Perinatal Periods of Risk

Perinatal Periods of Risk (PPOR): Healthy Start, in collaboration with the Delaware County Child Death Review Team, conducted an Institutional Review Board-approved PPOR project at the county level.

The purpose of the PPOR project was to collect data and review fetal and infant deaths to better understand why infants are dying during certain periods of risk. The project has now looked at two sets of Delaware County data and will continue to monitor birth outcomes in our region using this framework.

The categories considered periods of risk are: maternal health and prematurity, maternal care, newborn care and infant health. In Delaware County, there were 13.9 deaths per 1,000 births in 2012-2016, which is a rate higher than in the surrounding a counties and a slight increase from the previous five year data set. Most of these deaths are related to risk factors in the maternal health and prematurity category.

The project focused on determining why black, non-Hispanic women in Delaware County have poorer birth outcomes when compared with other demographic groups, leading to a disparity in infant death rates. During the time period 2012-2016, Black, non-Hispanic women were about two and half times more likely than white women to experience a fetal or infant death (20.4 deaths/1,000 births vs. 8.2 deaths/1,000 births). Over the last several years, the project explored risk factors associated with maternal health, prematurity and low birthweight to develop additional strategies for reducing this disparity. These short-term and longer-term strategies can be found in the report under the Community Action Plan.

To learn more about the PPOR framework, please review this abbreviated graphic summary or you can read and share the full report. And for more information, please contact Joanne Craig, (610) 497-7344.