Another look at the black-white gap in gestation-specific perinatal mortality

Area of Science:

• Perinatal epidemiology
• Neonatal health
• Growth and development

Background:

• Black infants experience higher mortality rates than white infants in the US.
• Understanding racial disparities in infant growth and survival is crucial.

Purpose of the Study:

• To compare race-specific perinatal mortality rates based on birthweight deviations from the median.
• To examine racial differences in the relationship between birthweight, gestational age, and mortality.
• To identify optimal birthweights for different gestational ages and races.

Main Methods:

• Analysis of US vital records for singleton births (1983-1984).
• Comparison of perinatal mortality by grams of deviation from median birthweight for gestational ages 35-43 weeks.
• Calculation of race-specific optimal birthweights relative to median birthweights.

Main Results:

• Black infants had better relative survival at 35-36 weeks gestation across all birthweight deviations.
• This survival advantage for black infants was reversed at 39-43 weeks gestation.
• Optimal birthweight for black infants (≥37 weeks) was closer to their median birthweight compared to white infants.

Conclusions:

• Racial differences exist in the relationship between birthweight, gestational age, and perinatal mortality.
• Optimal birthweight standards vary by race and gestational age.
• Further research is needed to understand the etiology of these racial disparities in infant mortality.