Perinatal Periods of Risk: Phase 2 Analytic Methods for Further Investigating Feto-Infant Mortality

• Published in: Maternal and child health journal 2010-11, Vol.14 (6), p.851-863
• Main Authors: Sappenfield, William M., Peck, Magda G., Gilbert, Carol S., Haynatzka, Vera R., Bryant, Thomas
• Format: Article
• Language: English
• Subjects: Birth Weight; Childrens health; Disease control; Disease prevention; Female; Fetal Mortality; Florida - epidemiology; Gestational Age; Gynecology; Health services; Health Status Disparities; Health surveillance; Healthcare Disparities; Humans; Infant; Infant Mortality; Infant Welfare - statistics & numerical data; Infant, Newborn; Infants; Investigations; Male; Maternal and Child Health; Maternal Welfare - statistics & numerical data; Medical screening; Medicine; Medicine & Public Health; Methods; Patient outcomes; Pediatrics; Perinatal Care - methods; Perinatal Care - statistics & numerical data; Planning; Population Economics; Pregnancy; Public Health; Residence Characteristics; Risk Assessment; Risk Factors; Socioeconomic Factors; Sociology; Urban areas; Urban Population
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-010-0624-5

The perinatal periods of risk (PPOR) methods provide a framework and tools to guide large urban communities in investigating their feto-infant mortality problem. The PPOR methods have 11 defined steps divided into three analytic parts: (1) Analytic Preparation; (2) Phase 1 Analysis—identifying the opportunity gaps or populations and risk periods with largest excess mortality; and (3) Phase 2 Analyses—investigating these opportunity gaps. This article focuses on the Phase 2 analytic methods, which systematically investigate the opportunity gaps to discover which risk and preventive factors are likely to have the largest effect on improving a community’s feto-infant mortality rate and to provide additional information to better direct community prevention planning. This article describes the last three PPOR epidemiologic steps for investigating identified opportunity gaps: identifying the mechanism for excess mortality; estimating the prevalence of risk and preventive factors; and estimating the impact of these factors. While the three steps provide a common strategy, the specific analytic details are tailored for each of the four perinatal risk periods. This article describes the importance, prerequisites, alternative approaches, and challenges of the Phase 2 methods. Community examples of the methods also are provided.