Disproportionate Preterm Delivery Among Black Women: a State-Level Analysis

Santos, Palmira; Joglekar, Gitanjali; Faughnan, Kristen; Darden, Jennifer; Hendrich, Ann

doi:10.1007/s40615-019-00657-x

Cited by 3 publications

(4 citation statements)

References 35 publications

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“…This again suggests that at a national level, most infants receive equitable neonatal care once born. Further analysis of the etiology resulting in extreme prematurity within subgroups would aid interpretation of this finding . This highlights the need for targeted health care and economic policy focused on preventing extreme prematurity, as a strategy to reduce social, racial, and ethnic disparities in preterm health.…”

Section: Discussionmentioning

confidence: 96%

“…Reducing racial inequalities in preterm infant mortality is a major public health problem in the United States. It is already known that Black infants are 1.5 to 2 times more likely to be born prematurely than White infants, with higher proportions of multiple births among Black infants . The cause of these differences is believed to be multifactorial; however, the relative contribution of different factors is debated .…”

Section: Discussionmentioning

confidence: 99%

“…It is already known that Black infants are 1.5 to 2 times more likely to be born prematurely than White infants, with higher proportions of multiple births among Black infants. 5,6,[31][32][33][34] The cause of these differences is believed to be multifactorial; however, the relative contribution of different factors is debated. 21,31,[35][36][37][38] Although studies of population-based data sets have looked at racial disparities in preterm mortality and morbidity, this is the first study to our knowledge to quantify this over 2 decades at a national level in the United States.…”

Section: Discussionmentioning

confidence: 99%

“…Further analysis of the etiology resulting in extreme prematurity within subgroups would aid interpretation of this finding. [30][31][32] This highlights the need for targeted health care and economic policy focused on preventing extreme prematurity, as a strategy to reduce social, racial, and ethnic disparities in preterm health. The gestational age at which an infant is born remains the major determinant of their risk of death.…”

Section: Discussionmentioning

confidence: 99%

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National Trends in Preterm Infant Mortality in the United States by Race and Socioeconomic Status, 1995-2020

Venkatesan,

Rees,

Gardiner

et al. 2023

JAMA Pediatr

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ImportanceInequalities in preterm infant mortality exist between population subgroups within the United States.ObjectiveTo characterize trends in preterm infant mortality by maternal race and socioeconomic status to assess how inequalities in preterm mortality rates have changed over time.Design, Setting, and ParticipantsThis was a retrospective longitudinal descriptive study using the US National Center for Health Statistics birth infant/death data set for 12 256 303 preterm infant births over 26 years, between 1995 and 2020. Data were analyzed from December 2022 to March 2023.ExposuresMaternal characteristics including race, smoking status, educational attainment, antenatal care, and insurance status were used as reported on an infant’s US birth certificate.Main Outcomes and MeasuresPreterm infant mortality rate was calculated for each year from 1995 to 2020 for all subgroups, with a trend regression coefficient calculated to describe the rate of change in preterm mortality.ResultsThe average US preterm infant mortality rate (IMR) decreased from 33.71 (95% CI, 33.71 to 34.04) per 1000 preterm births per year between 1995-1997, to 23.32 (95% CI, 23.05 to 23.58) between 2018-2020. Black non-Hispanic infants were more likely to die following preterm births than White non-Hispanic infants (IMR, 31.09; 95% CI, 30.44 to 31.74, vs 21.81; 95% CI, 21.43 to 22.18, in 2018-2020); however, once born, extremely prematurely Black and Hispanic infants had a narrow survival advantage (IMR rate ratio, 0.87; 95% CI, 0.84 to 0.91, in 2018-2020). The rate of decrease in preterm IMR was higher in Black infants (−0.015) than in White (−0.013) and Hispanic infants (−0.010); however, the relative risk of preterm IMR among Black infants compared with White infants remained the same between 1995-1997 vs 2018-2020 (relative risk, 1.40; 95% CI, 1.38 to 1.44, vs 1.43; 95% CI, 1.39 to 1.46). The rate of decrease in preterm IMR was higher in nonsmokers compared with smokers (−0.015 vs −0.010, respectively), in those with high levels of education compared with those with intermediate or low (−0.016 vs – 0.010 or −0.011, respectively), and in those who had received adequate antenatal care compared with those who did not (−0.014 vs −0.012 for intermediate and −0.013 for inadequate antenatal care). Over time, the relative risk of preterm mortality widened within each of these subgroups.Conclusions and RelevanceThis study found that between 1995 and 2020, US preterm infant mortality improved among all categories of prematurity. Inequalities in preterm infant mortality based on maternal race and ethnicity have remained constant while socioeconomic disparities have widened over time.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%