180038 Analysis of Greater New Haven Perinatal Outcomes: Prematurity, Sudden Unexplained Infant Deaths and Fetal & Infant Mortality

Sunday, October 26, 2008

Caesar A. Anderson, MD , School of Public Health, Yale University, New Haven, CT
Chhitij Bashyal, BS , School of Public Health, Yale University, New Haven, CT
Magdalena Boelsterl, MD , School of Public Health, Yale University, New Haven, CT
Shaan Chaturvedi, BS , School of Public Health, Yale University, New Haven, CT
Kathryn Foti, MPH , Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
Brian Karsif, MD , Department of Obstetrics and Gynecology, Yale New Haven Hospital, New Haven, CT
Laura Frye, BA , School of Public Health, Yale University, New Haven, CT
BACKGROUND: Within the US, Fetal and Infant Mortality (FIM) rates remain high compared to other developed nations. More alarmingly, the FIM rates within the Greater New Haven (GNH) area continue to rise. Prematurity is believed to account for approximately 80% - 90% of these deaths though other contributing factors have been offered. The Greater New Haven Fetal and Infant Mortality Review (FIMR) Project was developed in 2003 to elucidate these factors in an attempt to reduce this rising trend. It includes four health departments and eight cities/towns representing diverse socioeconomic sectors of the GNH area, hence offering widened perspective into this complex and troubling vital statistic.


The aim of our study is to identify the most important preventable medical and social risk factors associated with poor perinatal outcomes and fetal/infant demise.


We designed a case-control study identifying potential causes of the recent increase in FIM rates in the GNH area. Maternal medical records along with fetal/infant deaths occurring in 2007 were reviewed along with corresponding birth and death certificate data. Socio-demographic and medical risk factors were collected. Resident live births were randomly selected as matched controls. In depth statistical analysis was performed to identify the most relevant risk factors for fetal/infant demise.


This study is the first large scale chart review performed in this area. It provides insight about FIM contributors in the GNH area. Moreover, this study aims to utilize acquired data to tailor and implement local preventative measures while allowing inferences for regional application.

Learning Objectives:
Improving pregnancy outcomes via interpretation of maternal health records as they relate to fetal and infant mortality.

Keywords: Maternal and Child Health, Fetal Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I meet APHA Criteria for authorship as well as meet all Conflict of Interest and Commercial Support guidelines.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.