Epidemiological Risk Factors for Infant Mortality:
A study of Infant Mortality in Chesterfield County, Virginia
ABHA GUPTA
Background and Objectives: The purpose of this study was to identify the risk factors associated with risk of infant death in the Chesterfield County of Virginia. Infant mortality rate (IMR) is an indicator of population health, reflecting the state of maternal health including the quality and accessibility of primary health care for pregnant women and infants. This study examined trends, epidemiologic and sociodemographic risk factors of infant death in Chesterfield County, Virginia for the 5-year period from 1994 to 1998.
Methods: Obstetrical records of 16,333 live births, and birth-death linked files of 93 infants who died within one year of birth between January 1,1994 and December 31,1998 were obtained from the Center for Health Statistics, Virginia State Health Department. The following factors were available for examination: maternal demographics, prenatal care, source of care, payment method, maternal smoking status, maternal alcohol and substance abuse, gestational age, birth weight, congenital anomalies and causes of infant death. Univariate and multivariate analyses were conducted to estimate individual odds ratio for the factors contributing to infant mortality.
Results: There was no discernable trend in IMR for Chesterfield County, Virginia for the 5-year period studied (1994-98) with 3-year rolling rates being 6.1, 5.5 and 5.7 infant deaths per 1000 live births. Two-thirds of all infant deaths were neonatal (63.8%), one-third of neonatal deaths were due to disorders of short gestation and unspecified low birth weight (32.4%), and all other causes for death in neonates were less than 10% each. Two-fifths of post-neonatal death were due to Sudden Infant Death Syndrome (41%). There were only two statistically significant risk factors for infant death based on multivariate logistic regression analyses: Low birth weight of the child, which included Very Low Birth Weight and Low Birth weight (Adj. OR=60.37 95%CI 34.61,105.32 and Adj.OR=3.15,95% CI 1.51, 6.60 respectively) and self-paying patients (Adj. OR=2.52 95%CI 1.10,5.77). Other risk factors like race, age of mother, education, legitimacy of birth and number of prenatal visits, smoking status were not statistically significant when used in the logistic regression model, even though they showed statistically significant unadjusted odds-ratios.
Conclusions: Low birth weight is the major contributing factor for infant death in Chesterfield County. Health programs and efforts should target patients with these risk factors to reduce IMR. This finding is consistent with previous epidemiological studies.
