Racial differences in prenatal care of mothers delivering very low birth weight infants

Objectives: To determine whether there are any racial differences in the prenatal care of mothers delivering very low birth weight infants (VLBW). Study Design: Retrospective cohort study of infants cared for at a single regional level III neonatal intensive care unit over a 9-year period, July 1993 - June 2002, N = 1234. The main outcome variables investigated included antenatal administration of steroids, delivery by cesarean section, and use of tocolytic medications. Both univariate and multivariate analyses were performed. Results: After controlling for potential confounding variables, white mothers delivering VLBWs had an increased odds of cesarean delivery (odds ratio 1.5, 95% confidence intervals (CI) 1.1 - 2.0), receiving antenatal steroids (1.3, CI 1.01 - 1.8), and tocolysis (1.4, CI 1.1 - 2.0) compared to black mothers. The models controlled for gestational age, multiple gestation, premature labor, clinical chorioamnionitis, maternal age, income, year of birth, and presentation. Conclusions: In our population of VLBWs, white mothers are more likely to receive antenatal steroids, tocolytic medications, and deliver by cesarean section when compared to black mothers. From our data we cannot determine the reasons behind these racial differences in care of mothers delivering VLBWs.