Objective. To determine the effect of infant, maternal, and community-level risk factors on the postneonatal mortality rate (28-365 days, PNMR) of urban Mexican-Americans.
Methods. We analyzed a linked dataset of 1992-1995 Illinois vital records, 1990 US census income data, and 1995 Chicago public health information. Chicago communities with 1 or more ecologic risk factors (low median family income, high rates of unemployment, homicide and lead poisoning) were classified as impoverished.
Results. In Chicago, Mexican-American infants with U.S.-born mothers (N=10,599) had a 50% greater PNMR than infants with Mexican-born mothers (N=40,813); 3.2/1,000 vs. 2.1/1,000, respectively. The nativity differential in PNMR persisted among low-risk Mexican-Americans: 1) infant birthweight > 2500g; RR=1.6(1.0-2.5); 2) maternal age > 20 yrs, RR=1.6(1.0-2.5); and 3) maternal education > 12 yrs, RR=2.3(0.7-7.4). In a logistic model of Mexican-American infants who resided in non-impoverished communities, the adjusted (controlling for 6 independent variables) odds ratio of PNM was 1.4 (1.1-1.9) for those with U.S.-born mothers. Mexican-American infants with U.S.-born (compared to Mexican-born) mothers had a two-fold greater mortality rate from preventable causes (SIDS, injuries, and infections); RR=2.1 (1.4-2.8).
Conclusions. The PNMR of urban Mexican-American infants with U.S-born mothers exceeds that of infants with Mexican-born mothers independent of traditional risk factors. This suggest that unidentified variables closely related to maternal life-long underserved, minority status are detrimental to the postneonatal outcome of Mexican-American infants.
Learning Objectives: To understand the association between maternal nativity and postneonatal mortality rates
Keywords: Infant Mortality, Latino
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.