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Prepregnancy obesity and the racial disparity in infant mortality
Author(s) -
Lemon Lara S.,
Naimi Ashley I.,
Abrams Barbara,
Kaufman Jay S.,
Bodnar Lisa M.
Publication year - 2016
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21621
Subject(s) - medicine , infant mortality , obesity , obstetrics , population , live birth , demography , pregnancy , pediatrics , environmental health , sociology , biology , genetics
Objective To estimate the extent to which prepregnancy obesity explains the Black‐White disparity in stillbirth and infant mortality. Methods A population‐based study of linked Pennsylvania birth‐infant death certificates (2003‐2011; n = 1,055,359 births) and fetal death certificates (2006‐2011; n = 3,102 stillbirths) for all singleton pregnancies in non‐Hispanic (NH) White and NH Black women was conducted. Inverse probability weighted regression was used to estimate the role of prepregnancy obesity in explaining the race‐infant/fetal death association. Results Compared with NH White women, NH Black women were more likely to have obesity (≥30 kg/m 2 ) and experienced a higher rate of stillbirth (8.3 vs. 3.6 stillbirths per 1,000 live‐born and stillborn infants) and infant death (8.5 vs. 3.0 infant deaths per 1,000 live births). When the contribution of prepregnancy obesity was removed, the difference in risk between NH Blacks and NH Whites decreased from 6.2 (95% CI: 5.6‐6.7) to 5.5 (95% CI: 4.9‐6.2) excess stillbirths per 1,000 and 5.8 (95% CI: 5.3‐6.3) to 5.2 (95% CI: 4.7‐5.7) excess infant deaths per 1,000. Conclusions For every 10,000 live births in Pennsylvania (2003‐2011), 6 of the 61 excess infant deaths in NH Black women and 5 of the 44 excess stillbirths (2006‐2011) were attributable to prepregnancy obesity.