| Are very low birthweight births among American Indians and Alaska Natives underregistered? | |
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MedLine Citation:
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PMID: 10661653 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: International infant mortality rates vary widely. This variation has been attributed to many factors, including differential reporting. In the US, American Indians and Alaska Natives (AI/AN), who generally have low socioeconomic status, have a low neonatal mortality rate. One possible explanation is underregistration of very low birthweight (VLBW, < 1,500 g) births. We hypothesized that underregistration may occur disproportionately among AI/AN residing on or near reservations (areas controlled by an American Indian group). We estimated infant mortality in these areas. METHODS: Linked birth-infant death files for 1989-1991 were used to compare VLBW and neonatal mortality among AI/AN infants in counties with reservations with those in non-reservation counties. The VLBW rates for non-reservation counties were applied to the reservation risk distribution to calculate directly adjusted VLBW and neonatal mortality rates for reservation counties. This method assumes that greater registration in non-reservation counties yields a more accurate estimate of the relationship between risk factors and outcomes. RESULTS: Despite a higher prevalence in reservation counties of risk factors, the reported VLBW rate was 0.84% in reservation and 1.17% in non-reservation counties. The neonatal mortality rate was 5.4 per 1,000 in reservation counties and 6.0 in non-reservation counties. Direct adjustment yielded a VLBW rate of 1.28% (95% CI: 1.14-1.39) and a neonatal mortality rate of 6.7-9.8 per 1,000 in reservation counties. CONCLUSIONS: Reported neonatal mortality among AI/AN may understate the true rate due to underregistration of VLBW births. Direct adjustment may be useful in estimating infant mortality rates for populations with incomplete vital registration. |
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Authors:
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K E Heck; K C Schoendorf; J Parker |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: International journal of epidemiology Volume: 28 ISSN: 0300-5771 ISO Abbreviation: Int J Epidemiol Publication Date: 1999 Dec |
Date Detail:
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Created Date: 2000-02-29 Completed Date: 2000-02-29 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7802871 Medline TA: Int J Epidemiol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 1096-101 Citation Subset: IM |
Affiliation:
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National Center for Health Statistics, Hyattsville, MD 20782, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Distribution Alaska / epidemiology Educational Status Fetal Death / epidemiology Humans Indians, North American / statistics & numerical data* Infant Mortality* Infant, Newborn Infant, Very Low Birth Weight* Inuits / statistics & numerical data* Prevalence Registries / statistics & numerical data* Risk Factors Survival Rate United States / epidemiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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