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Composite “Pictures” of Infant Mortality in Mississippi

Composite “Pictures” of Infant Mortality in Mississippi. Marianne Zotti, DrPH, MS, RN Jaime C. Slaughter, MPH. Perinatal Periods of Risk. Age @ Death. Birthweight. Neonatal. Fetal. Post neonatal. Maternal Health/Prematurity. < 1500g. Maternal Care. Newborn Care. Infant Health.

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Composite “Pictures” of Infant Mortality in Mississippi

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  1. Composite “Pictures” of Infant Mortality in Mississippi Marianne Zotti, DrPH, MS, RN Jaime C. Slaughter, MPH

  2. Perinatal Periods of Risk Age @ Death Birthweight Neonatal Fetal Post neonatal Maternal Health/Prematurity < 1500g Maternal Care Newborn Care Infant Health >1500g

  3. MS Feto-Infant Mortality Rate Maternal Health/Prematurity 5.6 Maternal Care 3.3 Newborn Care 1.7 Infant Health 3.2 13.8 Feto-Infant deaths per 1,000 Live Births & Fetal Deaths

  4. Excess Feto-Infant Mortality Rate Maternal Health/Prematurity 2.8 Maternal Care 1.5 Newborn Care 0.4 Infant Health 1.7 6.4 Feto-Infant deaths per 1,000 Live Births & Fetal Deaths

  5. MS White Feto-Infant Mortality Rate Maternal Health/Prematurity 3.2 Maternal Care 2.5 Newborn Care 1.4 Infant Health 2.5 9.5 Feto-Infant deaths per 1,000 Live Births & Fetal Deaths

  6. MS White Excess Feto-Infant Mortality Rate Maternal Health/Prematurity 0.4 Maternal Care 0.7 Newborn Care 0.1 Infant Health 1.0 2.1 Feto-Infant deaths per 1,000 Live Births & Fetal Deaths

  7. MS Black Feto-Infant Mortality Rate Maternal Health/Prematurity 8.3 Maternal Care 4.1 Newborn Care 2.0 Infant Health 4.0 18.4 Feto-Infant deaths per 1,000 Live Births & Fetal Deaths

  8. MS Black Excess Feto-Infant Mortality Rate Maternal Health/Prematurity 5.5 Maternal Care 2.3 Newborn Care 0.7 Infant Health 2.5 11.0 Feto-Infant deaths per 1,000 Live Births & Fetal Deaths

  9. How did we use what we learned? Reviewed studies programs policies Discussed plans for next year

  10. Maternal Health/ Prematurity Maternal Health/Prematurity Perinatal Care Preconceptional Health Unintended Pregnancies Maternal Risk Factors Interpregnancy Interval Prematurity Maternal Health/ Prematurity 2.8 Maternal Health/Prematurity 2.6 Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

  11. Maternal Health/ PrematurityPerinatal Care • Perinatal Regionalization Study • 40% VLBW infants are born in Level A hospital • Decreasing hospital levels significantly increases mortality • Even when controlling for <1000 gm Infants • Exception: large volume Level B hospitals • Infants <1000 gm mortality incrementally increases as hospital level decreases Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

  12. Maternal Health/ PrematurityPreconceptional Care Folic Acid Intake Smoking Alcohol use Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

  13. Maternal Health/ PrematurityPreconceptional Care • Folic Acid study of Family Planning Clients • 47% of FP did not know the benefits of folic acid • ~50% don’t know best time to take folic acid • 86% of FP clients don’t take a multivitamin Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

  14. Maternal Health/ PrematurityPreconceptional Care • Smoking study (1995-1997) • Overall prenatal smoking rate is decreasing … • But increased among young pregnant women aged 15-19 years old • Smokers’ infants experience more • LBW • SIDS Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

  15. Maternal Health/ PrematurityUnintended Pregnancies • Future information available on PRAMS • Unintended pregnancies • Alcohol use • Prenatal experiences • Stressors • Abuse Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

  16. Maternal Health/ Prematurity Interpregnancy Interval (<1500 grams) Interpregnancy Interval <18 months=32% 0-3 months=3% Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

  17. Maternal Health/ Prematurity Prematurity (<1500 grams) Maternal Demographics for Premature Infants 68% were Black 24% were age <20 61% were single 18% had <12 years education Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

  18. Maternal Care Maternal Care Prenatal Care Referral of High Risk Pregnancies Maternal Health Risks Maternal Care 1.5 Maternal Health/Prematurity 2.6 Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

  19. Maternal CarePrenatal Care Prenatal Care Utilization 12% Inadequate (W=7%, B=20%) 75% Adequate and Adequate + Maternal Health/Prematurity 2.60 Maternal Care 1.35 Newborn Care 0.20 Infant Health 1.5

  20. Maternal CareInterpregnancy Interval Interpregnancy Interval <18 months=31% 0-3 months=2% Maternal Health/Prematurity 2.60 Maternal Care 1.35 Newborn Care 0.20 Infant Health 1.5

  21. Infant Health Infant Health SIDS Risk Reduction Activities Breastfeeding Promotion Access to Medical Homes Injury Prevention Infant Health 1.7 Maternal Health/Prematurity 2.6 Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

  22. Infant HealthSIDS • Mississippi SIDS Coalition/MSDH SIDS Study • 55 % stopped smoking while they were pregnant • Only 53 % of women put their baby down to sleep on its back • 82 % were told about keeping smoke away from the baby and having a safe baby bed environment Maternal Health/Prematurity 2.6 Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

  23. Infant HealthBreastfeeding • Ross Mothers Survey • From 1995 to 2000 the Mississippi’s breastfeeding rate has increased for all infants. • 1995 2000 • In hospital 35.8 % 48.8 % • 6 months 9.5 % 15.4 % Maternal Health/Prematurity 2.6 Maternal Care 1.4 Newborn Care 0.2 Infant Health 1.5

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