John L Kiely | University of Cincinnati College of Medicine (original) (raw)

Papers by John L Kiely

Public health reports (Washington, D.C. : 1974)

Objectives. To examine multiple dimensions of socioeconomic status and breastfeeding among a larg... more Objectives. To examine multiple dimensions of socioeconomic status and breastfeeding among a large, random sample of ethnically diverse women. This study used logistic regression analysis to examine the influence of a range of socioeconomic factors on the chances of ever breastfeeding among a stratified random sample of 10,519 women delivering live births in California for 1999 through 2001. Measures of socioeconomic status included family income as a percentage of the federal poverty level, maternal education, paternal education, maternal occupation, and paternal occupation. Consistent with previous research, there was a marked socioeconomic gradient in breastfeeding. Women with higher family incomes, those who had or whose partners had higher education levels, and women who had or whose partners had professional or executive occupations were more likely than their counterparts to breastfeed. After adjustment for many potential confounders, maternal and paternal education remained ...

American Journal of Diseases of Children, 1992

OBJECTIVES To describe changes in rates of higher-order multiple births (triplets and higher) bet... more OBJECTIVES To describe changes in rates of higher-order multiple births (triplets and higher) between 1972 and 1989, to compare infant mortality rates in infants of higher-order multiple births and singletons born from 1983 through 1985, and to compare infant mortality rates among higher-order multiples born from 1983 through 1985 with rates among those born in 1960. RESEARCH DESIGN Population-based analysis of live births (1972 through 1989) and infant deaths (1960 and 1983 through 1985) in the United States. The rate of higher-order multiple births was calculated per 100,000 live births. DATA SOURCE Computerized national natality files for 1972 through 1989 and national linked birth/infant death data sets for 1960 and 1983 through 1985 from the National Center for Health Statistics, Centers for Disease Control. POPULATION Live births to white and black women in the United States. INTERVENTIONS None. MAIN RESULTS Between 1972 through 1974 and 1985 through 1989 the rate of higher-order multiple births increased by 113% among infants of white mothers and by 22% among infants of black mothers. In whites the increase was mostly age specific and was not due to the upward shift in the maternal age distribution. The increase was particularly large in white women aged 30 through 34 years (152%) and 35 through 39 years (165%) and in more highly educated mothers. In blacks the modest increase in the rate of higher-order multiple births was mostly due to an upward shift in the maternal age distribution. From 1983 through 1985, mortality of infants of higher-order multiple births was about 15 times that of singletons. This was due almost entirely to the lower birth weight distribution of infants of higher-order multiple births. Their weight-specific mortality compared favorably with that of singletons. At 500 through 999 g, mortality was about the same. In weight categories between 1000 and 1999 g, mortality rates in higher-order multiple births were much lower: weight-specific relative risks ranged from 0.30 to 0.73. Between 1960 and 1983 through 1985 infant mortality in higher-order multiple births declined by about 50%. CONCLUSIONS It is likely that much of the increase in the incidence of higher-order multiple births is due to the rise in the use of ovulation-inducing drugs for the treatment of infertility. This increase and the decline in mortality risk have created a much greater need for medical and social services for infants of higher-order multiple births and their families.

American Journal of Epidemiology, 1994

Linked Birth/Infant Death Files available from the National Center for Health Statistics identify... more Linked Birth/Infant Death Files available from the National Center for Health Statistics identify an infant as a twin, but do not identify twin pairs. An algorithm based on maternal, paternal, and infant characteristics has been used to identify twin pairs, but the validity of this algorithm has never been tested. The Missouri linked birth/infant death file from 1980 to 1990 identifies twin pairs by a sequence number. The authors tested the rate and accuracy with which the algorithm identified true pairs in the Missouri file and whether estimates of risk and possible risk factors calculated from pairs of twins identified by the algorithm agreed with these characteristics as calculated from known twin pairs. The algorithm identified 96% (8,273 of 8,620) of true pairs and one false pair. Despite incomplete pair identification, and even identification of a false pair, estimates from the subset identified by the algorithm generally agreed well with characteristics measured from all twin pairs. Nonetheless, incorporation of a multiple birth sequence number into Linked Birth/Infant Death Files would enhance their utility.

Fertility and Sterility, 1998

Pediatrics, 1990

The international standing of the United States in postneonatal mortality has deteriorated from t... more The international standing of the United States in postneonatal mortality has deteriorated from third in 1950 to sixteenth in 1986. The high rate among United States blacks is not the reason for the poor United States standing: ten other countries had lower rates than that for United States whites. Recent trends show a slowdown in the decline in postneonatal mortality between 1970 to 1981 and 1981 to 1986 in Canada, England and Wales, Netherlands, and the United States. Norway actually experienced increases during the latter period. Only France showed an acceleration in its decline during the 1980s. Canada has maintained the most rapid rate of decline between 1950 and 1986. Although all countries examined here reported Sudden Infant Death Syndrome as the leading cause of postneonatal deaths, there was twofold variation among the countries in the Sudden Infant Death Syndrome rate. Similarly, congenital anomalies, the second leading cause of death, showed a 50% range in mortality rate...

Family Planning Perspectives, 1994

The increased risk of infant mortality associated with single motherhood is neither consistent am... more The increased risk of infant mortality associated with single motherhood is neither consistent among social and demographic subgroups nor inevitable, according to data from national linked birth and infant death files for 1983-1985. Maternal age is the only variable found to have a significant interaction with marital status among black mothers, and the risk associated with unmarried status increases with age. Among white mothers, age, educational level and receipt of prenatal care all show significant interactions with marital status; the increased risks of infant mortality attributed to unmarried motherhood are concentrated among subgroups usually thought to be at lower risk. For example, the risks of infant mortality among unmarried white women relative to married white women are highest among 25-29-year-olds. However, being unmarried did not affect the risk of infant mortality among babies born to college-educated white women.

BJOG: An International Journal of Obstetrics and Gynaecology, 1994

American Journal of Public Health, 1996

OBJECTIVES: This study investigated the independent and relative effects of family structure, rac... more OBJECTIVES: This study investigated the independent and relative effects of family structure, race, and poverty on the health of US children and youth under 20 years of age at two time periods, 1978 through 1980 and 1989 through 1991. METHODS: Data were from the National Health Interview Surveys. Multivariate logit regression methods were used to analyze the effects of family structure, poverty, and race on children's health. RESULTS: Children in families headed by single mothers, Black children, and those living below 150% of the poverty index were much more likely to be in poor or fair health than children in two-parent families, White children, or those in more affluent families. Poverty had the strongest effect on child health in both time periods. CONCLUSIONS: The association between children's health and living below 150% of the poverty index is not explained by race or family structure. The disparity in child health by family income has serious consequences for both t...

Pediatrics, 1984

In New York City, newborn units classified as level 1 (no intensive care) frequently transfer low... more In New York City, newborn units classified as level 1 (no intensive care) frequently transfer low-birth-weight infants to units classified as level 3 (complete intensive care), but level 2 units (those with intermediate levels of care) transfer rarely. As deaths occurring in the first hours of life are unlikely to be affected by infant transport services, early (first four hours), late (four hours to 28 days), and overall neonatal death rates were separately examined at each of the three levels of care for singleton live-births weighing 501 to 2,250 g. As previously reported, overall neonatal mortality (adjusted for birth weight, gestational age, sex, and race) for births at level 1 units (163.0/1,000) and level 2 units (168.1/1,000) was similar, and rates for births at level 3 (128.0/1,000) were significantly lower. Mortality up to four hours, and from four hours to 28 days, however, differed between level 1 and level 2 units. Among early deaths, the mortality for level 1 births wa...

Pediatrics, 1992

Sudden infant death syndrome (SIDS) is associated with maternal smoking during pregnancy. However... more Sudden infant death syndrome (SIDS) is associated with maternal smoking during pregnancy. However, the relationship between tobacco exposure during infancy and SIDS is unknown. The examination of infants whose mothers smoked only after pregnancy will help determine the relationship between passive cigarette exposure during infancy and SIDS risk. This case-control analysis used data on normal birth weight (≥2500 g) infants included in the National Maternal and Infant Health Survey, a nationally representative sample of approximately 10 000 births and 6000 infant deaths. Infants were assigned to one of three exposure groups: maternal smoking during both pregnancy and infancy (combined exposure), maternal smoking only during infancy (passive exposure), and no maternal smoking. SIDS death was determined from death certificate coding. Logistic regression was used to adjust for potentially confounding variables. Infants who died of SIDS were more likely to be exposed to maternal cigarette...

American Journal of Epidemiology, 1986

Vital and health statistics. Series 2, Data evaluation and methods research, 1993

International Journal of Epidemiology, 1996

Archives of Pediatrics & Adolescent Medicine, 1997

To examine birth-weight-specific and age-specific mortality among US infants to determine if the ... more To examine birth-weight-specific and age-specific mortality among US infants to determine if the large infant mortality decrease in 1990 was due to surfactant use. Population-based analysis of data from the 1983-1991 National Linked Birth and Infant Death files. Mortality trends from 1983 to 1989 were used to calculate expected infant mortality rates for 1990 to 1991. United States. PARTICIPANTS AND STUDY POPULATION: All singleton infants with known birth weight born in the United States from 1983 to 1991. None. Mortality at less than 1 day of life, 1 to 6 days, 7 to 27 days, or 28 to 364 days. Observed mortality rates were divided by the expected rates in 250-g birth-weight categories to create mortality ratios. The observed infant mortality rate in 1990 was 8.05, significantly lower than the expected rate of 8.36. Infants weighing 750 to 1749 g had mortality ratios of approximately 0.8 for 1- to 6-day mortality, with ratios significantly less than 1.0 for mortality in all age groups except less than 1 day. Observed mortality among infants weighing less than 750 g or from 1750 to 2499 g was not significantly lower than expected at any age. Postneonatal mortality among infants weighing 2500 g or more was significantly lower than expected. Infants weighing less than 1500 g accounted for almost 700 fewer infant deaths than predicted in 1990. Infants weighing 2500 g or more accounted for approximately 550 fewer deaths than expected. The hypothesis that surfactant was partially responsible for the overall infant mortality drop in 1990 is supported by the lower than expected mortality among infants weighing 750 to 1749 g. However, the unexpected improvement in postneonatal mortality among infants weighing 2500 g or more was responsible for a substantial portion of the overall decline and suggests that other factors also acted to decrease US infant mortality in 1990.

Paediatric and perinatal epidemiology, 2000

Many studies have examined associations between sociodemographic variables and preterm birth in s... more Many studies have examined associations between sociodemographic variables and preterm birth in singletons. However, almost no research has been published on whether variables such as maternal age, race, ethnicity, level of education and smoking are ...

Public health reviews, 1984

American journal of obstetrics and gynecology, 1985

The effect of level of perinatal care on rates of intrapartum fetal death was studied in births o... more The effect of level of perinatal care on rates of intrapartum fetal death was studied in births of infants weighing greater than 1000 gm in New York City in 1976 to 1978. With potential confounding by birth weight, gestational age, and several other variables controlled, intrapartum fetal death rates decreased as intensiveness of care increased. Compared with births in Level 3 maternity units (perinatal intensive care), births in Level 1 units (community hospitals) had a 61% excess risk of intrapartum fetal death (p less than 0.01) and births in Level 2 units (intermediate level of care) had a 35% excess risk (p = 0.06). The effect of hospital level on intrapartum fetal death rates could not be attributed to differences in the classification of fetal deaths during labor across hospital levels, since no compensatory differences in late antepartum fetal death rates were found. Our findings in a total population are compatible with several studies carried out in single hospitals that h...

American journal of diseases of children (1960), 1987

In an analysis of all singleton births and neonatal deaths with known birth weights and gestation... more In an analysis of all singleton births and neonatal deaths with known birth weights and gestational ages in New York City maternity services during a three-year period (1976 to 1978), intensive care services at the hospital of birth were found to influence mortality only in preterm (less than 37 weeks' gestation) or low-birth-weight infants (less than 2251 g). By contrast, for infants who were born at term and of normal birth weight, mortality rates did not differ by level of perinatal care available at the hospital of birth. On the average, preterm and low-birth-weight infants were at a 24% higher risk of death if birth occurred outside of a level 3 center, regardless of whether birth occurred at a level 1 or level 2 hospital. Preterm and low-birth-weight infants, though constituting only 12% of births, accounted for 70% of neonatal deaths in New York City. The remaining infants, ie, those born at term and of normal birth weight, who experienced no measurable mortality advantag...

Healthy People 2000 statistical notes / National Center for Health Statistics, 1991