HYALINE-MEMBRANE DISEASE IN BLACK NEWBORNS - DOES FETAL LUNG MATURATION OCCUR EARLIER

Debate has developed among several authors about possible accelerated maturation of black fetuses in comparison with whites. In Guadeloupe, French West indies, where 85% of the population is of black African-Am erican origin, it has been noted that the incidence of hyaline membran e disease (HMD) represents a significant drop beginning after the 32nd week of gestation. Over a 3-year period, 419 black low-birthweight si ngleton newborns were admitted in the University Hospital's Neonatal D epartment covering 70% of all births of the island. The incidence of H MD was 50% among very low birthweight (<1500 g) and 8.3% among moderat e low birthweight (greater than or equal to 32 weeks; P < 0.001). Thes e differences were similar for appropriate for gestational age and sma ll for gestational age infants Significant differences remained after controlling for several maternal risk factors. These results suggest t hat the 32nd week of gestation represents a significant drop in the ri sk for the respiratory distress syndrome in black premature compared w ith that reported in literature on European infants (34th week) and th erefore may implicate different obstetrical decisions in the managemen t of critical pregnancies in this population.