Racial disparity in meconium-stained amniotic fluid and meconium aspiration syndrome in the United States, 1989-2000.
OBJECTIVE
To estimate the prevalence of meconium-stained amniotic fluid and meconium aspiration syndrome, as well as the differences in case fatality from meconium aspiration syndrome, between non-Hispanic black and non-Hispanic white infants.


METHODS
We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989-1991, 1995-1997, and 1998-2000. We used logistic regression to estimate the risks of meconium-stained amniotic fluid and meconium aspiration syndrome and to estimate the case fatality of meconium aspiration syndrome by maternal race, birth weight, period, and pregnancy complications.


RESULTS
Risk of meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight-adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of meconium aspiration syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight-adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of meconium aspiration syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989-1991, 1995-1997, and 1998-2000, respectively.


CONCLUSIONS
Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for meconium-stained amniotic fluid and meconium aspiration syndrome but not for meconium aspiration syndrome case fatality.
Sriram
Sudhir
S
Neonatology Section and Center for Perinatal Epidemiology, University of Chicago Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA. ssriram@peds.bsd.uchicago.edu
Wall
Stephen N
SN
Khoshnood
Babak
B
Singh
Jaideep K
JK
Hsieh
Hui-Lung
HL
Lee
Kwang-Sun
KS
D000653:Amniotic Fluid; D044383:Black People; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008470:Meconium; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology / Q000208:ethnology; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D014481:United States; D044465:White People; D001741:Black or African American