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The application of a risk-approach model to reduce mortality in infancy

L A Morgan1, C J Simons, C M Britton

  • 1Department of Pediatrics, West Virginia University School of Medicine, Morgantown 26506-9218, USA.

The Journal of Pediatrics
|May 29, 1998
PubMed

Insights

The Sheffield Birth Score effectively identifies infants at high risk of postneonatal mortality (PNM). Linking these infants to primary care significantly reduces PNM rates, highlighting the importance of early intervention.

Area of Science:

  • Neonatal health
  • Public health interventions
  • Risk stratification models

Background:

  • Postneonatal mortality (PNM) remains a significant concern in infant health.
  • Identifying infants at risk early is crucial for effective intervention.
  • The role of primary health care linkage in mitigating PNM requires further investigation.

Purpose of the Study:

  • To evaluate the Sheffield Birth Score's utility in identifying infants at elevated risk of postneonatal mortality.
  • To ascertain the association between linkage to primary health care and postneonatal mortality rates in at-risk infants.

Main Methods:

  • The Sheffield Birth Score was administered to 90,846 newborns, categorizing them into high-score (HS) and low-score (LS) risk groups.
  • Health care visit data were collected for all HS infants referred to primary pediatric care.
  • Mortality rates were compared between HS and LS groups, and between linked and unlinked HS infants.

Main Results:

  • Infants in the HS group exhibited a significantly higher risk of postneonatal mortality (p < 0.0001).
  • A lower PNM rate was observed in the group of HS infants linked to primary care (p < 0.05).
  • Logistic regression analysis identified linkage to care as the sole significant predictor of reduced PNM (p < 0.01).

Conclusions:

  • The Sheffield Birth Score accurately identifies infants at increased risk for postneonatal mortality at birth.
  • Early pediatric intervention, facilitated by linkage to primary care, demonstrates a promising reduction in PNM.
  • Further research is recommended to explore factors influencing health care participation decisions among at-risk families.
Abstract

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