{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T10:57:00Z","timestamp":1778669820576,"version":"3.51.4"},"reference-count":33,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,9,1]]},"abstract":"<jats:p>Objective.\u2003To study the association between maternal\/infant characteristics and mortality from injury for children 0 through 4 years of age.<\/jats:p>\n               <jats:p>Design.\u2003Historical cohort.<\/jats:p>\n               <jats:p>Setting.\u2003State of Tennessee.<\/jats:p>\n               <jats:p>Participants.\u2003Children 0 through 4 years of age at any time between January 1, 1985 and December 31, 1994. We linked birth certificates and US census data to obtain information on maternal age, race, education, neighborhood income, parity, use of prenatal care, residence location, infant's gender, and gestational age.<\/jats:p>\n               <jats:p>Main Outcome Measures.\u2003The outcome was death from injury, as determined from linked death certificates. The incidence density rates for each stratum (defined by maternal\/child characteristics) were calculated by dividing the number of injury deaths by child years in the stratum. We used multivariate analysis to assess the independent contribution of each characteristic to risk of injury death.<\/jats:p>\n               <jats:p>Results.\u2003There were 1\u2009035\u2009504 children 0 through 4 years of age who contributed 3\u2009414\u2009436 child years. There were 803 deaths from injury, ie, 23.5 deaths per 100\u2009000 child years. In the multivariate analysis, children had at least a 50% increased risk of injury mortality if they were born to a mother who had less than a high school education (relative risk [RR] = 2.88; 95% confidence interval [CI]: 1.92\u20134.34) compared with a college education, was &amp;lt;20 years of age (RR = 2.42; 95% CI: 1.76\u20133.31) compared with &amp;gt;30 years, or had &amp;gt;2 other children (RR = 2.97; 95% CI: 2.29\u20133.85) compared with no other children. Neither race nor income was significantly associated with childhood injury mortality in the multivariate analysis. Classification of children by maternal education, age, and parity defined a pronounced risk gradient in which high-risk children had an injury mortality rate &amp;gt;15 times that of low-risk children. The steep risk gradient was present for both infants (24-fold increase for high-risk children) and children 1 through 4 years of age (13-fold increase for high-risk children). If the injury mortality rate for all children were equal to that of the low-risk group, 614\/803 (76.3%) of injury deaths would not have occurred.<\/jats:p>\n               <jats:p>Conclusions.\u2003For young children, maternal education, age, and parity are strongly and independently associated with injury mortality. These factors define a steep gradient of risk, suggesting that many injury deaths could be prevented.<\/jats:p>","DOI":"10.1542\/peds.100.3.342","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:40:17Z","timestamp":1092440417000},"page":"342-347","source":"Crossref","is-referenced-by-count":55,"title":["Predictors of Injury Mortality in Early Childhood"],"prefix":"10.1542","volume":"100","author":[{"given":"Seth J.","family":"Scholer","sequence":"first","affiliation":[{"name":"From the Division of General Pediatrics, Departments ofPediatrics and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Edward F.","family":"Mitchel","sequence":"additional","affiliation":[{"name":"Preventive Medicine, Vanderbilt University, Nashville, Tennessee."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne A.","family":"Ray","sequence":"additional","affiliation":[{"name":"Preventive Medicine, Vanderbilt University, Nashville, Tennessee."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[1997,9,1]]},"reference":[{"key":"2021121017004794900_B1"},{"key":"2021121017004794900_B2"},{"key":"2021121017004794900_B3","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1001\/archpedi.1990.02150300047016","article-title":"The causes, impact, and preventability of childhood injuries in the United States: the magnitude of the problem-an overview.","volume":"144","author":"Guyer","year":"1990","journal-title":"Am J Dis Child"},{"key":"2021121017004794900_B4","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.2105\/AJPH.79.11.1521","article-title":"Prevention of childhood injuries: evaluation of the statewide childhood injury prevention program (SCIPP).","volume":"79","author":"Guyer","year":"1989","journal-title":"Am J Public Health"},{"key":"2021121017004794900_B5","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/S0031-3955(16)38339-0","article-title":"Injury control in childhood.","volume":"39","author":"Grossman","year":"1992","journal-title":"Pediatr Clin North Am"},{"key":"2021121017004794900_B6"},{"key":"2021121017004794900_B7","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1001\/archpedi.1994.02170100019005","article-title":"Infant injury death in Washington State, 1981 through 1990.","volume":"148","author":"Cummings","year":"1994","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2021121017004794900_B8","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/S0196-0644(05)80478-0","article-title":"Pediatric injury prevention.","volume":"22","author":"Hazinski","year":"1993","journal-title":"Ann Emerg Med"},{"key":"2021121017004794900_B9","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1542\/peds.77.4.518","article-title":"Risk factors for traumatic infant death in Oregon, 1973 to 1982.","volume":"77","author":"Emerick","year":"1986","journal-title":"Pediatrics"},{"key":"2021121017004794900_B10","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.2105\/AJPH.74.10.1150","article-title":"Effects of maternal education, age, and parity on fatal infant accidents.","volume":"74","author":"Wicklund","year":"1984","journal-title":"Am J Public Health"},{"key":"2021121017004794900_B11","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/oxfordjournals.aje.a115692","article-title":"Methodological issues in evaluating expanded Medicaid coverage for pregnant women.","volume":"132","author":"Piper","year":"1990","journal-title":"Am J Epidemiol"},{"key":"2021121017004794900_B12","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1093\/oxfordjournals.aje.a116736","article-title":"Validation of 1989 Tennessee birth certificates using maternal and newborn hospital records.","volume":"137","author":"Piper","year":"1993","journal-title":"Am J Epidemiol"},{"key":"2021121017004794900_B13"},{"key":"2021121017004794900_B14"},{"key":"2021121017004794900_B15"},{"key":"2021121017004794900_B16"},{"key":"2021121017004794900_B17","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1093\/oxfordjournals.aje.a115403","article-title":"Validity of death certificates for injury-related causes of death.","volume":"130","author":"Moyer","year":"1989","journal-title":"Am J Epidemiol"},{"key":"2021121017004794900_B18","first-page":"1","article-title":"Accuracy of death certificates in neonatal deaths.","volume":"11","author":"Cole","year":"1989","journal-title":"Community Med"},{"key":"2021121017004794900_B19"},{"key":"2021121017004794900_B20"},{"key":"2021121017004794900_B21","doi-asserted-by":"crossref","first-page":"2571","DOI":"10.1001\/jama.1984.03350180025024","article-title":"The use and efficacy of child restraint devices.","volume":"252","author":"Decker","year":"1984","journal-title":"JAMA"},{"key":"2021121017004794900_B22","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1056\/NEJM199209173271207","article-title":"Risk factors for fatal residential fires.","volume":"327","author":"Runyan","year":"1992","journal-title":"N Engl J Med"},{"key":"2021121017004794900_B23","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1136\/bmj.311.7017.1381","article-title":"Deaths of children in house fires.","volume":"311","author":"Roberts","year":"1995","journal-title":"Br Med J"},{"key":"2021121017004794900_B24","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1136\/adc.58.1.6","article-title":"Teenage mothering, admission to hospital, and accidents during the first 5 years.","volume":"58","author":"Taylor","year":"1983","journal-title":"Arch Dis Child"},{"key":"2021121017004794900_B25","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1136\/jech.37.2.100","article-title":"Family type and accidents in preschool children.","volume":"37","author":"Wadsworth","year":"1983","journal-title":"J Epidemiol Commun Health"},{"key":"2021121017004794900_B26","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1056\/NEJM198508083130605","article-title":"Racial and socioeconomic disparities in childhood mortality in Boston.","volume":"313","author":"Wise","year":"1985","journal-title":"N Engl J Med"},{"key":"2021121017004794900_B27","doi-asserted-by":"crossref","first-page":"587","DOI":"10.2105\/AJPH.84.4.587","article-title":"Low-income neighborhoods and the risk of severe pediatric injury: a small-area analysis in Northern Manhattan.","volume":"84","author":"Durkin","year":"1994","journal-title":"Am J Public Health"},{"key":"2021121017004794900_B28","first-page":"399","article-title":"Injury fatalities among young children.","volume":"103","author":"Fingerhut","year":"1988","journal-title":"Public Health Rep"},{"key":"2021121017004794900_B29","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/S0749-3797(18)30178-8","article-title":"Effect of Medicaid expansions on preterm birth.","volume":"13","author":"Ray","year":"1996","journal-title":"Am J Prev Med"},{"key":"2021121017004794900_B30","first-page":"243","article-title":"The \u201caccident prone\u201d child: the perpetuation of a myth.","volume":"18","author":"Langley","year":"1982","journal-title":"Aust Paediatr J"},{"key":"2021121017004794900_B31","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2190\/4EKV-J0HB-DE0P-2ERW","article-title":"Accident proneness: Science or nonscience.","volume":"11","author":"Sass","year":"1981","journal-title":"Int J Health Serv"},{"key":"2021121017004794900_B32","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1056\/NEJM199607043350106","article-title":"Surveillance and prevention of residential-fire injuries.","volume":"335","author":"Mallonee","year":"1996","journal-title":"N Engl J Med"},{"key":"2021121017004794900_B33","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1136\/bmj.312.7022.29","article-title":"Does home visiting prevent childhood injury? A systematic review of randomised controlled trials.","volume":"312","author":"Roberts","year":"1996","journal-title":"Br Med J"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/100\/3\/342\/885658\/pe099700342o.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/100\/3\/342\/885658\/pe099700342o.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T05:14:21Z","timestamp":1639199661000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/100\/3\/342\/39047\/Predictors-of-Injury-Mortality-in-Early-Childhood"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,9,1]]},"references-count":33,"journal-issue":{"issue":"3","published-online":{"date-parts":[[1997,9,1]]},"published-print":{"date-parts":[[1997,9,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.100.3.342","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1997,9,1]]}}}