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Racial disparities in stillbirth risk across gestation in the United States

  • Marian Willinger
    Correspondence
    Reprints: Marian Willinger, PhD, Pregnancy and Perinatology Branch, Center for Developmental Biology and Perinatal Medicine, National Institute of Child Health and Human Development, 6100 Executive Blvd., Room 4B03H, Rockville, MD 20852
    Affiliations
    Pregnancy and Perinatology Branch, Center for Developmental Biology and Perinatal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
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  • Chia-Wen Ko
    Affiliations
    Epidemiology and Biostatistics Program, National Institutes on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD
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  • Uma M. Reddy
    Affiliations
    Pregnancy and Perinatology Branch, Center for Developmental Biology and Perinatal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
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Published:September 18, 2009DOI:https://doi.org/10.1016/j.ajog.2009.06.057

      Objective

      We sought to determine factors associated with racial disparities in stillbirth risk.

      Study Design

      Stillbirth hazard was analyzed using 5,138,122 singleton gestations from the National Center of Health Statistics perinatal mortality and birth files, 2001–2002.

      Results

      Black women have a 2.2-fold increased risk of stillbirth compared with white women. The black/white disparity in stillbirth hazard at 20–23 weeks is 2.75, decreasing to 1.57 at 39–40 weeks. Higher education reduced the hazard for whites more than for blacks and Hispanics. Medical, pregnancy, and labor complications accounted for 30% of the hazard in blacks and 20% in whites and Hispanics. Congenital anomalies and small for gestational age contributed more to preterm stillbirth risk among whites than blacks. Pregnancy and labor conditions contributed more to preterm stillbirth risk among blacks than whites.

      Conclusion

      The excess stillbirth risk for blacks was greatest at preterm gestations, and factors contributing to stillbirth risk vary by race and gestational age.

      Key words

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      Linked Article

      • The study of stillbirth
        American Journal of Obstetrics & GynecologyVol. 201Issue 5
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