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Contribution of previable births to infant mortality rate racial disparity in the United States

Journal of Perinatology volume 39, pages 1190–1195 (2019)Cite this article

Subjects

Abstract

Objective

To quantify racial differences in contribution of previable live births (<20 weeks gestational age (GA)) to United States (US) Infant Mortality Rates (IMR).

Methods

Population-based retrospective cohort of US live births (2007–14) using CDC WONDER database stratified by maternal race/ethnicity. We compared the contribution of previable births to IMR and calculated modified IMRs (≥20 weeks GA) excluding previable live births in each group. Contingency tables and chi-square calculations were performed to detect differences between groups.

Results

Previable deaths represented 4.1%, 7.7%, and 5.0% of total deaths for nonHispanic white, nonHispanic black, and Hispanic, respectively. Previable contribution to total IMR are 0.21, 0.89, and 0.26 per 1000 live births (P < 0.0001). Modified IMRs are 4.98, 10.85, and 4.69 deaths per 1000 live births.

Conclusion

IMR standardization with a minimum GA may obscure the disproportionate contribution of previable births to IMRs among the black population, which has the largest proportion of previable births.

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Funding

ML received research funding from an educational grant from the University of Cincinnati, Department of Obstetrics and Gynecology Women’s Health Scholars Program at the University of Cincinnati College of Medicine. ED received research funding from the Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; March of Dimes Prematurity Research Center Ohio Collaborative

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    MacKenzie Lee & Emily DeFranco

  2. Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Eric S. Hall & Emily DeFranco

  3. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Eric S. Hall

Authors
  1. MacKenzie Lee
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  2. Eric S. Hall
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  3. Emily DeFranco
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Corresponding author

Correspondence to Emily DeFranco.

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The authors declare that they have no conflict of interest.

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Presentation information

The abstract for this study was presented at the 2018 American College of Obstetricians and Gynecologists (ACOG) Annual Clinical and Scientific Meeting (poster presentation), April 27–30, 2018, Austin, TX

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Lee, M., Hall, E.S. & DeFranco, E. Contribution of previable births to infant mortality rate racial disparity in the United States. J Perinatol 39, 1190–1195 (2019). https://doi.org/10.1038/s41372-019-0394-x

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