Document Detail

Racial disparity in stillbirth among singleton, twin, and triplet gestations in the United States.
MedLine Citation:
PMID:  15458894     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We investigated the relationship between maternal race and stillbirth among singletons, twins, and triplets. METHODS: We conducted a retrospective cohort study on 14,348,318 singletons, 387,419 twins, and 20,953 triplets delivered in the United States from 1995 through 1998. We compared the risk of stillbirth between pregnancies of black and those of white mothers using the generalized estimating equations framework to adjust for intracluster correlation in multiples. RESULTS: The proportion of black infants was 16%, 18%, and 8% among singletons, twins, and triplets, respectively. Crude stillbirth rate among singletons was 6.6 per 1,000 and 3.5 per 1,000 for black and white fetuses, respectively. Among twins, 796 stillbirths (11.6 per 1,000) were recorded for black mothers versus 3,209 stillbirths (10.1 per 1,000) among white mothers, whereas among triplets there were 233 stillbirths, of which 39 stillbirths were black fetuses (24.6 per 1,000) and 194 stillbirths were white fetuses (10.0 per 1,000). Black singletons, twins, and triplets weighed 278 g, 186 g, and 216 g less than white fetuses, respectively (P <.001). Risk of stillbirth was elevated in black fetuses compared with white fetuses among singletons (adjusted odds ratio [OR] 2.9, 95% confidence interval [CI] 2.8-3.0) and twins (OR 1.3. 95% CI 1.2-1.4) but comparable among triplets (OR 1.2, 95% CI 0.7-2.1). This decreasing trend was significant (P for trend <.001). CONCLUSION: The disparity of stillbirths between black and white fetuses still persists among singletons and twins. Among triplet gestations, however, the 2 racial groups have a comparable risk level. Our findings highlight the need for a rigorous research agenda to elucidate causes of stillbirth across racial/ethnic entities in the United States. LEVEL OF EVIDENCE: II-2
Hamisu M Salihu; Brooke A Kinniburgh; Muktar H Aliyu; Russell S Kirby; Greg R Alexander
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  104     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-01     Completed Date:  2004-11-16     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  734-40     Citation Subset:  AIM; IM    
Department of Maternal and Child Health and Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294, USA.
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MeSH Terms
African Continental Ancestry Group / statistics & numerical data
Cohort Studies
European Continental Ancestry Group / statistics & numerical data
Gestational Age
Medical Records
Pregnancy Outcome / ethnology*
Pregnancy, Multiple*
Retrospective Studies
Triplets / statistics & numerical data
Twins / statistics & numerical data
United States / ethnology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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