• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of pubhealthrepLink to Publisher's site
Public Health Rep. 1987 Mar-Apr; 102(2): 182–192.
PMCID: PMC1477813

Differences in neonatal and postneonatal mortality by race, birth weight, and gestational age.

Abstract

In recent decades, neonatal and postneonatal mortality rates have declined overall in the United States. Yet, the mortality rates for black infants continue to be approximately twice those for white infants. With the use of data from 45 of the 53 vital statistics reporting areas that participated in the 1980 National Infant Mortality Surveillance project, we extended previous State analyses to describe differences, nationally, in neonatal and postneonatal mortality risks for black and white infants according to gestational age and birth weight. After restricting our analysis to single-delivery infants with known and plausible combinations of gestational age of 26 or more weeks and birth weights of 500 grams (g) or more, the neonatal mortality risk (NMR)--that is, the number of deaths to infants less than 28 days of life per 1,000 live births--for black infants was 1.6 times higher than the NMR for whites. This difference was largely explained by two findings: First, although the NMR was lower for black than for white infants with gestational ages of less than 38 weeks and birth weights less than 3,000 g, that advantage was heavily outweighed by the higher percentage of such births among blacks, accounting for roughly two-thirds of the overall difference in NMR between blacks and whites. Second, most of the remaining difference in NMR was accounted for by higher NMRs among black infants with gestational ages of 38 or more weeks and birth weights of 3,000 g or more. A comparison of the lowest mortality risk for any combination of birth weight and gestational age showed that the black NMR was 1.89 times higher than the white NMR. The postneonatal mortality risk (PNMR)--PNMR equals the number of deaths to infants 28 days to less than 1 year of life per 1,000 neonatal survivors--for black infants was 2.09 times the PNMR for white infants. Black infants had higher PNMRs than white infants for nearly all combinations of birth weight and gestational age. Higher PNMRs among infants with gestational ages of 38 or more weeks and birth weights of 2,500 g or more accounted for 43 percent of the difference in PNMR between black infants and white infants. Eliminating the U.S. black-white infant mortality disparity will require not only reducing the higher frequency of prematurity and low birth weight among black infants, but also improving the survival during both the neonatal and postneonatal periods of term black infants with normal birth weights.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (3.6M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Lee KS, Paneth N, Gartner LM, Pearlman MA, Gruss L. Neonatal mortality: an analysis of the recent improvement in the United States. Am J Public Health. 1980 Jan;70(1):15–21. [PMC free article] [PubMed]
  • David RJ, Siegel E. Decline in neonatal mortality, 1968 to 1977: better babies or better care? Pediatrics. 1983 Apr;71(4):531–540. [PubMed]
  • Goldenberg RL, Humphrey JL, Hale CB, Boyd BW, Wayne JB. Neonatal deaths in Alabama, 1970-1980: an analysis of birth weight- and race-specific neonatal mortality rates. Am J Obstet Gynecol. 1983 Mar 1;145(5):545–552. [PubMed]
  • Buehler JW, Kleinman JC, Hogue CJ, Strauss LT, Smith JC. Birth weight-specific infant mortality, United States, 1960 and 1980. Public Health Rep. 1987 Mar-Apr;102(2):151–161. [PMC free article] [PubMed]
  • Hogue CJ, Buehler JW, Strauss LT, Smith JC. Overview of the National Infant Mortality Surveillance (NIMS) project--design, methods, results. Public Health Rep. 1987 Mar-Apr;102(2):126–138. [PMC free article] [PubMed]
  • Binkin NJ, Williams RL, Hogue CJ, Chen PM. Reducing black neonatal mortality. Will improvement in birth weight be enough? JAMA. 1985 Jan 18;253(3):372–375. [PubMed]
  • Alexander GR, Tompkins ME, Altekruse JM, Hornung CA. Racial differences in the relation of birth weight and gestational age to neonatal mortality. Public Health Rep. 1985 Sep-Oct;100(5):539–547. [PMC free article] [PubMed]
  • Lambert DA, Strauss LT. Analysis of unlinked infant death certificates from the NIMS project. Public Health Rep. 1987 Mar-Apr;102(2):200–204. [PMC free article] [PubMed]
  • David RJ. The quality and completeness of birthweight and gestational age data in computerized birth files. Am J Public Health. 1980 Sep;70(9):964–973. [PMC free article] [PubMed]
  • Buehler JW, Strauss LT, Hogue CJ, Smith JC. Birth weight-specific causes of infant mortality, United States, 1980. Public Health Rep. 1987 Mar-Apr;102(2):162–171. [PMC free article] [PubMed]
  • Chinnici JP, Sansing RC. Mortality rates, optimal and discriminating birthweights between white and nonwhite single births in Virginia (1955-1973). Hum Biol. 1977 Sep;49(3):335–348. [PubMed]
  • Berry RJ, Buehler JW, Strauss LT, Hogue CJ, Smith JC. Birth weight-specific infant mortality due to congenital anomalies, 1960 and 1980. Public Health Rep. 1987 Mar-Apr;102(2):171–181. [PMC free article] [PubMed]
  • Wilcox AJ, Russell IT. Perinatal mortality: standardizing for birthweight is biased. Am J Epidemiol. 1983 Dec;118(6):857–864. [PubMed]
  • Wilcox AJ, Russell IT. Birthweight and perinatal mortality: III. Towards a new method of analysis. Int J Epidemiol. 1986 Jun;15(2):188–196. [PubMed]

Articles from Public Health Reports are provided here courtesy of Association of Schools of Public Health

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...