Maternal race, weight for gestational age, and infant survival

Abstract. Objective: To examine racial differences in survival among small, large, and appropriate for gestational age (SGA, LGA and AGA, respectively) infants born to non-Hispanic black and non-Hispanic white mothers and assess the impact of selected sociodemographic and behavioral risk factors on infant survival for the three weight for gestational age (WGA) groups. Methods: Data were obtained from the North Carolina (U.S.) linked birth/infant death files from 1999 to 2007. Kaplan-Meier survival curves and Cox regression were used to assess the effect of maternal race and other factors on infant survival for all WGA groups.  Results: Unadjusted analyses demonstrated that black SGA and LGA infant survival time was greater than that of white infants in these categories. However, when our analyses were adjusted for sociodemographic, behavioral, and life factors, the significant differences in survival between black and white infants no longer remained for any of the three WGA groups. We did not find any significant racial differences in survival time among the AGA infants. Conclusion: Overall, the findings of this study indicate that infants born to black mothers do not survive longer than infants born to white mothers. Further, our results show that several socioeconomic and behavioral factors need to be addressed if the national Healthy People 2020 objective of reducing infant mortality rate is to be met.