The effect of maternal demographic factors on infant mortality rates. Summary of the findings of the Louisiana Infant Mortality Study. Part I

Abstract

Birth and infant death certificates for Louisiana in 1972 were matched and reviewed to identify groups particularly in need of close medical support and counselling during the identify groups particularly in need of close medical support and counselling during the life phases of preparation for reproduction, gestation, and parenthood. From all recorded birth and infant death certificates for 1972 (69,556 birth and 1,541 death certificates) infant, neonatal, and postneonatal mortality rates were computed for maternal demographic (intrinsic patient physiocal and life-style characteristics) factors including age, race, parity by age cohort, education, and legitimacy. Excessive infant deaths were found among illegitimate offspring, except in mothers less than 15 years of age or nonwhites over 35 years of age; the less educated; those having too many children too soon; those of low birth weight; and whites relying on Charity Hospitals. An increased mortality rate was seen with nonwhites and with the younger and older mothers.

PIP: 69,556 birth and 1541 death certificates for infants in Louisiana du ring 1972 were matched and reviewed to identify groups needing special medical care. This, the 1st of 3 reports, analyzes the effect of intrinsic patient factors such as age, child spacing, legitimacy, education, socioeconomic status, and race on infant mortality rates. In general, nonwhites have higher infant mortality than whites (24.5 vs. 15.8). This pattern is unchanged when controlled by education, legitimacy status, age (except under age 15), number of children, or place of delivery. Only white patients who delivered in state charity hospitals, or who had fewer than 9 prenatal visits, or infants weighting less than 5 1/2 pounds at birth had greater rates. Rates were higher for illigitimate babies than for those born in wedlock (22.8 vs. 15.5) and for babies born to women under age 15 (41.1 for white women, 29.9 for black women). Very old mothers also had higher infant death rates; for women over 40 infant death rates were 25.1 for white women, 32.9 for black and neonatal death rates were 20.1 for white and 30.4 for black. When parity is examined in relationship to maternal age, the old dictum that "too many children too soon leads to greater risk" is upheld. Infant mortality rates for the 2nd child or a mother aged 15-19 is 30.1; for her 3rd child, 68.3; for a 5th child of a mother aged 20-24, 50. There is a steady decline in infant mortality, both neonatal and postnat al, with increased education regardless of race. There was almost a 75% drop between the rate for women with less than 8th grade education and those who had completed high school (6.8 to 1.9). These data show the less educated, poor, black, unmarried, and the mother who has too many children too soon have higher infant mortality while the educated, middle-class back woman delivering in a private hospital fares about as well as the acomparable white patient. The health professional must continue to try to improve education, nutrition, medical care, and support of community welfare programs.