title: Prepregnancy obesity and the racial disparity in infant mortality.
abstract: To estimate the extent to which prepregnancy obesity explains the Black-White disparity in stillbirth and infant mortality.
  
  
  
  A population-based study of linked Pennsylvania birth-infant death certificates (2003-2011; n = 1,055,359 births) and fetal death certificates (2006-2011; n = 3,102 stillbirths) for all singleton pregnancies in non-Hispanic (NH) White and NH Black women was conducted. Inverse probability weighted regression was used to estimate the role of prepregnancy obesity in explaining the race-infant/fetal death association.
  
  
  
  Compared with NH White women, NH Black women were more likely to have obesity (≥30 kg/m2) and experienced a higher rate of stillbirth (8.3 vs. 3.6 stillbirths per 1,000 live-born and stillborn infants) and infant death (8.5 vs. 3.0 infant deaths per 1,000 live births). When the contribution of prepregnancy obesity was removed, the difference in risk between NH Blacks and NH Whites decreased from 6.2 (95% CI: 5.6-6.7) to 5.5 (95% CI: 4.9-6.2) excess stillbirths per 1,000 and 5.8 (95% CI: 5.3-6.3) to 5.2 (95% CI: 4.7-5.7) excess infant deaths per 1,000.
  
  
  
  For every 10,000 live births in Pennsylvania (2003-2011), 6 of the 61 excess infant deaths in NH Black women and 5 of the 44 excess stillbirths (2006-2011) were attributable to prepregnancy obesity.
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA.|Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pennsylvania, USA.|Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA.
authors.forename: Lara S
authors.initials: LS
authors.lastname: Lemon
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA.
authors.forename: Ashley I
authors.initials: AI
authors.lastname: Naimi
authors.affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, California, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Abrams
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA.|Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pennsylvania, USA.|Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Bodnar
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D066088:Infant Death; D007226:Infant Mortality / Q000208:ethnology*; D007231:Infant, Newborn; D050498:Live Birth / Q000208:ethnology; D009765:Obesity / Q000208:ethnology* / Q000523:psychology; D010414:Pennsylvania; D044465:White People / Q000706:statistics & numerical data*