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

William M. Sappenfield, Magda G. Peck, Carol S. Gilbert, Vera R. Haynatzka, Thomas Bryant

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


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 fetoinfant 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.

Original languageEnglish (US)
Pages (from-to)851-863
Number of pages13
JournalMaternal and Child Health Journal
Issue number6
StatePublished - Nov 2010


  • Feto-infant mortality
  • Health disparities methodology
  • Perinatal periods of risk (PPOR)

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Epidemiology
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health


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