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225: Trends in perinatal mortality and racial/ethnic disparity among twins in the United States, 2000-2013

      Objective

      We performed an epidemiological investigation of trends in twin perinatal mortality overall and by major race/ethnicity group in the U.S. between 2000 and 2013.

      Study Design

      We undertook a population-based retrospective analysis of twin perinatal mortality in the United States (2000-2013) among newborns without congenital malformations and chromosomal abnormalities. We utilized ‘Period Linked Birth - Infant death’ and ‘Fetal Death’ data files from the National Center for Health Statistics for years 2000 - 2013. Perinatal mortality was defined as stillbirth at ≥22 weeks and neonatal death up to 28 days. Also, perinatal mortality was calculated for different categories of race/ethnicity (i.e. Hispanic, non-Hispanic Black and non-Hispanic White).

      Results

      The overall number of twin perinatal deaths from 2000 to 2013 was 40,156/1,646,922 (24.4 per 1000 live births). Table shows the rates for perinatal mortality in overall and by race-ethnicity. In all racial/ethnic groups the overall trend of twin perinatal mortality was decreasing; however, during each year of this trend analysis twin perinatal mortality was the highest in non-Hispanic Black population followed by Hispanic and non-Hispanic White population.

      Conclusion

      Perinatal mortality among twins decreased between 2000 and 2013 in all ethnic groups. During all 14 years of this trend analysis non-Hispanic Black and White population demonstrated the highest and lowest perinatal mortality rates, respectively. Racial disparities in health care availability, access, or utilization by underserved populations with twin gestation remain important issues in efforts to decrease perinatal mortality in the U.S.
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