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Am J Perinatol 2013; 30(06): 469-476
DOI: 10.1055/s-0032-1326992
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Racial and Ethnic Disparities in Infant Mortality in the United States: The Role of Gestational Age

Han-Yang Chen
1   Center for Urban Population Health, Milwaukee, Wisconsin
2   School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
,
Suneet P. Chauhan
3   Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia
,
Nicole C. Rankins
3   Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia
,
Cande V. Ananth
4   Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York
,
Danish S. Siddiqui
5   Department of Obstetrics and Gynecology, Aurora Sinai Medical Center, Milwaukee, Wisconsin
,
Anthony M. Vintzileos
6   Department of Obstetrics and Gynecology, Winthrop University Hospital, Mineola, New York
› Author Affiliations
Further Information

Publication History

14 April 2012

14 June 2012

Publication Date:
21 September 2012 (online)

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Abstract

Objective We assessed the association among gestational age (GA) at birth, timing of death, and risk status of the pregnancy and racial/ethnic disparities in infant mortality rate in the United States.

Study Design We utilized U.S. 2000 to 2004 birth cohort–linked birth and infant death data restricted to nonanomalous singleton live births. Multivariable log-binomial regression models were fit to evaluate racial/ethnic disparities in infant mortality while adjusting for potential confounders.

Results Compared with whites, blacks had a higher adjusted infant mortality rate (IMR) (risk ratio [RR] 1.96, 95% confidence interval [CI] 1.91, 2.01), and Hispanics had a lower adjusted IMR (RR 0.79, 95% CI 0.76, 0.82). When categorized by GA, at 24 to 31 weeks, the adjusted early neonatal mortality (ENM) is significantly lower for black than whites, similar at 32 to 36 weeks, and at 37 weeks or more, blacks have significantly higher ENM.

Conclusions The racial/ethnic disparities in infant mortality in the United States persist and vary across GA. These disparities may largely be driven by the excess post-neonatal deaths among blacks.

Keywords

infant mortality - racial disparities - gestational age - high-risk pregnancy

Note

The abstract (#628) of this manuscript was presented in the Oral Session at the 78th Central Association of Obstetricians and Gynecologists' Annual Meeting, October 26 to 29, 2011.


 

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