Reliability of fetal–infant mortality rates in perinatal periods of risk (PPOR) analysis

Abstract The Fetal–Infant mortality rate (FIMR) is the basic surveillance statistic in perinatal periods of risk (PPOR) analyses. This paper presents a model for the FIMR as the ratio of two Poisson random variables. From this model, expressions for estimators of variance, standard error, and relative standard error are developed. The coverage properties of interval estimators for the FIMR are investigated in a simulation study for both small and large populations and FIMR rates. Results from these studies are applied to a PPOR analysis of NC vital records. Results suggest that the sample size guidance provided in the literature to ensure statistical reliability is overly conservative and interval construction methodology should be selected based on population size.