greater than or equal to 2,500 g who survive the first 27 days of life have a reasonable opportunity to grow into healthy children. However, some of these infants succumb to two potentially preventable causes of death: infections and injuries. Although the relationship between maternal attributes and risk of death from these causes has been described, little is known about how maternal attributes relate to postneonatal age at death. To examine this relationship, we analyzed postneonatal deaths from infections and injuries among 3,116,391 white and 638,915 black neonatal survivors with birthweights greater than or equal to 2,500 g. We grouped postneonates by maternal race and risk status. Infants of mothers greater than or equal to 20 years of age who started prenatal care in the first trimester were considered low risk; all others were high risk. For each category of infection death (respiratory, central nervous system, and other bacterial--including sepsis), neither race nor maternal risk status was related to age at death. The same was true for three categories of injury death (motor vehicle, fire, and homicide), but not for injury deaths in the category of choking, drowning, or suffocation. Among blacks, these deaths occurred at younger ages, regardless of maternal risk status. Thus, efforts to prevent deaths from choking, drowning, or suffocation among blacks should focus on early infancy.