Background
Infant mortality in the city of Racine is a serious problem. During 2004, infant mortality in the city of Racine was as follows:- Non-Hispanic black = 35/1000
- Non-Hispanic white = 4.0/1000
Although Racine is a small urban community, the rate of infant mortality is higher than that of Milwaukee. In the city of Racine, the rate of infant deaths among African-American infants is 28 per 1000, which is higher than the city of Milwaukee (WI 2005 statistics). During 2005, 12 out of 16 infants that died were premature and weighed less than 1000 grams at birth. Although most women in this community receive prenatal care by the end of the first trimester, the disparity in fetal and infant mortality remain.
Purpose
To develop a formal FIMR process to explore prenatal, intrapartal, and neonatal factors that may contribute to the high fetal and infant mortality rate in the city of Racine.
Objectives
- Conduct review of prenatal, inpatient, outpatient, and vital statistics records from 2007 to 2008.
- Develop an intervention study based on results of this review.
Progress to date
- Review of identified fetal and infant deaths through this time period were conducted.
- Results are being compiled.
- Emily Nowak, BAN & doctoral candidate, has almost completed her dissertation from data from this project that includes qualitative analysis of interviews from 12 women and 4 of their partners.
- A FIMR project report to the Racine Health Department is in process.
Preliminary Findings
- Approximately 25% of the cases had chorioamnionitis,
- A large percentage of the fetal and infant deaths are occurring between 20-24 weeks, around the time of viability. This continues to be highest among African-American infants.
- The number of infant deaths where bedsharing occurs has decreased.
Timeline
May 21, 2007 – May 25, 2009
Funding Source
Center for Urban Population Health’s Center Scientist Development Program through the Wisconsin Partnership Fund
Dissemination
Johnson, T.S. & Stier, A.C. (2008). Strategic Approaches to Increasing Healthy Birth Outcomes. Update on Fetal and Infant Mortality Review (FIMR) Project in Racine. Wingspread Conference Center, Racine, WI (October 16).
Johnson, T.S., Nowak, E., Malnory, M.M., Stich, D., Stier, A.C., & Jones, T.C. (2008). Fetal and infant mortality in the city of Racine. Update for the Racine Infant Mortality Coalition, Racine, WI (June 23).
Nowak, E., Johnson, T.S., Malnory, M., & Jones, T.C. (2008). Losing a Baby: Statistics and What Mothers Stories Tell Us. Poster presentation, Building Bridges to Evidence Based Practice, Milwaukee, WI (May).
Johnson, T.S. & Stich, D. (2008). Fetal and infant mortality in the city of Racine. Pediatric Grand Rounds, Wheaton Franciscan Healthcare-All Saints, Racine, WI (May 13).
Nowak, E., Johnson, T.S., Malnory, M., & Jones, T.C. (2008). Losing a Baby: Statistics and What Mothers Stories Tell Us. Poster presentation, Wisconsin Association of Perinatal Care, Appleton, WI (April).
Nowak, E., Johnson, T.S., Malnory, M., & Jones, T.C. (2008). Losing a Baby: Statistics and What Mothers Stories Tell Us. Poster presentation, Midwest Society for Nursing Research, Indianapolis, IN (March).
Partner Institutions
University of Wisconsin – Milwaukee
Teresa S. Johnson, Ph.D., R.N.
Emily Nowak, B.A.N.
Wheaton Franciscan Healthcare – All Saints
Margaret Malnory, M.S.N., R.N.
Duane Stitch, M.D.
City of Racine Health Department
Thelma Jones, M.S.N., R.N.
Teri Hicks, R.N., M.S.N.
Ana Christina Stier, M.S.W.
City of Milwaukee Health Department
Karen Michalski, M.A., M.S.W.
Racine Infant Mortality Coalition
Center for Urban Population Health
Dale Steber, M.S.
