Periods of Risk Boston

1
Periods of RiskBoston

• Lise Fried, MS
• Director
• Office of Research, Health Assessment, and Data
  Systems
• Boston Public Health Commission
• 1010 Massachusetts Avenue, Sixth Floor
• Boston, Massachusetts 02118

2
Fetal and Infant Mortality Boston, 1992-1996

• Births 42,105
• Infant Deaths 340
• Late Fetal Deaths 172
• IMR 8.1 deaths/1,000 live births
• FIMR 12.2 deaths/1,000 live births and late
  fetal deaths

3
FIMR, Boston, 1992-1996 Overall Rate 12.2/1,000
Late Fetal
Early Neonatal
Late Neonatal
Post- neonatal
21
163
19
16
21
163
19
16
lt1,000g
Maternal Health 6.2/1,000
15
13
4
8
1000-1,499g
15
13
4
8
62
16
3
13
1,500-2,499g
62
16
3
13
Infant Care 1.8/1,000
74
24
9
52
74
24
9
52
?2,500g
Maternal Care 3.2/1,000
Newborn Care 1.0/1,000
4
Finding a Reference Group Boston, 1992-1996

• Calculate rates for each demographic subgroup
• Select lowest-rate group or one good for
  cross-site comparisons
• White non-Hispanics ?20 years old, with ?13
  years education
• MH 2.6
• MC 1.7
• NC 0.4
• IC 0.6

5
Prevalence of Risk CharacteristicsBoston,
1992-1996
6
Excess FIMR, Boston, 1992-1996 Reference Whites
?20 Yrs Old, with ?13 Yrs Educ
Late Fetal
Early Neonatal
Late Neonatal
Post- neonatal
lt1,000g
Maternal Health 3.6/1,000
1,000-1,499g
Newborn Care 0.6/1,000
1,500-2,499g
Maternal Care 1.5/1,000
Infant Care 1.1/1,000
?2,500g
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Excess Maternal Health Deaths Boston, 1992-1996
8
Excess FIMR by Kitagawa Category Boston, 1992-1996
9
Maternal Health Risk Characteristics Boston,
1992-1996
10
Community ConnectionBoston

• Goal
• Improving general, preconception, and prenatal
  maternal health
• Strategy
• Utilizing existing community partnerships
• Periods of Risk analysis as a communication and
  mobilization tool
• Lessons Learned