Racial/ethnic differences in infant mortality attributable to birth defects by gestational age

Area of Science:

• Public Health
• Neonatalogy
• Epidemiology

Background:

• Birth defects are a significant cause of infant mortality in the US.
• Previous studies indicated racial disparities in infant mortality, including that from birth defects (IMBD).
• The role of gestational age in these racial/ethnic differences in IMBD requires further investigation.

Purpose of the Study:

• To assess the impact of gestational age on racial/ethnic disparities in infant mortality due to birth defects (IMBD) in the United States.
• To compare IMBD rates between non-Hispanic black, Hispanic, and non-Hispanic white infants across different gestational age categories.

Main Methods:

• Utilized period-linked birth/infant death data from January 2003 to December 2006 for US residents.
• Excluded infants with missing or implausible gestational ages (<20 or >44 weeks).
• Categorized gestational age into three groups (20-33, 34-36, 37-44 weeks) and used Poisson regression to compare IMBD rates stratified by race/ethnicity and gestational age.

Main Results:

• Infant mortality due to birth defects (IMBD) occurred at a rate of 12.2 per 10,000 live births.
• Among infants born at 37-44 weeks gestation, black and Hispanic infants exhibited significantly higher neonatal and postneonatal IMBD compared to white infants.
• Conversely, for infants born at 20-33 or 34-36 weeks gestation, neonatal IMBD was significantly lower among black infants than white infants, though postneonatal rates did not differ significantly.

Conclusions:

• Gestational age differences do not account for the observed racial/ethnic disparities in infant mortality due to birth defects.
• Further research is needed to explore potential racial/ethnic variations in the severity of birth defects and access to timely diagnosis and management.