title: Racial/ethnic differences in preterm perinatal outcomes.
abstract: BACKGROUND
  Racial disparities in preterm birth and infant death have been well documented. Less is known about racial disparities in neonatal morbidities among infants who are born at <37 weeks of gestation.
  
  
  OBJECTIVE
  The purpose of this study was to determine whether the risk for morbidity and death among infants who are born preterm differs by maternal race.
  
  
  METHODS
  A retrospective cohort design included medical records from preterm deliveries of 19,325 black, Hispanic, and white women in the Consortium on Safe Labor. Sequentially adjusted Poisson models with generalized estimating equations estimated racial differences in the risk for neonatal morbidities and death, controlling for maternal demographics, health behaviors, and medical history. Sex differences between and within race were examined.
  
  
  RESULTS
  Black preterm infants had an elevated risk for perinatal death, but there was no difference in risk for neonatal death across racial groups. Relative to white infants, black infants were significantly more likely to experience sepsis (9.1% vs 13.6%), peri- or intraventricular hemorrhage (2.6% vs 3.3%), intracranial hemorrhage (0.6% vs 1.8%), and retinopathy of prematurity (1.0% vs 2.6%). Hispanic and white preterm neonates had similar risk profiles. In general, female infants had lower risk relative to male infants, with white female infants having the lowest prevalence of a composite indicator of perinatal death or any morbidity across all races (30.9%). Differences in maternal demographics, health behaviors, and medical history did little to influence these associations, which were robust to sensitivity analyses of pregnancy complications as potential underlying mechanisms.
  
  
  CONCLUSIONS
  Preterm infants were at similar risk for neonatal death, regardless of race; however, there were notable racial disparities and sex differences in rare, but serious, adverse neonatal morbidities.
authors.affiliation: Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
authors.forename: Maeve E
authors.initials: ME
authors.lastname: Wallace
authors.affiliation: Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
authors.forename: Pauline
authors.initials: P
authors.lastname: Mendola
authors.affiliation: Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
authors.forename: Nikira
authors.initials: N
authors.lastname: Epps
authors.affiliation: Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
authors.forename: Melissa
authors.initials: M
authors.lastname: Smarr
authors.affiliation: Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
authors.forename: Stefanie N
authors.initials: SN
authors.lastname: Hinkle
authors.affiliation: Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
authors.forename: Yeyi
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD. Electronic address: katherine.grantz@nih.gov.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Grantz
mesh_terms: D000328:Adult; D001741:Black or African American; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D008297:Male; D012189:Retrospective Studies; D044465:White People
keywords: intracranial hemorrhage; intraventricular hemorrhage; necrotizing enterocolitis; neonatal death; perinatal death; preterm birth; respiratory distress syndrome; retinopathy of prematurity; sepsis; transient tachypnea