Maternal race/ethnicity and predictors of pregnancy and infant outcomes.
OBJECTIVE
To examine predictors of pregnancy and infant outcomes, including maternal race/ethnicity.


METHODS
Prospective and observational follow-up of high-risk pregnancies and births.


METHODS
Three hundred fifty-four mothers and their preterm and/or high-risk live-born neonates were closely followed in three tertiary care centers from the prenatal to postnatal periods for potential high-risk and/or preterm births that required neonatal resuscitations.


METHODS
Pregnancy complications, birth complications, and infant outcomes were examined in conjunction with maternal factors, including preexisting health problems, health behaviors (smoking, alcohol consumption, prenatal visits), and the birth setting (tertiary care centers or community hospitals).


RESULTS
About 22% of these infants were transferred into the tertiary care centers from the community hospitals right after birth; the rest were born in the centers. According to regression analyses, predictors of the birth setting were race (White vs. non-White), maternal health behaviors, pregnancy complications, fetal distress, and the presence of congenital defects for infants (p < .001). Predictors for fetal distress included race (Whites) and pregnancy-induced hypertension (p < .003). Predictors for lower birth weight included race (non-Whites), maternal cigarette smoking, pregnancy complications, fetal distress, and congenital defects (p < .001). Infant mortality rate was 3.9% for these high-risk infants, with the highest rate in infants born to Black mothers (8%).


CONCLUSIONS
There are obvious health disparities among White and non-White women experiencing high-risk pregnancies and births. Future studies are needed to develop interventions targeted to different racial/ethnic groups during pregnancy to reduce preterm and high-risk births.
Shiao
Shyang-Yun Pamela K
SY
School of Nursing, University of Texas Health Science Center at Houston, 77225-0334, USA. Pamela.Shiao@uth.tmc.edu
Andrews
Claire M
CM
Helmreich
Rebecca Jo
RJ
D001741:Black or African American / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data; D001213:Asian / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics; D005500:Follow-Up Studies; D015438:Health Behavior; D006630:Hispanic or Latino / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data; D007226:Infant Mortality; D007231:Infant, Newborn; D016015:Logistic Models; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology; D011256:Pregnancy Outcome / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics; D018566:Pregnancy, High-Risk / Q000208:ethnology / Q000235:genetics; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology / Q000235:genetics; D013781:Texas / Q000453:epidemiology / Q000208:ethnology; D044465:White People / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data