Low-weight neonatal survival paradox in the Czech Republic

Analysis of vital statistics for the Czech Republic between 1986 and 1993, including 3,254 infant deaths from 350,978 first births to married and sing le women who conceived at ages 18-29 years, revealed a neonatal survival ad vantage for low-weight infants born to disadvantaged (single, less educated ) women, particularly for deaths from congenital anomalies. This advantage largely disappeared after the neonatal period. The same patterns have been observed for low-weight infants born to black women in the United States. S ince the Czech Republic had an ethnically homogenous population, virtually universal prenatal care, and uniform institutional conditions for delivery, Czech results must be attributed to social rather than to biologic or medi cal circumstances. This strengthens the contention that in the United State s, the black neonatal survival paradox may be due as much to race-related s ocial stigmatization and consequent disadvantage as to any hypothesized her editary influences on birth-weight-specific survival.