K. Demissie et al., Trends in preterm birth and neonatal mortality among blacks and whites in the United States from 1989 to 1997, AM J EPIDEM, 154(4), 2001, pp. 307-315
Citations number
21
Categorie Soggetti
Envirnomentale Medicine & Public Health","Medical Research General Topics
Preterm birth, a major determinant of infant mortality, has been increasing
in recent years. The authors examined trends in preterm birth and its dete
rminants by using the US birth and infant death files for 1989-1997. The im
pact of trends in preterm birth rates on neonatal and infant mortality was
also evaluated. Among Whites, preterm births (<37 completed weeks of gestat
ion) increased from 8.8% of livebirths in 1989 to 10.2% in 1997, a relative
increase of 15.6%. On the other hand, preterm births among Blacks decrease
d by 7.6% (from 19.0% to 17.5%) during the same period. An increase in obst
etric interventions contributed to increases in preterm births for both rac
es but was outweighed by other unidentified favorable influences for Blacks
. Neonatal mortality among preterm Whites dropped 34% during the 8 years of
the study, while the decrease was only 24% among Blacks. This large dispar
ity countered the changes in preterm birth rates so that the percentage dec
line in neonatal mortality was similar in the two racial groups (18-20%). I
n conclusion, the anticipated mortality benefit from a lower preterm birth
rate for Blacks has been blunted by suboptimal improvement in mortality amo
ng the remaining preterm infants. The widening race gap in mortality among
preterm infants merits attention.