Document Detail

Racial differences in birthweight for gestational age and infant mortality in extremely-low-risk US populations.
MedLine Citation:
PMID:  10214610     Owner:  NLM     Status:  MEDLINE    
Using national data, we develop and contrast the birth-weight percentiles for gestational age by infants of extremely-low-risk (ELR) White and African-American women and examine racial differences in the proportion of small-for-gestational-age (SGA) births. We then scrutinise racial variations in infant mortality rates of the infants of ELR women. We further compare the infant mortality rates of infants at or below the 10th percentile of birthweight for gestational age of each race group to determine whether infants with similar restricted fetal growth have comparable risks of subsequent mortality. Single live births, 34-42 weeks' gestation, to White and African-American US-resident mothers were selected from the 1990-91 US Linked Live Birth--Infant Death File (n = 4,360,829). Extremely-low-risk mothers were defined as: married, aged 20-34 years, 13+ years of education, multiparae, with average parity for age, adequate prenatal care, vaginal delivery, and no reports of medical risk factors, tobacco use or alcohol use during pregnancy. Marked racial variation in birthweight percentiles by gestational age was evident. Compared with ELR White mothers, the risk of an SGA infant was 2.64 times greater for ELR African-American mothers and the risk of infant mortality was 1.61 times greater. For the ELR group, the infant mortality rates of African-American and White infants at or below the 10th percentile of birthweight for gestational age of their respective maternal race group were essentially identical after controlling for gestational age. In conclusion, race differences in fetal growth patterns remained after controlling for risk status. Efforts to remove racial disparities in infant mortality will need to develop aetiological pathways that can explain why African-Americans have relatively higher rates of preterm birth and higher infant mortality rates among term and non-SGA infants.
G R Alexander; M D Kogan; J H Himes; J M Mor; R Goldenberg
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Paediatric and perinatal epidemiology     Volume:  13     ISSN:  0269-5022     ISO Abbreviation:  Paediatr Perinat Epidemiol     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-07-02     Completed Date:  1999-07-02     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8709766     Medline TA:  Paediatr Perinat Epidemiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  205-17     Citation Subset:  IM    
Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham 35294-0022, USA.
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MeSH Terms
African Continental Ancestry Group*
Birth Weight
Confidence Intervals
European Continental Ancestry Group*
Fetal Growth Retardation / ethnology*
Gestational Age
Infant Mortality*
Infant, Newborn
Infant, Small for Gestational Age*
Logistic Models
Medical Record Linkage
Obstetric Labor, Premature / ethnology*
Odds Ratio
Reference Values
Retrospective Studies
United States / epidemiology
Grant Support
MCJ-0111//PHS HHS; MCJ-0156//PHS HHS; MCJ-9040//PHS HHS

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