Racial and Ethnic Disparities in Perinatal Mortality: METHODS

7 Nov
2009

The PPOR model was applied to fetal and infant mortality data collected in New York City from 1996 to 2000. In accordance with the model, birthweight was imputed from gestational age where weight was missing, as described in the cited reference. Imputation was needed for 7.7% of spontaneous abortion records, 1.5% of infant death records and <1% of birth records.

Data Source

Spontaneous abortion, live birth and composite birth/infant death files for the five-year period were used. These computer files are routinely created by the New York City Department of Health and Mental Hygiene’s Office of Vital Statistics and are based on spontaneous abortion, birth and death certificates registered in the city.
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Definitions

A fetal death was defined as the extraction or expulsion of a fetus that showed no sign of life. Fetal deaths were limited to those of >20 weeks’ gestation. Neonatal deaths were defined as infant deaths occurring through the first 27 days of life, and postneonatal deaths as those from 28-364 days.

Analysis

In accordance with the model, only fetuses/infants weighing >500 g were included in the analysis. Analysis was also limited to New York City residents. Analysis was completed for the city as a whole and by racial/ethnic group (white non-Hispanic, black non-Hispanic, Hispanic, Asian/Pacific Islander). Differences in feto-infant mortality among racial/ethnic groups were calculated using white non-Hispanics as the referent group. To determine if these differences were statistically significant, a z score was calculated and the p value examined. A p value <0.05 was considered significant. Excess deaths between black and white non-Hispanics were then calculated by subtracting the rates of blacks from the rates of whites. The significance of this excess was calculated using a z score. Analysis was completed using SPSS version 10.1.
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