Infant birthweight, gestational age and mortality by race/ethnicity: a non-parametric regression approach to birthweight optima identification

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2007

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Abstract

In order to better understand the statistical relationship between measures of birthweight and gestational age and their effects on infant mortality, national vital statistics data was examined using non-parametric regression techniques (GAM) that allow for a sophisticated and detailed analysis of infant mortality models. These models allow for various non-linear effects of birthweight and gestational age on infant mortality to be quantified based upon extant methodologies (Solis, Pullum and Frisbie, 2000). Utilizing over-time, race/ethnicand sex-specific approaches, the identification of "zones" of optimal birth outcomes based upon infant mortality probabilities is successfully accomplished. This process results from the creation of a rigorous cross-classification of GAMsupplied birthweight and gestational age parameters. From these results, I find that Non-Hispanic Black infants still exhibit an infant mortality disadvantage relative to Non-Hispanic Whites and Mexican American infants. For the four birth outcome parameters and their interactions, I find evidence of infant mortality disadvantage for infants that are early or late as well as small or heavy relative to their race/ethnic-specific, birthweight-adjusted optima.

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