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US Black vs White disparities in foetal growth: physiological or pathological?

Michael S Kramer1, Cande V Ananth, Robert W Platt

  • 1Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, Canada. michael.kramer@mcgill.ca

International Journal of Epidemiology
|July 19, 2006
PubMed

Insights

Black infants have lower birthweight for gestational age than White infants. This study suggests these differences are pathological, not physiological, indicating potential fetal growth restriction.

Area of Science:

  • Perinatal epidemiology
  • Neonatal health outcomes
  • Fetal growth research

Background:

  • US Black infants exhibit lower birthweight for gestational age compared to US White infants.
  • The underlying cause remains unclear: physiological variation or pathological fetal growth restriction.

Purpose of the Study:

  • To investigate whether the disparity in birthweight for gestational age between Black and White infants is physiological or pathological.
  • To compare fetal growth restriction and neonatal mortality rates across different ethnic groups.

Main Methods:

  • Analysis of singleton infants (gestation >= 22 weeks, weight >= 500g) born between 1998-2000.
  • Comparison of live birth, small-for-gestational-age (SGA), and neonatal mortality rates among US White, US-born Black, and foreign-born Black mothers.
  • Utilized graphical methods and Cox proportional hazards regression for outcome comparisons.

Main Results:

  • US-born Black infants had the highest rates of live birth and neonatal mortality, followed by foreign-born Black infants, with White infants having the lowest rates.
  • Small-for-gestational-age (SGA) patterns aligned more closely with neonatal mortality when using a single standard for birthweight, rather than ethnic-specific standards.
  • Foreign-born Black infants showed intermediate patterns for both SGA and mortality.

Conclusions:

  • The findings suggest that Black-White differences in birthweight for gestational age are pathological, indicative of fetal growth restriction.
  • The data supports the hypothesis that these disparities are not merely physiological variations.
  • Implications for understanding and addressing disparities in infant health outcomes.
Abstract

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