A HYPOTHESIS TO EXPLAIN PARADOXICAL RACIAL-DIFFERENCES IN NEONATAL-MORTALITY

We suggest an explanation for a pediatric paradox: the low-birthweight -specific (LBW) neonatal mortality rate (NMR) for black infants is les s than the NMR for white infants, even though the overall NMR for blac k infants is about twice the overall NMR for white infants. Analyzing the Delivery Interview Program data set-a large matrix of information collected at the Boston Hospital for Women (now the Brigham and Women' s Hospital)-we found that, overall, black infants' gestations are abou t four days shorter than white infants'. However, after stratifying by birthweight, we found a reversal in our data, namely, LBW (<2,500 g) black infants' gestations are seven days longer than the gestations of LBW white infants. We believe that this increased chronological matur ity may account for some of the survival advantage of the LBW black in fant compared with the LBW white infant of the same weight.