MacKenzie Lee1, Eric S Hall2,3, Emily DeFranco4,5. 1. Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 2. Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 3. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 4. Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH, USA. emily.defranco@uc.edu. 5. Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. emily.defranco@uc.edu.
Abstract
OBJECTIVE: To quantify racial differences in contribution of previable live births (<20 weeks gestational age (GA)) to United States (US) Infant Mortality Rates (IMR). METHODS: Population-based retrospective cohort of US live births (2007-14) using CDC WONDER database stratified by maternal race/ethnicity. We compared the contribution of previable births to IMR and calculated modified IMRs (≥20 weeks GA) excluding previable live births in each group. Contingency tables and chi-square calculations were performed to detect differences between groups. RESULTS: Previable deaths represented 4.1%, 7.7%, and 5.0% of total deaths for nonHispanic white, nonHispanic black, and Hispanic, respectively. Previable contribution to total IMR are 0.21, 0.89, and 0.26 per 1000 live births (P < 0.0001). Modified IMRs are 4.98, 10.85, and 4.69 deaths per 1000 live births. CONCLUSION: IMR standardization with a minimum GA may obscure the disproportionate contribution of previable births to IMRs among the black population, which has the largest proportion of previable births.
OBJECTIVE: To quantify racial differences in contribution of previable live births (<20 weeks gestational age (GA)) to United States (US) InfantMortality Rates (IMR). METHODS: Population-based retrospective cohort of US live births (2007-14) using CDC WONDER database stratified by maternal race/ethnicity. We compared the contribution of previable births to IMR and calculated modified IMRs (≥20 weeks GA) excluding previable live births in each group. Contingency tables and chi-square calculations were performed to detect differences between groups. RESULTS: Previable deaths represented 4.1%, 7.7%, and 5.0% of total deaths for nonHispanic white, nonHispanic black, and Hispanic, respectively. Previable contribution to total IMR are 0.21, 0.89, and 0.26 per 1000 live births (P < 0.0001). Modified IMRs are 4.98, 10.85, and 4.69 deaths per 1000 live births. CONCLUSION: IMR standardization with a minimum GA may obscure the disproportionate contribution of previable births to IMRs among the black population, which has the largest proportion of previable births.
Authors: J M Fonseca; A A M Silva; P R H Rocha; R L F Batista; E B A F Thomaz; F Lamy-Filho; M A Barbieri; H Bettiol Journal: Braz J Med Biol Res Date: 2021-01-22 Impact factor: 2.590