Ao. Scottwright et al., PREDICTORS OF INFANT-MORTALITY AMONG COLLEGE-EDUCATED BLACK-AND-WHITEWOMEN, DAVIDSON COUNTY, TENNESSEE, 1990-1994, Journal of the National Medical Association, 90(8), 1998, pp. 477-483
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.