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Related Experiment Videos

Racial differences in temporal changes in newborn viability and survival by gestational age.

M C Allen1, G R Alexander, M E Tompkins

  • 1The Johns Hopkins University School of Medicine, Baltimore, MD, USA. mcallen@jhmi.edu

Paediatric and Perinatal Epidemiology
|May 3, 2000
PubMed
Summary

Neonatal mortality declined significantly from 1975-1994, but racial disparities widened. Greater reductions in gestational age-specific mortality for White infants contributed to this trend, with technological advances potentially benefiting White infants more.

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Area of Science:

  • Neonatal mortality trends
  • Perinatal epidemiology
  • Racial disparities in healthcare

Background:

  • Investigated trends in neonatal mortality rates and gestational age at viability in South Carolina (SC) from 1975 to 1994.
  • Examined racial differences in these trends between African-American and White populations.
  • Hypothesized that differential reductions in gestational age-specific mortality, not changes in gestational age distribution, drive racial disparities.

Purpose of the Study:

  • To analyze trends in very preterm, moderately preterm, and gestational age-specific neonatal mortality.
  • To assess changes in the gestational age limit of viability.
  • To compare these trends between African-American and White infants.

Main Methods:

  • Included single livebirths to mothers resident in SC, categorized by race (African-American or White).

Related Experiment Videos

  • Defined gestational age limit of viability as the age at which >= 50% of infants died within 28 days.
  • Analyzed mortality data from 1975-1994.

    • Main Results:

    • Despite no improvement in preterm birth percentages, neonatal mortality markedly declined for both racial groups.
    • Gestational age-specific neonatal mortality decreased, with greater reductions observed in White preterm infants.
    • By 1994, the African-American neonatal mortality rate was 2.3 times that of Whites; viability was 24.5 weeks for Whites and 23.9 weeks for African-Americans.

    Conclusions:

    • Declining neonatal mortality is primarily due to reduced gestational age-specific mortality, likely from advances in obstetric and neonatal care.
    • Technological advancements may have disproportionately benefited White infants, widening the racial disparity in neonatal mortality.
    • Preterm African-American infants no longer hold a survival advantage over White infants, even at the limit of viability.