Hogue C J, Buehler J W, Strauss L T, Smith J C
Public Health Rep. 1987 Mar-Apr;102(2):126-38.
The recent slowdown in the decline of infant mortality in the United States and the continued high risk of death among black infants (twice that of white infants) prompted a consortium of Public Health Service agencies to collaborate with all States in the development of a national data base from linked birth and infant death certificates. This National Infant Mortality Surveillance (NIMS) project for the 1980 U.S. birth cohort provides neonatal, postneonatal, and infant mortality risks for blacks, whites, and all races in 12 categories of birth weights. (Note: Neonatal mortality risk = number of deaths to infants less than 28 days of life per 1,000 live births; postneonatal mortality risk = number of deaths to infants 28 days to less than 1 year of life per 1,000 neonatal survivors; and infant mortality risk = number of deaths to infants less than 1 year of life per 1,000 live births.) Separate tabulations were requested for infants born in single and multiple deliveries. For single-delivery births, tabulations included birth weight, age at death, race of infant, and each of these characteristics: infant's live-birth order, sex, gestation, type of delivery, and cause of death; and mother's age, education, prenatal care history, and number of prior fetal losses at 20 weeks' or more gestation. An estimated 95 percent of eligible deaths were included in the NIMS tabulations. The analyses focus on three components of infant mortality: birth weight distribution of live births, neonatal mortality, and postneonatal mortality. The most important predictor for infant survival was birth weight, with an exponential improvement in survival by increasing birth weight to its optimum level. The nearly twofold higher risk of infant mortality among blacks was related to a higher prevalence of low birth weights and to higher mortality risks in the neonatal period for infants weighing 3,000 grams or more, and in the postneonatal period for all infants, regardless of birth weight. Regardless of other infant or maternal risk factors, the black-white gap persisted for infants weighing 2,500 grams or more.
近期美国婴儿死亡率下降速度放缓，且黑人婴儿的死亡风险持续居高不下（是白人婴儿的两倍），这促使公共卫生服务机构联盟与各州合作，利用关联的出生证明和婴儿死亡证明建立一个全国性数据库。这个针对1980年美国出生队列的全国婴儿死亡率监测（NIMS）项目，提供了12种出生体重分类下黑人、白人及所有种族的新生儿、新生儿后期和婴儿死亡风险。（注：新生儿死亡率风险=每1000例活产中出生后28天内死亡的婴儿数；新生儿后期死亡率风险=每1000例新生儿幸存者中出生28天至不满1岁死亡的婴儿数；婴儿死亡率风险=每1000例活产中不满1岁死亡的婴儿数。）要求分别列出单胎和多胎分娩出生的婴儿情况。对于单胎分娩出生的婴儿，列表包括出生体重、死亡年龄、婴儿种族，以及以下各项特征：婴儿的出生顺序、性别、孕周、分娩类型和死亡原因；母亲的年龄、教育程度、产前护理史，以及妊娠20周或更久之前的既往胎儿丢失数。估计约95%符合条件的死亡案例被纳入NIMS列表。分析聚焦于婴儿死亡率的三个组成部分：活产婴儿的出生体重分布、新生儿死亡率和新生儿后期死亡率。婴儿存活的最重要预测因素是出生体重，将出生体重提高到最佳水平可使存活率呈指数级提高。黑人婴儿死亡率高出近两倍，这与低出生体重的较高发生率有关，也与体重3000克及以上婴儿在新生儿期、所有婴儿在新生儿后期（无论出生体重如何）的较高死亡风险有关。无论其他婴儿或母亲风险因素如何，体重2500克及以上婴儿的黑白差距依然存在。
