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- Title
Racial differences in temporal changes in newborn viability and survival by gestational age.
- Authors
Allen, Marilee C.; Alexander, Greg R.; Tompkins, Mark E.; Hulsey, Thomas C.; Allen, M C; Alexander, G R; Tompkins, M E; Hulsey, T C
- Abstract
This study examines trends in the rates of very preterm, moderately preterm and gestational age-specific neonatal mortality, and in the gestational age limit of viability in South Carolina (SC) from 1975 to 1994. We also investigate whether trends were similar between African-Americans and Whites. We hypothesised that disproportionate reductions in gestational age-specific mortality, rather than any major changes in the gestational age distributions of either race group, underlie any increasing racial disparity in overall mortality rates. During 1975-94, single livebirths, who were born to mothers resident in SC and were either White or African-American based on recorded maternal race, were selected for the investigation. We define the gestational age limit of viability as the gestational age at which > or = 50% of infants in the population died within 28 days of life. Although preterm percentages have not improved, there was a marked decline in neonatal mortality. Gestational age-specific neonatal mortality decreased for both race groups, although there were greater reductions for White preterm infants. By the end of the study period, the African-American neonatal mortality rate was 2.3 times that of Whites and the gestational age at which 50% of newborns died within 28 days of life was 24.5 weeks for Whites and 23.9 weeks for African-Americans. The ongoing decline in neonatal mortality continues to be mainly due to reductions in gestational age-specific neonatal mortality, probably related to high-risk obstetric and neonatal care. Technological developments in these areas may have differentially benefited Whites, resulting in an increasing racial disparity in neonatal mortality rates. Preterm African-American infants no longer have a marked survival advantage over White infants, even at the gestational age limit of viability.
- Subjects
NEONATAL mortality; GESTATIONAL age; BIRTH weight; CROSS-cultural studies
- Publication
Paediatric & Perinatal Epidemiology, 2000, Vol 14, Issue 2, p152
- ISSN
0269-5022
- Publication type
journal article
- DOI
10.1046/j.1365-3016.2000.00255.x