The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60244

Kwame Asamoa, MD, MSc¹, William M. Sappenfield, MDMPH², Emily Kahn, PhD, MPH³, Brian J McCarthy, MD⁴, and Dale Casto, JD, MBA¹. (1) Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, 770-488-6347, kasamoa@cdc.gov, (2) Reproductive Health, CDC, 4770 Buford Hwy K-23, Atlanta, GA 30341, (3) GA Division of Public Health, Maternal Child Health, Epi Section, 2 Peachtree St., Suite 14-430, Atlanta, GA 30303, (4) WHO/CC/Activity, DRH/NCCDPHP, CDC, 4770 Buford Hwy, MS K-20, Atlanta, GA 30341

Background: The Feto-infant mortality rate (FIMR) is the combination of fetal and infant deaths per 1,000 births. Georgia°¯s FIMR declined from 20.8 in 1980-1984 to 13.6 in 1995-1999. The black/white ratio increased from 2.0 to 2.4 over the same period. Exploring reasons for the gap may suggest new prevention strategies. Methods: We used linked birth and death certificate data for Georgia to examine FIMRs among black and white women for 1980-1984 and 1995-1999. We calculated rates by selected maternal and fetal/infant characteristics. Births were restricted to >500g (grams) and >20 weeks gestation. Results: FIMRs declined by 41.2% for white women but only 29.5% for black women. An increase in the percentage of birth to adult (>20 years) educated (>13 years) women accounted for 6% of the FIMR decline among white women and 4% among black women using Kitagawa°¯s formula. FIMR declines were greater for whites than blacks in all age/educational groups. (Teenagers: white, 31.8%; black 26.8%) (less educated adults: white, 34%; black 21.1%) (educated adults: white, 45.4%; black 36.6%). In 1995-1999, teenage births was greater among blacks (23.6%). White women had larger FIMR declines than black women in most birthweight and age-at-death groups. However, declines in FIMR were comparable for black and white mothers of postneonates weighing °Ý1500g at birth. In 1995-1999, 70% of the excess FIMR among black women was attributed to low birthweight (<1500g) fetal-infant deaths. Conclusions: The racial gap in Georgia°¯s FIMR widened across maternal groups and types of death. To reduce Georgia°¯s FIMR and the racial gap, we must prevent low birthweight/prematurity and teenage pregnancy while promoting higher education among black women.

Learning Objectives:

• * Participants will learn to use 2-dimensional framework for fetal-infant mortality analysis.
• * Use feto-infant mortality data to identify opportunity gaps
• * Turn data into information for priorities settings

Keywords: Infant Mortality, Fetal Mortality

Presenting author's disclosure statement:
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.