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. 1985 Sep-Oct;100(5):539–547.

Racial differences in the relation of birth weight and gestational age to neonatal mortality.

G R Alexander, M E Tompkins, J M Altekruse, C A Hornung
PMCID: PMC1425069  PMID: 3931169

Abstract

Utilizing South Carolina live birth-infant death cohort files for the period 1975-80, this study examines the bivariate distribution of birth weight-gestational age (BW-GA), intrauterine growth curves, and BW-GA specific neonatal mortality rates (NMRs) by race. Comparison of BW-GA distributions revealed an appreciable shift between racial subgroups. Nonwhites, on the average, were born 1 week earlier and 270 grams lighter in weight than whites. In addition to racial differences in rates of intrauterine growth, nonwhites experienced lower BW-GA NMRs than whites in BW-GA categories less than 3,000 grams and less than 38 weeks. However, the improved mortality experience of nonwhites at more immature BW-GA categories was not consistently present when different cause-specific NMRs were considered. These persistent racial variations highlight continuing issues regarding both the use of a single norm for defining low birth weight or prematurity and the role of nonsocioeconomic factors related to racial BW-GA distribution and mortality disparities. As birth weight and gestational age represent empirical indicators of the maturity and survivability of an infant at birth, these data and previous supporting research raise further concerns regarding the ability of these indicators to accurately reflect equivalent fetal development and subsequent risk of mortality among racial groups.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ANCTIL A. O., JOSHI G. B., LUCAS W. E., LITTLE W. A., CALLAGAN D. A. PREMATURITY: A MORE PRECISE APPROACH TO IDENTIFICATION. Obstet Gynecol. 1964 Nov;24:716–721. [PubMed] [Google Scholar]
  2. Adams M. S., MacLean C. J., Niswander J. D. Discrimination between deviant and ordinary low birth weight: American Indian infants. Growth. 1968 Jun;32(2):153–161. [PubMed] [Google Scholar]
  3. American Academy of Pediatrics. Committee on fetus and newborn. Nomenclature for duration of gestation, birth weight and intra-uterine growth. Pediatrics. 1967 Jun;39(6):935–939. [PubMed] [Google Scholar]
  4. Battaglia F. C., Frazier T. M., Hellegers A. E. Birth weight, gestational age, and pregnancy out- come, with special reference to high birth weight-low gestational age infant. Pediatrics. 1966 Mar;37(3):417–422. [PubMed] [Google Scholar]
  5. Battaglia F. C., Lubchenco L. O. A practical classification of newborn infants by weight and gestational age. J Pediatr. 1967 Aug;71(2):159–163. doi: 10.1016/s0022-3476(67)80066-0. [DOI] [PubMed] [Google Scholar]
  6. Binkin N. J., Williams R. L., Hogue C. J., Chen P. M. Reducing black neonatal mortality. Will improvement in birth weight be enough? JAMA. 1985 Jan 18;253(3):372–375. doi: 10.1001/jama.253.3.372. [DOI] [PubMed] [Google Scholar]
  7. Brenner W. E., Edelman D. A., Hendricks C. H. A standard of fetal growth for the United States of America. Am J Obstet Gynecol. 1976 Nov 1;126(5):555–564. doi: 10.1016/0002-9378(76)90748-1. [DOI] [PubMed] [Google Scholar]
  8. Buescher P. A., Nugent R. R., Levine R. H. The impact of low birth weight on North Carolina neonatal mortality 1976-1982. N C Med J. 1984 Jul;45(7):437–441. [PubMed] [Google Scholar]
  9. Carlson E. D. Social determinants of low birth weight in a high-risk population. Demography. 1984 May;21(2):207–215. [PubMed] [Google Scholar]
  10. David R. J., Siegel E. Decline in neonatal mortality, 1968 to 1977: better babies or better care? Pediatrics. 1983 Apr;71(4):531–540. [PubMed] [Google Scholar]
  11. David R. J. The quality and completeness of birthweight and gestational age data in computerized birth files. Am J Public Health. 1980 Sep;70(9):964–973. doi: 10.2105/ajph.70.9.964. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. ERHARDT C. L., JOSHI G. B., NELSON F. G., KROLL B. H., WEINER L. INFLUENCE OF WEIGHT AND GESTATION ON PERINATAL AND NEONATAL MORTALITY BY ETHNIC GROUP. Am J Public Health Nations Health. 1964 Nov;54:1841–1855. doi: 10.2105/ajph.54.11.1841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Eberstein I. W., Parker J. R. Racial differences in infant mortality by cause of death: the impact of birth weight and maternal age. Demography. 1984 Aug;21(3):309–321. [PubMed] [Google Scholar]
  14. Freman M. G., Graves W. L., Thompson R. L. Indigent Negro and Caucasian birth weight-gestational age tables. Pediatrics. 1970 Jul;46(1):9–15. [PubMed] [Google Scholar]
  15. Goldenberg R. L., Humphrey J. L., Hale C. B., Boyd B. W., Wayne J. B. Neonatal deaths in Alabama, 1970-1980: an analysis of birth weight- and race-specific neonatal mortality rates. Am J Obstet Gynecol. 1983 Mar 1;145(5):545–552. doi: 10.1016/0002-9378(83)91193-6. [DOI] [PubMed] [Google Scholar]
  16. Goldenberg R. L., Nelson K. G., Hale C. D., Wayne J., Bartolucci A. A., Koski J. Survival of infants with low birth weight and early gestational age, 1979 to 1981. Am J Obstet Gynecol. 1984 Jul 1;149(5):508–511. doi: 10.1016/0002-9378(84)90026-7. [DOI] [PubMed] [Google Scholar]
  17. Gruenwald P. Growth of the human fetus. I. Normal growth and its variation. Am J Obstet Gynecol. 1966 Apr 15;94(8):1112–1119. doi: 10.1016/0002-9378(66)90774-5. [DOI] [PubMed] [Google Scholar]
  18. Karn M. N., Penrose L. S. Birth weight and gestation time in relation to maternal age, parity and infant survival. Ann Eugen. 1952;16:147–164. [PubMed] [Google Scholar]
  19. Kleinman J. C. Re: "Perinatal mortality: standardizing for birthweight is biased". Am J Epidemiol. 1984 Nov;120(5):798–801. doi: 10.1093/oxfordjournals.aje.a113950. [DOI] [PubMed] [Google Scholar]
  20. Koops B. L., Morgan L. J., Battaglia F. C. Neonatal mortality risk in relation to birth weight and gestational age: update. J Pediatr. 1982 Dec;101(6):969–977. doi: 10.1016/s0022-3476(82)80024-3. [DOI] [PubMed] [Google Scholar]
  21. LUBCHENCO L. O., HANSMAN C., DRESSLER M., BOYD E. INTRAUTERINE GROWTH AS ESTIMATED FROM LIVEBORN BIRTH-WEIGHT DATA AT 24 TO 42 WEEKS OF GESTATION. Pediatrics. 1963 Nov;32:793–800. [PubMed] [Google Scholar]
  22. Lin C. C., Emanuel I. A comparison of American and Chinese intrauterine growth standards. Are American babies really smaller? Am J Epidemiol. 1972 May;95(5):418–430. doi: 10.1093/oxfordjournals.aje.a121409. [DOI] [PubMed] [Google Scholar]
  23. Lubchenco L. O. Assessment of gestational age and development of birth. Pediatr Clin North Am. 1970 Feb;17(1):125–145. doi: 10.1016/s0031-3955(16)32381-1. [DOI] [PubMed] [Google Scholar]
  24. Lubchenco L. O., Searls D. T., Brazie J. V. Neonatal mortality rate: relationship to birth weight and gestational age. J Pediatr. 1972 Oct;81(4):814–822. doi: 10.1016/s0022-3476(72)80114-8. [DOI] [PubMed] [Google Scholar]
  25. Milner R. D., Richards B. An analysis of birth weight by gestational age of infants born in England and Wales, 1967 to 1971. J Obstet Gynaecol Br Commonw. 1974 Dec;81(12):956–967. doi: 10.1111/j.1471-0528.1974.tb00414.x. [DOI] [PubMed] [Google Scholar]
  26. North A. F., Jr, MacDonald H. M. Why are neonatal mortality rates lower in small black infants than in white infants in similar birth weight? J Pediatr. 1977 May;90(5):809–810. doi: 10.1016/s0022-3476(77)81258-4. [DOI] [PubMed] [Google Scholar]
  27. Pethybridge R. J., Ashford J. R., Fryer J. G. Some features of the distribution of birthweight of human infants. Br J Prev Soc Med. 1974 Feb;28(1):10–18. doi: 10.1136/jech.28.1.10. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Tanner J. M. Standards for birth weight or intra-uterine growth. Pediatrics. 1970 Jul;46(1):1–6. [PubMed] [Google Scholar]
  29. Wilcox A. J. Birth weight, gestation, and the fetal growth curve. Am J Obstet Gynecol. 1981 Apr 15;139(8):863–867. doi: 10.1016/0002-9378(81)90950-9. [DOI] [PubMed] [Google Scholar]
  30. Wilcox A. J., Russell I. T. Birthweight and perinatal mortality: I. On the frequency distribution of birthweight. Int J Epidemiol. 1983 Sep;12(3):314–318. doi: 10.1093/ije/12.3.314. [DOI] [PubMed] [Google Scholar]
  31. Wilcox A. J., Russell I. T. Perinatal mortality: standardizing for birthweight is biased. Am J Epidemiol. 1983 Dec;118(6):857–864. doi: 10.1093/oxfordjournals.aje.a113704. [DOI] [PubMed] [Google Scholar]
  32. Williams R. L., Chen P. M. Identifying the sources of the recent decline in perinatal mortality rates in California. N Engl J Med. 1982 Jan 28;306(4):207–214. doi: 10.1056/NEJM198201283060404. [DOI] [PubMed] [Google Scholar]
  33. Williams R. L., Creasy R. K., Cunningham G. C., Hawes W. E., Norris F. D., Tashiro M. Fetal growth and perinatal viability in California. Obstet Gynecol. 1982 May;59(5):624–632. [PubMed] [Google Scholar]
  34. Williams R. L. Intrauterine growth curves: intra- and international comparisons with different ethnic groups in California. Prev Med. 1975 Jun;4(2):163–172. doi: 10.1016/0091-7435(75)90081-x. [DOI] [PubMed] [Google Scholar]
  35. Yerushalmy J. The classification of newborn infants by birth weight and gestational age. J Pediatr. 1967 Aug;71(2):164–172. doi: 10.1016/s0022-3476(67)80067-2. [DOI] [PubMed] [Google Scholar]

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