The effect of prenatal support on birth outcomes in an urban midwestern county
In Dane County, Wisconsin, the black-white infant mortality gap started decreasing from 2000 and was eliminated from 2004 to 2007. Unfortunately, it has reappeared since 2008. This paper examines risk factors and levels of prenatal care to identify key contributors to the dramatic decline and recent...
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Veröffentlicht in: | Wisconsin medical journal (Madison, Wis.) Wis.), 2012-12, Vol.111 (6), p.267-273 |
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creator | Schlenker, Thomas Dresang, Lee T Ndiaye, Mamadou Buckingham, William R Leavitt, Judith W |
description | In Dane County, Wisconsin, the black-white infant mortality gap started decreasing from 2000 and was eliminated from 2004 to 2007. Unfortunately, it has reappeared since 2008. This paper examines risk factors and levels of prenatal care to identify key contributors to the dramatic decline and recent increase in black infant mortality and extremely premature birth rates.
This retrospective cohort study analyzed approximately 100,000 Dane County birth, fetal, and infant death records from 1990 to 2007. Levels of prenatal care received were categorized as "less-than-standard," "standard routine" or "intensive." US Census data analysis identified demographic and socioeconomic changes. Infant mortality rates and extremely premature ( < or = 28 weeks gestation) birth rates were main outcome measures. Contributions to improved outcomes were measured by calculating relative risk, risk difference and population attributable fraction (PAF). Mean income and food stamp use by race were analyzed as indicators of general socioeconomic changes suspected to be responsible for worsening outcomes since 2008.
Risk of extremely premature delivery for black women receiving standard routine care and intensive care decreased from 1990-2000 to 2001-2007 by 77.8% (95% CI = 49.9-90.1%) and 57.3% (95% CI = 27.6-74.8%) respectively. Women receiving less-than-standard care showed no significant improvement over time. Racial gaps in mean income and food stamp use narrowed 2002-2007 and widened since 2008.
Prenatal support played an important role in improving black birth outcomes and eliminating the Dane County black-white infant mortality gap. Increasing socioeconomic disparities with worsening US economy since 2008 likely contributed to the gap's reappearance. |
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This retrospective cohort study analyzed approximately 100,000 Dane County birth, fetal, and infant death records from 1990 to 2007. Levels of prenatal care received were categorized as "less-than-standard," "standard routine" or "intensive." US Census data analysis identified demographic and socioeconomic changes. Infant mortality rates and extremely premature ( < or = 28 weeks gestation) birth rates were main outcome measures. Contributions to improved outcomes were measured by calculating relative risk, risk difference and population attributable fraction (PAF). Mean income and food stamp use by race were analyzed as indicators of general socioeconomic changes suspected to be responsible for worsening outcomes since 2008.
Risk of extremely premature delivery for black women receiving standard routine care and intensive care decreased from 1990-2000 to 2001-2007 by 77.8% (95% CI = 49.9-90.1%) and 57.3% (95% CI = 27.6-74.8%) respectively. Women receiving less-than-standard care showed no significant improvement over time. Racial gaps in mean income and food stamp use narrowed 2002-2007 and widened since 2008.
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This retrospective cohort study analyzed approximately 100,000 Dane County birth, fetal, and infant death records from 1990 to 2007. Levels of prenatal care received were categorized as "less-than-standard," "standard routine" or "intensive." US Census data analysis identified demographic and socioeconomic changes. Infant mortality rates and extremely premature ( < or = 28 weeks gestation) birth rates were main outcome measures. Contributions to improved outcomes were measured by calculating relative risk, risk difference and population attributable fraction (PAF). Mean income and food stamp use by race were analyzed as indicators of general socioeconomic changes suspected to be responsible for worsening outcomes since 2008.
Risk of extremely premature delivery for black women receiving standard routine care and intensive care decreased from 1990-2000 to 2001-2007 by 77.8% (95% CI = 49.9-90.1%) and 57.3% (95% CI = 27.6-74.8%) respectively. Women receiving less-than-standard care showed no significant improvement over time. Racial gaps in mean income and food stamp use narrowed 2002-2007 and widened since 2008.
Prenatal support played an important role in improving black birth outcomes and eliminating the Dane County black-white infant mortality gap. Increasing socioeconomic disparities with worsening US economy since 2008 likely contributed to the gap's reappearance.</description><subject>Adult</subject><subject>African Americans - statistics & numerical data</subject><subject>European Continental Ancestry Group - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Infant Mortality</subject><subject>Infant, Newborn</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome - ethnology</subject><subject>Prenatal Care - organization & administration</subject><subject>Regression Analysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Urban Population</subject><subject>Wisconsin - epidemiology</subject><issn>1098-1861</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMtqwzAURLVoSdKkv1C07Magh2VLyxL6gtBu0rWR5CviYkuuHpT8fQ1N92VgLgyH4TJXaEOJkhWVDV2jm5Q-CeFMSLlCa8Z5w1rCN-jteAIMzoHNODg8R_A66xGnMs8hLpnHZoj5hEPJNkyQ8OCx9rhEs_g09N-QMkSPbSg-n3fo2ukxwe3lbtHH0-Nx_1Id3p9f9w-HaqZC5UoqrXirubGaGuhbRVhTO2iVZU4KAUYY5Xpu-ho0Ea42zlEla84Io5ZQzrfo_rd3juGrLC9005AsjKP2EErqKJOCkkXqPyhvOWlovaB3F7SYCfpujsOk47n7m4v_AATxZVY</recordid><startdate>201212</startdate><enddate>201212</enddate><creator>Schlenker, Thomas</creator><creator>Dresang, Lee T</creator><creator>Ndiaye, Mamadou</creator><creator>Buckingham, William R</creator><creator>Leavitt, Judith W</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201212</creationdate><title>The effect of prenatal support on birth outcomes in an urban midwestern county</title><author>Schlenker, Thomas ; Dresang, Lee T ; Ndiaye, Mamadou ; Buckingham, William R ; Leavitt, Judith W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p159t-89a937a3bca1bed790264fe79c2f855eb5b9fd3bd4ea05f4bff198432021c0133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>African Americans - statistics & numerical data</topic><topic>European Continental Ancestry Group - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Infant Mortality</topic><topic>Infant, Newborn</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome - ethnology</topic><topic>Prenatal Care - organization & administration</topic><topic>Regression Analysis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Urban Population</topic><topic>Wisconsin - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schlenker, Thomas</creatorcontrib><creatorcontrib>Dresang, Lee T</creatorcontrib><creatorcontrib>Ndiaye, Mamadou</creatorcontrib><creatorcontrib>Buckingham, William R</creatorcontrib><creatorcontrib>Leavitt, Judith W</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Wisconsin medical journal (Madison, Wis.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schlenker, Thomas</au><au>Dresang, Lee T</au><au>Ndiaye, Mamadou</au><au>Buckingham, William R</au><au>Leavitt, Judith W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of prenatal support on birth outcomes in an urban midwestern county</atitle><jtitle>Wisconsin medical journal (Madison, Wis.)</jtitle><addtitle>WMJ</addtitle><date>2012-12</date><risdate>2012</risdate><volume>111</volume><issue>6</issue><spage>267</spage><epage>273</epage><pages>267-273</pages><issn>1098-1861</issn><abstract>In Dane County, Wisconsin, the black-white infant mortality gap started decreasing from 2000 and was eliminated from 2004 to 2007. Unfortunately, it has reappeared since 2008. This paper examines risk factors and levels of prenatal care to identify key contributors to the dramatic decline and recent increase in black infant mortality and extremely premature birth rates.
This retrospective cohort study analyzed approximately 100,000 Dane County birth, fetal, and infant death records from 1990 to 2007. Levels of prenatal care received were categorized as "less-than-standard," "standard routine" or "intensive." US Census data analysis identified demographic and socioeconomic changes. Infant mortality rates and extremely premature ( < or = 28 weeks gestation) birth rates were main outcome measures. Contributions to improved outcomes were measured by calculating relative risk, risk difference and population attributable fraction (PAF). Mean income and food stamp use by race were analyzed as indicators of general socioeconomic changes suspected to be responsible for worsening outcomes since 2008.
Risk of extremely premature delivery for black women receiving standard routine care and intensive care decreased from 1990-2000 to 2001-2007 by 77.8% (95% CI = 49.9-90.1%) and 57.3% (95% CI = 27.6-74.8%) respectively. Women receiving less-than-standard care showed no significant improvement over time. Racial gaps in mean income and food stamp use narrowed 2002-2007 and widened since 2008.
Prenatal support played an important role in improving black birth outcomes and eliminating the Dane County black-white infant mortality gap. Increasing socioeconomic disparities with worsening US economy since 2008 likely contributed to the gap's reappearance.</abstract><cop>United States</cop><pmid>23362703</pmid><tpages>7</tpages></addata></record> |
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source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
subjects | Adult African Americans - statistics & numerical data European Continental Ancestry Group - statistics & numerical data Female Humans Infant Mortality Infant, Newborn Pregnancy Pregnancy Outcome - ethnology Prenatal Care - organization & administration Regression Analysis Retrospective Studies Risk Factors Urban Population Wisconsin - epidemiology |
title | The effect of prenatal support on birth outcomes in an urban midwestern county |
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