Document Detail

Survival in the perinatal period: a prospective analysis.
MedLine Citation:
PMID:  8360230     Owner:  NLM     Status:  MEDLINE    
A prospective study of 3080 Filipino mothers and non-twin births in 33 communities is used to study the determinants of mortality in week 1 postpartum. The results show significant nonlinear birth weight effects and the importance of environmental contamination, particularly for infants born by traditional methods at home, and several other intermediate and underlying determinants of perinatal mortality. The pathways through which important sociodemographic factors affect perinatal mortality are also presented.
The Cebu Study Team collected and analyzed prospective data on 3080 women living in Metropolitan Cebu, the Philippines, who delivered singletons between May 1983 and April 1984 to learn what the determinants of mortality during the first 7 days of life are. The team used a generalized method prohibit estimation technique to control for confounding relationships from unobserved heterogeneity and the endogeneity of intermediate variables, thus significantly reducing bias. The strongest determinant of early neonatal mortality was birth weight. The probability of dying among newborns weighing less than 2500 gm was 7% compared with .25% for newborns weighing about 3000 gm (p .01). A relatively high birth weight was also a determinant of early neonatal mortality. Fecal contamination around the home coupled with a traditional delivery also had a significant effect on mortality (probability of death, 1.39% vs. .22% for no fecal contamination p .01). Modern delivery in a home with fecal contamination was not a determinant of neonatal mortality (probability of death, .29% with contamination, .21% with no contamination, and .22% for traditional delivery with no contamination). Delivery during the first days of life (.27% vs. .19%; p .05). Yet seasonality was also a significant determinant of many endogenous variables (e.g., birth weight and environmental quality), so this finding could not be easily explained. These results should be replicated in other settings with larger sample sizes. Nevertheless, they did show the benefit of the underlying=intermediate-outcome behavioral framework (the estimation and simulation procedure) which elucidates effects of key socioeconomic factors on biological outcomes.
B M Popkin; D K Guilkey; J B Schwartz; W Flieger
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of biosocial science     Volume:  25     ISSN:  0021-9320     ISO Abbreviation:  J Biosoc Sci     Publication Date:  1993 Jul 
Date Detail:
Created Date:  1993-09-29     Completed Date:  1993-09-29     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0177346     Medline TA:  J Biosoc Sci     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  359-70     Citation Subset:  IM; J    
Carolina Population Center, University of North Carolina, Chapel Hill.
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MeSH Terms
Developing Countries*
Fetal Death / epidemiology*
Infant, Newborn
Infant, Newborn, Diseases / mortality*
Philippines / epidemiology
Prospective Studies
Risk Factors
Rural Population / statistics & numerical data
Socioeconomic Factors
Survival Rate
Urban Population / statistics & numerical data
Grant Support
R01-19983A//PHS HHS

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