Racial differences in neonatal mortality. What causes of death explain the gap?
N. J. Binkin, K. R. Rust and R. L. Williams
Division of Nutrition, Centers for Disease Control, Atlanta.
To examine further the differences in birth-weight-specific neonatal
mortality rates between ethnic groups, we studied causes of death for
infants of white, black, United States-born Hispanic, and Mexican-born
Hispanic women using linked California birth-death records from 1981 to
1983. Black infants of low birth weight had considerably lower neonatal
mortality rates from respiratory distress syndrome and congenital
abnormalities. In the normal birth-weight category, however, black neonatal
mortality rates for most conditions were higher than those for whites. The
greatest differences between Mexican-born Hispanic and white neonatal
mortality rates were seen for other respiratory conditions and
trauma/hypoxia/asphyxia. These differences were most marked in the 1500- to
2499-g and greater than or equal to 2500-g birth-weight categories.
Attempts to lower the neonatal mortality rate for black infants of normal
birth weight may require providers to focus on both broad preventive
measures and improved perinatal management. In contrast, improvements in
perinatal management among Mexican-born Hispanics may produce improvement
in the neonatal mortality rate for this group.
