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Factors that Contribute to Neonatal Mortality at a Community Hospital.

Chrystal Pristell1, Alison Huffstetler2, Serenity Budd3

  • 1Robert Graham Center for Policy Studies, Washington, DC, USA. chrystal.l.pristell@medstar.net.

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|May 1, 2025
PubMed
Summary

Black mothers face a higher risk of intrauterine fetal demise (IUFD), even after accounting for other factors. Addressing healthcare disparities is crucial to reduce this risk.

Keywords:
Fetal deathIntrauterine fetal demise (IUFD)Maternal health servicesSocial determinants of health (SDOH)Systemic racism

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Health
  • Health Disparities Research

Background:

  • Intrauterine fetal demise (IUFD) affects 5.74 per 1000 live births in the US, with higher rates in Maryland (6.75 per 1000).
  • Racial disparities in IUFD prevalence are evident, with Black populations experiencing nearly double the rate compared to white populations.
  • At MedStar Franklin Square Medical Center (MFSMC), electronic medical records indicate IUFDs occur 2.5 times more frequently in Black women than white women.

Purpose of the Study:

  • To identify factors contributing to the higher incidence of IUFD among Black women at MFSMC.
  • To analyze the association between specific risk factors, race, and IUFD.
  • To compare predictors of IUFD in Black and white mothers.

Main Methods:

  • A retrospective chart review of deliveries at MFSMC from 2018 to 2020 was conducted.
  • Literature-supported variables for pregnancies ending in IUFD were collected.
  • Logistic regression models were used to analyze predictors of IUFD and their association with race, comparing them to outcomes in women with live births.

Main Results:

  • Unadjusted analysis showed a 2.21 times higher odds of IUFD for Black mothers compared to white mothers.
  • No other unadjusted risk factors demonstrated significant association with IUFD.
  • After adjusting for diabetes, growth restriction, substance abuse, and hypertension, the odds of IUFD remained significantly higher (2.31 times) for Black mothers.

Conclusions:

  • Black mothers exhibit an increased risk for IUFD, independent of other analyzed factors.
  • Addressing this health disparity requires interventions targeting healthcare provider bias, enhancing maternal health services, and improving patient education.
  • Further research and targeted interventions are needed to mitigate racial disparities in perinatal outcomes.