Three Maternal Risk Factors Associated with Elevated Risk of Postneonatal Mortality Among Alaska Native Population |
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Authors: | Margaret H Blabey Bradford D Gessner |
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Institution: | (1) Alaska Division of Public Health, Maternal and Child Health Epidemiology Unit, 3601 C. Street, Suite 424, P.O. Box 240249, Anchorage, AK 99524-0249, USA |
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Abstract: | Objective Compared to non-Natives in Alaska, the Alaska Native population has a postneonatal mortality rate 2.3 times higher (95% CI
1.9, 2.7). The objective of the study was to identify variables that account for this elevated risk. Methods The dataset used included birth and death certificate records for all Alaska-resident live births and infant deaths occurring
during 1992–2004. Race was defined as Alaska Native or non-Native. The association between race and postneonatal mortality
was examined using univariate, stratified and regression analyses. Variables were considered confounding if they resulted
in a change of at least 10% in the odds ratio between race and postneonatal mortality when added to a bivariate model, or
when removed from a multivariate model. Results In stratified analysis, race remained associated with postneonatal mortality within most categories of marital status, maternal
education, maternal age, prenatal tobacco or alcohol use, prenatal care utilization, parity and residence. The odds ratio
between race and postneonatal mortality was reduced to 1.3 (95% CI 1.0, 1.6) by controlling for education, a composite variable
of marital status and the presence of father’s name on the birth certificate, and prenatal tobacco or alcohol use. Conclusions A small number of potentially modifiable factors explain most of the postneonatal mortality disparity between Alaska Natives
and non-Natives, leaving a relatively small increase in risk. These findings suggest that by targeting Alaska Native women
who display these characteristics, the postneonatal mortality gap may be reduced. |
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Keywords: | Alaska Birth certificates Infant mortality Alaska Natives |
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