Maternal and Child Health Journal

, Volume 15, Issue 1, pp 68–76

Assessing Maternal Risk for Fetal-Infant Mortality: A Population-Based Study to Prioritize Risk Reduction in a Healthy Start Community

  • Catherine L. Kothari
  • Annie Wendt
  • Oemeeka Liggins
  • Jacqueline Overton
  • Luz del Carmen Sweezy

DOI: 10.1007/s10995-009-0561-3

Cite this article as:
Kothari, C.L., Wendt, A., Liggins, O. et al. Matern Child Health J (2011) 15: 68. doi:10.1007/s10995-009-0561-3


Study goals were to distinguish between maternal risk factors for fetal versus infant mortality, and to identify which maternal characteristics contributed the greatest risk of mortality overall. This case–control retrospective study abstracted data on more than forty maternal characteristics from 261 prenatal and delivery records: all 26 fetal deaths, all 40 infant deaths and 195 randomly selected surviving births in a high-mortality Healthy Start community. Bivariate and multivariate analyses were conducted. The fetal-mortality population was significantly more likely than the infant-mortality population to have no insurance (P = .047), inadequate prenatal care (P = .039) and previous fetal death (P = .021). Comparing the combined mortality population with the surviving sample, two tiers of risk emerged: Rare-but-lethal risks, including no prenatal care (P < .001) and Child-Protective-Service involvement (P = .001), and common-and-dangerous risks, including inadequate maternal weight gain (OR = 13.55), drug or alcohol abuse (OR = 8.67), obesity (OR = 2.77) and anemia (OR = 3.61). Both fetal and infant mortality groups must be considered when identifying maternal risks. Inadequate prenatal weight gain, obesity and anemia contribute as much to feto-infant mortality as substance abuse. Public health efforts to improve maternal nutrition and healthy weight should be redoubled.


Maternal risk Fetal mortality Infant mortality 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Catherine L. Kothari
    • 1
  • Annie Wendt
    • 2
  • Oemeeka Liggins
    • 3
  • Jacqueline Overton
    • 4
  • Luz del Carmen Sweezy
    • 5
  1. 1.Research Department & Emergency Department, Kalamazoo Center for Medical StudiesMichigan State UniversityKalamazooUSA
  2. 2.Epidemiology DepartmentKalamazoo County Department of Health & Human ServicesKalamazooUSA
  3. 3.Fetal-Infant Mortality Review TeamKalamazoo County Department of Health & Human ServicesKalamazooUSA
  4. 4.Michigan State UniversityKalamazooUSA
  5. 5.Healthy Babies-Healthy StartKalamazoo County Department of Health & Human ServicesKalamazooUSA

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