PREDICTORS OF INFANT-MORTALITY AMONG COLLEGE-EDUCATED BLACK-AND-WHITEWOMEN, DAVIDSON COUNTY, TENNESSEE, 1990-1994

Strategies to reduce US infant mortality rates often focus on the blac k-white disparity in rates. Linked Infant Birth and Death Files for Da vidson County Tennessee, from 1990 through 1994 were used to determine infant outcomes for infants born to college-educated white and black women. Risks for adverse outcomes were identified by comparing infant deaths to live births using logistic regression analyses. The followin g variables entered the logistic model process: maternal and paternal age; race and education; nativity status; maternal risk Factors; inter pregnancy interval; parity; infant gender; tobacco or alcohol use; num ber of prenatal visits; trimester in which prenatal care began; marita l status: gestational age; and birth weight. After adjustment For the effects of the other variables, a gestational age <28 completed weeks of gestation was the most significant independent predictor of infant death. Black race was not identified as a significant predictor of inf ant mortality Regardless of race, a decrease in infant mortality rates among college-educated women in this country depends on the preventio n of preterm births. Strategies to diagnose early preterm labor must p roceed From a comprehensive maternal care program for all women. Open channels of communication between patient and provider with form the c ornerstone for preterm prevention-intervention programs. Analysis of s tate and local infant mortality data may identify regional differences in infant mortality rates and differences in risk factors associated with adverse infant outcomes.