Adverse perinatal outcomes among interracial couples in the United States.
OBJECTIVE
We examined the association between parental race and stillbirth and adverse perinatal and infant outcomes.


METHODS
We conducted a retrospective cohort analysis using the 1995-2001 linked birth and infant death files that are composed of live births and fetal and infant deaths in the United States. The study included singleton births delivered at 20 or more weeks of gestation with a fetus weighing 500 g or more (N = 21,005,786). Parental race was categorized as mother white-father white, mother white-father black, mother black-father white, and mother black-father black. Multivariable logistic regression analysis was performed to examine the association between parental race and risks of stillbirth (at > or = 20 weeks), small for gestational age (defined as birth weight < 5th and < 10th percentile for gestational age), and early neonatal (< 7 days), late neonatal (7-27 days), and postneonatal (28-364 days) mortality. All analyses were adjusted for the confounding effects of maternal age, education, trimester at which prenatal care began, parity, marital status, and smoking during pregnancy.


RESULTS
Although risks varied across parental race categories, stillbirth was associated with a higher-than-expected risk for interracial couples: mother white-father black, relative risk (RR) 1.17 (95% confidence interval [CI] 1.10-1.26) and mother black-father white, RR 1.37 (95% CI 1.21-1.54) compared with mother white-father white parents. The RR for stillbirth was even higher among mother black-father black parents (RR 1.67, 95% CI 1.62-1.72). The overall patterns of association for small for gestational age births (< 5th and < 10th percentile) and early neonatal mortality were similar to those seen for stillbirth.


CONCLUSIONS
There is an increased risk of adverse perinatal outcomes for interracial couples, including stillbirth, small for gestational age infants, and neonatal mortality.


METHODS
II-2.
Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Medicine & Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, 08901, USA. getahuda@umdnj.edu
Darios
D
Getahun
Cande V
CV
Ananth
Nandini
N
Selvam
Kitaw
K
Demissie
D001741:Black or African American; D015331:Cohort Studies; D005191:Family Characteristics; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D049590:Postpartum Period; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology; D044465:White People