title: Disparities in perinatal medicine: preterm birth, stillbirth, and infant mortality.
abstract: Infant mortality, stillbirths, and preterm births are major public health priorities with significant disparities based on race and ethnicity. Interestingly, when evaluating the rates over the past 30 to 50 years, the disparity persists in all three and is remarkably consistent. In the United States, the infant mortality rate is 6.7 deaths per 1,000 live births, the stillbirth rate is 6.2 per 1,000 deliveries, and the preterm birth rate is 12.8% of live births. The rates among non-Hispanic African Americans are dramatically higher, nearly double the infant mortality at 13.4 infant deaths per 1,000 live births, nearly double the stillbirth rate at 11.1 stillbirths per 1,000 deliveries, and one third higher with preterm births at 18.4% of live births. Despite numerous conferences, workshops, articles, and investigators focusing on this line of work, the disparities persist and, in some cases, are growing. In this article, we summarize a Eunice Kennedy Shriver National Institute of Child Health and Human Development workshop that focused on these disparities to identify the associated factors to determine their relative contributions, identify gaps in knowledge, and develop specific strategies to address the disparities in the short-term and long-term.
authors.affiliation: From the Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; the Departments of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, and Drexel University College of Medicine, Philadelphia, Pennsylvania; and Family Medicine and Public Health Sciences, University of Virginia, Charlottesville, Virginia.
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Jay
authors.initials: J
authors.lastname: Iams
authors.forename: Robert
authors.initials: R
authors.lastname: Goldenberg
authors.forename: Fern R
authors.initials: FR
authors.lastname: Hauck
authors.forename: Marian
authors.initials: M
authors.lastname: Willinger
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D020380:Needs Assessment; D018743:Perinatal Care / Q000458:organization & administration*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D018570:Risk Assessment; D050497:Stillbirth / Q000453:epidemiology* / Q000208:ethnology; D014481:United States / Q000453:epidemiology