Perinatal and Infant Health Among Rural and Urban American Indians/Alaska Natives

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Abstract
Objectives. We sought to provide a national profile of rural and urban American Indian/Alaska Native (AI/AN) maternal and infant health. Methods. In this cross-sectional study of all 1989–1991 singleton AI/AN births to US residents, we compared receipt of an inadequate pattern of prenatal care, low birthweight (< 2500 g), infant mortality, and cause of death for US rural and urban AI/AN and non-AI/AN populations. Results. Receipt of an inadequate pattern of prenatal care was significantly higher for rural than for urban mothers of AI/AN infants (18.1% vs 14.4%, P ≤ .001); rates for both groups were over twice that for Whites (6.8%). AI/AN postneonatal death rates (rural = 6.7 per 1000; urban = 5.4 per 1000) were more than twice that of Whites (2.6 per 1000). Conclusions. Preventable disparities between AI/ANs and Whites in maternal and infant health status persist.