Burns Paulette G
Texas Christian University, Fort Worth, Texas 76129, USA.
Public Health Nurs. 2005 Jan-Feb;22(1):2-7. doi: 10.1111/j.0737-1209.2005.22102.x.
Despite decreases in the last 50 years, infant mortality rates in the United States remain higher than in other industrialized countries. Using overall infant mortality rates to determine the effectiveness of interventions does not help communities focus on particular underlying factors contributing to static, and sometimes increasing, community rates. This study was designed to determine and rank contributing factors to fetal-infant mortality in a specific community using the Perinatal Periods of Risk (PPOR) model. The PPOR model was used to map fetal-infant mortality for 1995 to 1998 in the Tulsa, Oklahoma, Healthy Start Program as compared to traditional calculation methods. The overall fetal-infant mortality rate using the PPOR model was 12.7 compared to 7.11 calculated using the traditional method. The maternal health cell rate was 5.4, maternal care cell rate was 2.9, newborn care cell was 1.9 compared to a 4.1 neonatal death rate calculated using the traditional method, and the infant health cell was 2.4 compared to a 2.9 postneonatal rate calculated using the traditional method. Because the highest infant mortality was in the maternal health cell, intervention strategies were designed to promote the health of women prior to and between pregnancies. The PPOR model was helpful in targeting interventions to reduce fetal-infant mortality based on the prioritization of contributing factors.
尽管在过去50年里有所下降，但美国的婴儿死亡率仍高于其他工业化国家。使用总体婴儿死亡率来确定干预措施的有效性，并不能帮助社区关注导致社区死亡率停滞甚至有时上升的特定潜在因素。本研究旨在使用围产期风险（PPOR）模型确定并排列特定社区中导致胎儿-婴儿死亡的因素。与传统计算方法相比，PPOR模型被用于绘制1995年至1998年俄克拉荷马州塔尔萨市健康启动项目中的胎儿-婴儿死亡率。使用PPOR模型得出的总体胎儿-婴儿死亡率为12.7，而使用传统方法计算得出的为7.11。孕产妇健康单元率为5.4，孕产妇护理单元率为2.9，新生儿护理单元率为1.9，而使用传统方法计算得出的新生儿死亡率为4.1，婴儿健康单元率为2.4，而使用传统方法计算得出的新生儿后期死亡率为2.9。由于最高的婴儿死亡率出现在孕产妇健康单元，因此设计了干预策略以促进女性在怀孕前和怀孕间隔期的健康。PPOR模型有助于根据促成因素的优先级确定旨在降低胎儿-婴儿死亡率的干预措施。
