HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vintzileos, A. M. Articles by Knuppel, R. A. Search for Related Content PubMed PubMed Citation Articles by Vintzileos, A. M. Articles by Knuppel, R. A.

Prenatal Care and Black–White Fetal Death Disparity in the United States: Heterogeneity by High-Risk Conditions

From the Division of Maternal-Fetal Medicine, and Section of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, St. Peter’s University Hospital, New Brunswick, New Jersey.

Address reprint requests to: Anthony M. Vintzileos, MD, UMDNJ-Robert Wood Johnson Medical School, St. Peter’s University Hospital, Division of Maternal-Fetal Medicine, 254 Easton Avenue, MOB 4th Floor, New Brunswick, NJ 08903-0591; E-mail: vintziam{at}umdnj.edu.

OBJECTIVE: To determine the impact of prenatal care in the United States on the fetal death rate in the presence and absence of obstetric and medical high-risk conditions, and to explore the role of these high risk conditions in contributing to the black–white disparity.

METHODS: This is a population-based, retrospective cohort study using the national perinatal mortality data for 1995–1997 assembled by the National Center for Health Statistics. Fetal death rate (per 1000 births) and adjusted relative risks were derived from multivariable logistic regression models.

RESULTS: Of 10,560,077 singleton births, 29,469 (2.8 per 1000) resulted in fetal death. Fetal death rates were higher for blacks than whites in the presence (4.2 versus 2.4 per 1000) and absence (17.2 versus 2.5 per 1000) of prenatal care. Lack of prenatal care increased the (adjusted) relative risk for fetal death 2.9-fold in blacks and 3.4-fold in whites. Blacks were 3.3 times more likely to have no prenatal care compared with whites. Over 20% of all fetal deaths were associated with growth restriction and placental abruption, both in the presence and absence of prenatal care. Lack of prenatal care was associated with increased fetal death rates for both blacks and whites in the presence and absence of high-risk conditions.

CONCLUSION: In the Unites States, strategies to increase prenatal care participation, especially among blacks, are expected to decrease fetal death rates.

This article has been cited by other articles:

				R. M. Silver Fetal Death Obstet. Gynecol., January 1, 2007; 109(1): 153 - 167. [Abstract] [Full Text] [PDF]

				A. J. Healy, F. D. Malone, L. M. Sullivan, T. F. Porter, D. A. Luthy, C. H. Comstock, G. Saade, R. Berkowitz, S. Klugman, L. Dugoff, et al. Early Access to Prenatal Care: Implications for Racial Disparity in Perinatal Mortality. Obstet. Gynecol., March 1, 2006; 107(3): 625 - 631. [Abstract] [Full Text] [PDF]

				J. R. Ickovics, T. S. Kershaw, C. Westdahl, S. S. Rising, C. Klima, H. Reynolds, and U. Magriples Group Prenatal Care and Preterm Birth Weight: Results From a Matched Cohort Study at Public Clinics Obstet. Gynecol., November 1, 2003; 102(5): 1051 - 1057. [Abstract] [Full Text] [PDF]