Racial disparity in pregnancy outcomes: analysis of black and white teenage pregnancies.
The pregnancies of black women are complicated by adverse outcomes such as prematurity and low birth weight at twice the rate of complications in pregnancies of white women. Although the cause of this racial disparity is unknown, it is most likely multifactorial. The disparity in outcomes has been found in many studies despite implementation of controls for the factors of age, socioeconomic status, and access to health care. We hypothesized that the increased incidence of adverse outcomes may be strongly affected by adequacy of prenatal care. We investigated the effects of comprehensive prenatal care delivered at the University of North Carolina-Chapel Hill Teenage Obstetric Clinic. The gestational age at the onset of prenatal care and the mean number of prenatal visits were the same for black and white teenagers. Among 183 teenagers we found no significant difference between black and white pregnancies for the outcomes of premature labor, premature delivery, fetal death, neonatal mortality, or hypertensive diseases. The mean gestational age at delivery was 38.3 weeks and 39.1 weeks for black and white women, respectively. The mean birth weight was 3126 gm and 3272 gm for black and white women, respectively. There was a trend (p < 0.09) toward more low birth weight infants in white women: 7% for black infants and 12% for white infants. We believe that comprehensive prenatal care significantly lessens the racial disparity in pregnancy outcomes between black and white adolescent women.
Taylor
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Department of Obstetrics and Gynecology, UNC School of Medicine, Chapel Hill 27599-7570, USA.
Katz
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Moos
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D000293:Adolescent; D044383:Black People; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D011253:Pregnancy in Adolescence / Q000208:ethnology*; D011295:Prenatal Care / Q000639:trends; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D044465:White People