Racial/ethnic differences in preterm perinatal outcomes

被引:77
|
作者
Wallace, Maeve E. [1 ]
Mendola, Pauline [1 ]
Kim, Sung Soo [1 ]
Epps, Nikira [1 ]
Chen, Zhen [2 ]
Smarr, Melissa [1 ]
Hinkle, Stefanie N. [1 ]
Zhu, Yeyi [1 ]
Grantz, Katherine L. [1 ]
机构
[1] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Epidemiol Branch, Rockville, MD 20852 USA
[2] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Biostat & Bioinformat Branch, Div Populat Hlth Res, Rockville, MD USA
基金
美国国家卫生研究院;
关键词
intracranial hemorrhage; intraventricular hemorrhage; necrotizing enterocolitis; neonatal death; perinatal death; preterm birth; respiratory distress syndrome; retinopathy of prematurity; sepsis; transient tachypnea; INTRAVENTRICULAR HEMORRHAGE; RACIAL-DIFFERENCES; NEONATAL-MORTALITY; BIRTH-WEIGHT; RACE; RISK; DISPARITIES; RETINOPATHY; IMPACT; AGE;
D O I
10.1016/j.ajog.2016.11.1026
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
BACKGROUND: Racial disparities in preterm birth and infant death have been well documented. Less is known about racial disparities in neonatal morbidities among infants who are born at <37 weeks of gestation. OBJECTIVE: The purpose of this study was to determine whether the risk for morbidity and death among infants who are born preterm differs by maternal race. STUDY DESIGN: A retrospective cohort design included medical records from preterm deliveries of 19,325 black, Hispanic, and white women in the Consortium on Safe Labor. Sequentially adjusted Poisson models with generalized estimating equations estimated racial differences in the risk for neonatal morbidities and death, controlling for maternal demographics, health behaviors, and medical history. Sex differences between and within race were examined. RESULTS: Black preterm infants had an elevated risk for perinatal death, but there was no difference in risk for neonatal death across racial groups. Relative to white infants, black infants were significantly more likely to experience sepsis (9.1% vs 13.6%), peri- or intraventricular hemorrhage (2.6% vs 3.3%), intracranial hemorrhage (0.6% vs 1.8%), and retinopathy of prematurity (1.0% vs 2.6%). Hispanic and white preterm neonates had similar risk profiles. In general, female infants had lower risk relative to male infants, with white female infants having the lowest prevalence of a composite indicator of perinatal death or any morbidity across all races (30.9%). Differences in maternal demographics, health behaviors, and medical history did little to influence these associations, which were robust to sensitivity analyses of pregnancy complications as potential underlying mechanisms. CONCLUSION: Preterm infants were at similar risk for neonatal death, regardless of race; however, there were notable racial disparities and sex differences in rare, but serious, adverse neonatal morbidities.
引用
收藏
页码:306.e1 / 306.e12
页数:12
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