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Persistent disparities in black infant mortality across gestational ages in the United States

Journal of Perinatology volume 44, pages 584–586 (2024)Cite this article

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The US has a higher infant mortality rate (IMR) than other high-income countries [1]. This is particularly pronounced for Black infants. Higher preterm birth rates amongst Black pregnancies have been implicated as an important contributing factor [2]. Prior regional studies from California and Florida have found that IMR was lower in Black infants than White infants from 22 to 25 weeks birth gestational age [3, 4]; however, at birth gestational age 32 weeks and above, the regional study from California found higher IMR in Black infants than White infants [3]. Studies using neonatal intensive care registries [5, 6] have also reported racial disparities in care practices, mortality, and other major adverse outcomes, disproportionately affecting Black infants. It is possible that absolute rates comparisons as done in the prior studies could have under-recognized racial disparities in IMR due to racial differences in gestational age distribution of births, and a population-weighted analysis is necessary to uncover the full extent of IMR disparities. These prior studies also have limited national generalizability, underscoring the need for a nationwide population-based study to inform national strategies for addressing racial IMR disparities.

The current study used US national data to test the hypothesis that Black infants have higher IMR at all gestational ages.

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Fig. 1: Absolute and population-weighted gestational age-specific infant, neonatal, and post-neonatal mortality by race.

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Funding

VVS is supported by a grant from the American Heart Association (23CDA1048106). CPT is supported by a grant from the National Heart Lung and Blood Institute (K23 HL157618). The funders had no role in this study’s design, conduct, analysis, or reporting.

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Authors and Affiliations

  1. University of Alabama at Birmingham, Division of Neonatology, Birmingham, AL, USA

    Vivek V. Shukla, Emily M. Youngblood, Rachel R. Tindal, Waldemar A. Carlo & Colm P. Travers

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  1. Vivek V. Shukla
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  2. Emily M. Youngblood
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  3. Rachel R. Tindal
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  4. Waldemar A. Carlo
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  5. Colm P. Travers
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Contributions

VVS conceptualized and designed the study, designed the data collection instruments, drafted the initial manuscript, and critically reviewed and revised the manuscript. EMY designed the data collection instruments, collected data, drafted the initial manuscript, and critically reviewed and revised the manuscript. RRT designed the data collection instruments, collected data, carried out the initial analyzes, and critically reviewed and revised the manuscript. WAC conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed and revised the manuscript for important intellectual content. CPT ravers conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Vivek V. Shukla.

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Shukla, V.V., Youngblood, E.M., Tindal, R.R. et al. Persistent disparities in black infant mortality across gestational ages in the United States. J Perinatol 44, 584–586 (2024). https://doi.org/10.1038/s41372-023-01863-6

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