Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Matern Child Health J. 2010 Nov;14(6):851-63. doi: 10.1007/s10995-010-0624-5.
The perinatal periods of risk (PPOR) methods provide a framework and tools to guide large urban communities in investigating their feto-infant mortality problem. The PPOR methods have 11 defined steps divided into three analytic parts: (1) Analytic Preparation; (2) Phase 1 Analysis-identifying the opportunity gaps or populations and risk periods with largest excess mortality; and (3) Phase 2 Analyses-investigating these opportunity gaps. This article focuses on the Phase 2 analytic methods, which systematically investigate the opportunity gaps to discover which risk and preventive factors are likely to have the largest effect on improving a community's feto-infant mortality rate and to provide additional information to better direct community prevention planning. This article describes the last three PPOR epidemiologic steps for investigating identified opportunity gaps: identifying the mechanism for excess mortality; estimating the prevalence of risk and preventive factors; and estimating the impact of these factors. While the three steps provide a common strategy, the specific analytic details are tailored for each of the four perinatal risk periods. This article describes the importance, prerequisites, alternative approaches, and challenges of the Phase 2 methods. Community examples of the methods also are provided.
围产风险期（PPOR）方法为调查胎儿-婴儿死亡率问题提供了一个框架和工具，以指导大型城市社区。PPOR 方法有 11 个定义步骤，分为三个分析部分：（1）分析准备；（2）第 1 阶段分析——确定机会差距或人群以及死亡率最高的风险期；（3）第 2 阶段分析——调查这些机会差距。本文重点介绍第二阶段分析方法，该方法系统地调查机会差距，以发现哪些风险和预防因素最有可能对改善社区胎儿-婴儿死亡率产生最大影响，并提供更多信息，以更好地指导社区预防规划。本文介绍了最后三个调查确定机会差距的 PPOR 流行病学步骤：确定超额死亡率的机制；估计风险和预防因素的流行率；以及估计这些因素的影响。虽然这三个步骤提供了一个共同的策略，但具体的分析细节是针对四个围产期风险期中的每一个量身定制的。本文介绍了第二阶段方法的重要性、前提条件、替代方法和挑战。还提供了社区方法的实例。
