Trends and racial differences in birth weight and related survival.
Trends and racial differences in birth weight and related survival.
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DOI：
10.1023/a:1021849209722
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发表时间：
1999-06-01
影响因子：
2.3
通讯作者：
Hulsey, T C
中科院分区：
文献类型：
--
作者：
Alexander, G R;Tompkins, M E;Hulsey, T C
目的：在过去的二十年中，美国非洲裔美国人和白色人群的婴儿死亡率下降。尽管如此，婴儿死亡率方面的种族差异有所增加，出生体重不足的比率变化不大。在这项研究中，我们研究了出生体重分布的时间变化，出生体重特定的新生儿死亡率，以及两个种族群体内不利生存风险的出生体重阈值，以探讨婴儿死亡率差异的机制。1975年至1994年间，南卡罗来纳州居民母亲所生的单活产婴儿，被视为白色或非洲人-根据美国母亲的报告，选择出生证明上的母亲种族进行调查。我们定义的出生体重阈值为不利的生存几率的出生体重，在人口中的50%或更多的婴儿死亡的第一个月内life.RESULTS：尽管非常低的出生体重百分比显着增加，新生儿死亡率显着下降。两个种族的特定出生体重新生儿死亡率都有所下降，尽管白色低出生体重婴儿的下降幅度更大。在研究期间结束时，出生体重超过50%的新生儿死亡的第一个月内的生命是696克白人和673克为African-American.Discussion：新生儿死亡率的持续下降主要是由于出生体重特定的新生儿死亡率的减少，可能与高风险的产科和新生儿护理。这些领域的技术发展可能使白人受益不同，导致死亡率的种族差异越来越大。此外，非洲裔美国母亲的婴儿因过熟和巨大儿而死亡的风险相对更大且不断增加，这可能进一步加剧婴儿死亡率的种族差距。
OBJECTIVE: In the past two decades, infant mortality rates in the United States declined in African-American and White populations. Despite this, racial disparities in infant mortality rates have increased and rates of low birth weight deliveries have shown little change. In this study, we examine temporal changes in birth weight distributions, birth weight specific neonatal mortality, and the birth weight threshold for an adverse risk of survival within both racial groups in order to explore the mechanisms for the disparities in infant mortality rates.METHOD: Single live births born to South Carolina resident mothers between 1975 and 1994 and considered White or African-American based on the mother's report of maternal race on the birth certificate were selected for investigation. We define the birth weight threshold for adverse survival odds as the birth weight at which 50% or more of infants in the population died within the first month of life.RESULTS: Despite significant increases in very low birth weight percentages, neonatal mortality rates markedly declined. Birth weight specific neonatal mortality decreased for both races, although greater reductions accrued to White low birth weight infants. By the end of the study period, the birth weight at which over 50% of newborns died within the first month of life was 696 g for Whites and 673 g for African-Americans.DISCUSSION: The ongoing decline in neonatal mortality is mainly due to reductions in birth weight 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 mortality rates. Moreover, the relatively greater and increasing mortality risk from postmaturity and macrosomia in infants of African-America mothers may further exacerbate the racial gap in infant mortality.