Document Detail

Are very low birthweight births among American Indians and Alaska Natives underregistered?
MedLine Citation:
PMID:  10661653     Owner:  NLM     Status:  MEDLINE    
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.
K E Heck; K C Schoendorf; J Parker
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of epidemiology     Volume:  28     ISSN:  0300-5771     ISO Abbreviation:  Int J Epidemiol     Publication Date:  1999 Dec 
Date Detail:
Created Date:  2000-02-29     Completed Date:  2000-02-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802871     Medline TA:  Int J Epidemiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1096-101     Citation Subset:  IM    
National Center for Health Statistics, Hyattsville, MD 20782, USA.
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MeSH Terms
Age Distribution
Alaska / epidemiology
Educational Status
Fetal Death / epidemiology
Indians, North American / statistics & numerical data*
Infant Mortality*
Infant, Newborn
Infant, Very Low Birth Weight*
Inuits / statistics & numerical data*
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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