In many of the world’s most affluent countries, Black women are twice as likely as white women to have their babies die within four weeks of delivery, according to a new study that highlights persistent racial disparities in neonatal outcomes.
The new analysis, published December 10 in the Lancet, examined data on almost 2.2 million pregnancies across 20 high-income and middle-income countries including the United States, Canada, the United Kingdom, and several other European nations. Even after researchers accounted for a wide range of factors that can influence the risk of pregnancy and birth complications — such as age, previous pregnancies, obesity, and education levels — Black women and their infants still fared much worse.
Compared with white women, the study showed, Black mothers were more than twice as likely to have stillborn infants. Black women were also 65 percent more likely to have preterm deliveries and 39 percent more likely to have infants born small for their gestational age.
Poor Outcomes Are More Likely for Hispanic and Asian Mothers and Infants, Too
Some of these outcomes were also more common for women from other racial and ethnic groups than for white mothers. For example, Hispanic women had more than three times the risk of infant death within four weeks of delivery. People of South Asian and East Asian descent were 61 percent more likely to have newborns who were small for their gestational age.
“Our analysis shows that babies of mothers from underserved and underrepresented racial and ethnic groups are more likely to die or face serious complications [and it’s] a global phenomenon,” says the senior study author, Shakila Thangaratinam, MD, PhD, the chair of maternal and perinatal health at the University of Birmingham in the England.
“Race and ethnic disparities in perinatal care is not located to one specific country or region, which means that there is a systemic issue across richer countries that needs to be addressed as an international community,” Dr. Thangaratinam adds.
One limitation of the study is that many of the smaller studies included in the analysis used different definitions for certain racial and ethnic groups, making it harder to estimate outcomes for certain women of color, the study team noted. Another drawback is that researchers lacked data on insurance status and access to healthcare, making it difficult to determine whether the availability of prenatal care or other medical services influenced the outcomes.
Even so, the findings add to a large and growing body of evidence that shows how decades of declining newborn mortality rates mask stark racial and ethnic disparities in outcomes.
Black Mothers and Babies and Other Minorities Are Not Getting the Healthcare They Need
While the study didn’t examine the reasons behind these disparities, other studies suggest that a complex mix of factors may be in play.
In the United States, for example, previous research has shown that Black women have infant mortality rates more than double those of white women. Black infants are also more likely to die as a result of complications related to low birth weight, and from sudden infant death syndrome, according to the U.S. Department of Health and Human Services.
Black women are also twice as likely to receive no prenatal care at all, or none until very late in pregnancy when it’s too late for doctors to prevent some complications. Early prenatal care is one of the best ways to help minimize the risk of neonatal mortality, according to the U.S. Centers for Disease Control and Prevention.
“Taken together with strong evidence that ethnic minority mothers themselves are at increased risk of death or major health complications during pregnancy, this paper further supports the need to urgently understand how healthcare systems are struggling to provide the right care for underserved families.” Thangaratinam says.
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