Overall postneonatal mortality declined from 4. Among non-AN, and rates were identical 3. In a multivariate logistic regression model containing education, cigarette use, alcohol use, and partner status, education was no longer significant and therefore was dropped from the final model. Cause-specific mortality rates, allowing for multiple causes of death, were calculated for 4-year intervals because of the small numbers of events Table 2.
Less than five postneonatal deaths during — were attributed to preterm birth or perinatal events, compared with 11 or more deaths related to preterm birth during other 4-year periods and 10 perinatal event-related deaths during — Among AN infants only, no cause-specific trends were significant.
The Importance of Establishing Paternity
Margaret B. Corresponding contributor: Margaret B. Young, margaret. Postneonatal mortality often is related to exposure to environmental risks and family socioeconomic characteristics, and thus, in theory, should be preventable 3. Although mortality rates declined among the non-AN population, AN postneonatal mortality rates did not show a significant trend.
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Postneonatal mortality for the United States declined from 3. The decrease in mortality caused by SIDS and SUID is encouraging because both account for a large proportion of postneonatal deaths among the overall population 1. However, this result might have resulted, in part, from a diagnostic shift whereby deaths during later years were assigned to different causes 6.
A lack of decline in the overall U. Prior research identified three independent factors that are associated with increased postneonatal mortality among AN compared with non-AN infants in Alaska: low maternal education, any prenatal substance use, and unmarried marital status combined with the lack of a father's name on the birth certificate 3. The prevalence of the latter among AN births increased during —, and these infants were three times more likely to die in the postneonatal period than infants with a father listed or a married mother.
AN infants also might have additional risk factors that were not measured. For example, preliminary evidence suggests that carnitine palmitoyltransferase type 1A deficiency, a fatty acid disorder highly prevalent in AN and other indigenous circumpolar populations, might contribute to infant mortality 8. The findings in this report are subject to at least three limitations. First, the small annual number of postneonatal deaths in Alaska complicates interpretation and identification of factors influencing yearly changes in rates. Annual rates are presented here to increase the information available for examining trends; however, rates based on fewer than 20 occurrences are statistically unreliable and should be used with caution.
Second, information on risk factors and cause of death might be biased and incomplete.
Postneonatal Mortality Among Alaska Native Infants — Alaska, –
Birth certificates might provide unreliable data on prenatal substance use 9. Prenatal care was not included as a risk factor because of suspected misclassification and reporting issues, particularly for rural Alaska. The significance of marital status and presence of a father's name on the birth certificate has limitations related to interpretability and misclassification, and the meaning might vary by cultural group 3.
Finally, MIMR data are subject to potential bias resulting from changes in committee membership and the knowledge and expertise of individual members. However, the information available from MIMR on each case was comprehensive and might more accurately indicate cause of death than death certificate data 6, This has been the most remarkable experience! I actually found my son within 24 hours of my registering on the website! They found my daughter after giving her up 57 years ago and oh how wonderful it is!
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