Prepregnancy obesity and the racial disparity in infant mortality

Area of Science:

• Reproductive Health
• Perinatal Epidemiology
• Public Health

Background:

• Significant racial disparities exist in stillbirth and infant mortality rates in the United States.
• Non-Hispanic Black women experience disproportionately higher rates of these adverse outcomes compared to non-Hispanic White women.

Purpose of the Study:

• To quantify the extent to which prepregnancy obesity explains the Black-White disparity in stillbirth and infant mortality.
• To assess the impact of prepregnancy obesity on racial differences in adverse pregnancy outcomes.

Main Methods:

• A population-based study utilized linked birth and infant death certificates in Pennsylvania from 2003-2011 and fetal death certificates from 2006-2011.
• Included singleton pregnancies of non-Hispanic White and non-Hispanic Black women.
• Inverse probability weighted regression analysis was employed to estimate the role of prepregnancy obesity.

Main Results:

• Non-Hispanic Black women had higher rates of obesity, stillbirth, and infant death compared to non-Hispanic White women.
• Removing the contribution of prepregnancy obesity reduced the risk difference for stillbirth and infant death between the two racial groups.
• Prepregnancy obesity accounted for a notable proportion of excess infant deaths and stillbirths among non-Hispanic Black women.

Conclusions:

• Prepregnancy obesity is a significant, though not sole, contributor to the Black-White disparity in stillbirth and infant mortality.
• Interventions targeting prepregnancy obesity may help mitigate racial disparities in adverse perinatal outcomes.
• Reducing prepregnancy obesity among Black women could lead to a decrease in excess infant deaths and stillbirths.