Perinatal periods of risk: phase 2 analytic methods for further investigating feto-infant mortality

Matern Child Health J. 2010 Nov;14(6):851-63. doi: 10.1007/s10995-010-0624-5.


The perinatal periods of risk (PPOR) methods provide a framework and tools to guide large urban communities in investigating their feto-infant mortality problem. The PPOR methods have 11 defined steps divided into three analytic parts: (1) Analytic Preparation; (2) Phase 1 Analysis-identifying the opportunity gaps or populations and risk periods with largest excess mortality; and (3) Phase 2 Analyses-investigating these opportunity gaps. This article focuses on the Phase 2 analytic methods, which systematically investigate the opportunity gaps to discover which risk and preventive factors are likely to have the largest effect on improving a community's feto-infant mortality rate and to provide additional information to better direct community prevention planning. This article describes the last three PPOR epidemiologic steps for investigating identified opportunity gaps: identifying the mechanism for excess mortality; estimating the prevalence of risk and preventive factors; and estimating the impact of these factors. While the three steps provide a common strategy, the specific analytic details are tailored for each of the four perinatal risk periods. This article describes the importance, prerequisites, alternative approaches, and challenges of the Phase 2 methods. Community examples of the methods also are provided.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Birth Weight
  • Female
  • Fetal Mortality*
  • Florida / epidemiology
  • Gestational Age
  • Health Status Disparities
  • Healthcare Disparities
  • Humans
  • Infant
  • Infant Mortality*
  • Infant Welfare / statistics & numerical data
  • Infant, Newborn
  • Male
  • Maternal Welfare / statistics & numerical data
  • Perinatal Care / methods*
  • Perinatal Care / statistics & numerical data
  • Pregnancy
  • Residence Characteristics
  • Risk Assessment*
  • Risk Factors
  • Socioeconomic Factors
  • Urban Population