Date of Conferral

2022

Degree

Ph.D.

School

Public Health

Advisor

Hadi Danawi

Abstract

While prepregnancy body mass index (BMI), gestational weight gain (GWG), and birthplace have been suggested to play a key role in predicting infant mortality outcomes, they have not been thoroughly investigated across all races/ethnicities. The purpose of this study was to examine the associations between prepregnancy BMI, GWG, birthplace as independent variables, and infant mortality as the outcome variable within the United States Sub-Saharan African Immigrants (SSAI). A quantitative cross-sectional study design grounded in the biopsychosocial model was used. Data were extracted from the 2017-2018 natality-linked birth/infant death file from the Centers for Disease Control and Prevention Wonder Database. It included 1,877 child-bearing mothers between ages 15 and 49. Simple and stepwise multiple logistic regressions were conducted using SPSS Version 25. The key findings revealed that BMI (underweight and obese with normal-weight as a reference) were significant with the following odds ratio respectively (OR = 22.628; 95% CI = 2.868, 178.555; p = .000), and (OR = 1.903; 95% CI = 1.416, 2.558; p =.000). Only BMI (normal and obese) stratified by inadequate and excessive GWGs, respectively showed significant associations (OR =1.469; 95% CI = 1.151, 1.875; p = .002), (OR =1.362; 95% CI = 1.061, 1.748; p = .015). Infant mortality varied largely by birthplace with Cameroon (OR=10.535; p = .000); Kenya (OR= 8.195; p =.000); Liberia (OR = 5.945; p =.000); Sudan (OR = 5.054; p =.000); Congo (OR = 4.538; p =.000); and Ghana (OR = 2.268; p=.00) showing strong predictors, respectively. The study provided clinical and public health knowledge to help improve infant mortality outcomes within the U.S. SSAI population therefore creating a positive social change.

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