Schempf Ashley H, Branum Amy M, Lukacs Susan L, Schoendorf Kenneth C
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md 21205, USA.
Am J Public Health. 2007 Jul;97(7):1255-60. doi: 10.2105/AJPH.2006.093708. Epub 2007 May 30.
We evaluated whether the decline of the racial disparity in preterm birth during the last decade was commensurate with a decline in the contribution of preterm birth to the infant mortality gap.
We used linked files of 1990 and 2000 data on US infant births and deaths to partition the gap between Black and White infant mortality rates into differences in the (1) distribution of gestational age and (2) gestational age-specific mortality rates.
Between 1990 and 2000, the Black-White infant mortality rate ratio did not change significantly (2.3 vs 2.4). Excess deaths among preterm Black infants accounted for nearly 80% of the Black-White infant mortality gap in both 1990 and 2000. The narrowing racial disparity in the preterm birth rate was counterbalanced by greater mortality reductions in White than in Black preterm infants. Extremely preterm birth (<28 weeks) was 4 times higher in Black infants and accounted for more than half of the infant mortality gap.
Substantial reductions in the Black-White infant mortality gap will require improved prevention of extremely preterm birth among Black infants.
我们评估了过去十年间早产方面种族差异的下降是否与早产对婴儿死亡率差距的影响下降程度相当。
我们使用了1990年和2000年美国婴儿出生及死亡数据的关联文件，将黑人与白人婴儿死亡率之间的差距划分为以下两方面的差异：（1）孕周分布；（2）特定孕周死亡率。
1990年至2000年间，黑人与白人婴儿死亡率之比无显著变化（2.3对2.4）。早产黑人婴儿的超额死亡在1990年和2000年都占黑人与白人婴儿死亡率差距的近80%。早产率方面种族差异的缩小被白人早产婴儿比黑人早产婴儿死亡率更大幅度的降低所抵消。黑人婴儿的极早产（<28周）发生率高出4倍，且占婴儿死亡率差距的一半以上。
要大幅缩小黑人与白人婴儿死亡率差距，需要更好地预防黑人婴儿的极早产。
