Infant Mortality Definitions

Unless otherwise specified, all numbers and rates pertain to place of residence (not occurrence).

• Fetal & Infant Conditions
• Birth Defects
• SIDS
• External Causes

Cohort

A group of people sharing a common temporal demographic experience who are observed through time. For example, the birth cohort of 1940 is the people born that year. Another example is school class cohort.

Early Fetal Death

A fetal death occuring between 20 and 27 weeks of gestation.

Early Neonatal Period

The period from birth to 6 days of age.

Ethnicity

Hispanic or Latino includes persons of Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin, regardless of race. Non-Hispanic + Hispanic may not equal the total number of events due to persons of unknown ethnicity.

Fetal Death

Death prior to the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such expulsion or extraction the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles

Feto-Infant Mortality Rate (FIMR) and Perinatal Periods of Risk (PPOR)

Feto-infant mortality rate (FIMR) is defined as the number of fetal deaths (>= 20 weeks gestation) plus the number of infant deaths (<1 year) divided by the total number of fetal deaths plus live births and expressed as a rate per 1,000.

PPOR	Examples of Suggested Causes	Examples of Suggested Interventions
Women's Health	Unintended Pregnancy, Poor Nutrition, No Prenatal Care, Substance Abuse/Smoking, First or 4th-or-higher birth, Untreated STD's, < 2 year birth interval.	Pre-conceptual, peri-conceptual and early prenatal interventions which affect the mother's health and increase birthweight. Examples include assuring good nutritional status including folic acid intake.
Maternal Care	Prenatal Care not matched to need.	Prenatal, intra-partum and postpartum services which directly affect the maternal outcome by reducing excessive maternal and fetal mortality and morbidity. Assuring an appropriate match between need and content of prenatal care.
Newborn Care	Group B Strep untreated.	Intra-partum, early neonatal, and postpartum services which directly affect the newborn outcome by reducing excessive early neonatal mortality and morbidity. These are chiefly biomedical interventions.
Infant Care	No Parenting Skills Education, No Immunizations, No breastfeeding, Injury: Falls, burns, etc, Child Abuse / neglect, No Monitoring Growth / Development.	Post discharge services which directly affect the infant outcome by reducing excessive post discharge mortality and morbidity. For example, SIDS and injury prevention through health education.

Formulae

Women's Health = [Number of Feto-Infant deaths related to Women's Health / (Births 500+ grams + Fetal Deaths >= 20 weeks and 500+ grams)] * 1,000
Maternal Care = [Number of deaths occurring to fetuses related to Maternal Care / (Births 500+ grams + Fetal Deaths >= 20 weeks and 500+ grams)] * 1,000
Newborn Care = [Number of infant deaths related to Newborn Care / (Births 500+ grams + Fetal Deaths >= 20 weeks and 500+ grams)] * 1,000
Infant Care = [Number of infant deaths related to Infant Care / (Births 500+ grams + Fetal Deaths >= 20 weeks and 500+ grams)] * 1,000

For more interpretation see PPOR Description

Infant Mortality Rate

Formula = [Number of infant deaths / Live births] * 1,000. (Rates maybe cause specific)

International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM)

A statistical classification system, in use since 1979, that arranges diseases and injuries into groups according to established criteria. It is used to improve comparability of cause of death statistics reported by different governmental entities. Most ICD-9-CM codes are numeric and consist of three, four or five numbers and a description. The codes are revised approximately every 10 years by the World Health Organization and annual updates are published by the Health Care Financing Administration (HCFA), now the Center for Medicare, Medicaid Services.

International Classification of Diseases, 10th Revision, (ICD-10)

An alphanumeric coding scheme that replaces ICD-9, and used for mortality data since 1999. ICD-10 codes were developed by the World Health Organization Collaborating Centres for Classification of Diseases.

Late Fetal Death

A fetal death occuring on or after 28 weeks of gestation.

Late Neonatal Period

The period after birth 7 through 27 days of age.

Neonatal Period

The period from birth to 27 days of age.

Non-Rural

Any county with 35,000 or more total population per year 2000 Census.

Percent of Births

The percent of Georgia's births represented by the cluster, county, or district.

Percent Within Area - Proportional Mortality Ratio (PMR) Show me

The percent of deaths from a selected cause in a cluster, county or district of all deaths in the cluster, county or district.
Formula = [Number of cause-specific deaths in a cluster, county or district / Number of deaths in a in a cluster, county or district] * 100

Percent Within State - State Proportional Mortality Ratio

The percent of deaths from a selected cause that a cluster, county, or district contributes to Georgia deaths from the selected cause.
Formula = [Number of cause-specific deaths in a cluster, county or district / Number of cause-specific deaths in Georgia] * 100

Perinatal Periods of Risk (PPOR)

Fetal death and infant death rates organized by intervention strategies in order to facilitate local health planning (see feto-infant mortality rate).

Postneonatal Period

The period after birth 28 through 364 days of age.

Race

Per the Federal Office of Management and Budget, Directive 15 (1997),

• White is a person having origins in any of the original peoples of Europe, the Middle East or North Africa;
• Black or African-American is a person having origins in any of the black racial groups of Africa;
• Asian is a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam;
• American Indian/Alaska Native is a person having origins in any of the original peoples of North and South America (including Central American), and who maintains tribal affiliation or community attachment;
• Native Hawaiian or Other Pacific Islander is a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands;
• Multiracial is a person declaring 2 or more of these races.

Rate

Both Numerator and Denominator can be Place, Race, Age, Time, Ethnicity, Sex-specific:
Rate = [ N _PRATES-M / D _PRATES ] * 1000
where

M - Measure(s)
N - Number of Infant Deaths
D - Number of Live Births

Rates that use Census Population Estimates in the denominator are unable to be calculated when the selected population is Unknown.

Rural

Any county with less than 35,000 total population per year 2000 Census.

V1.9 (12/19/2011)