Department of Family Medicine, University of Michigan, Ann Arbor, Michigan 48104-1213, USA.
J Womens Health (Larchmt). 2010 Apr;19(4):767-73. doi: 10.1089/jwh.2009.1561.
Although births of multiracial and multiethnic infants are becoming more common in the United States, little is known about birth outcomes and risks for adverse events. We evaluated risk of fetal death for mixed race couples compared with same race couples and examined the role of prematurity and low birth weight as potential mediating risk factors.
We performed a retrospective cohort analysis using data from the 1998-2002 California Birth Cohort to evaluate the odds of fetal death, low birth weight, and prematurity for couples with a mother and father who were categorized as either being of same or different racial groups. Risk of prematurity (birth prior to 37 weeks gestation) and low birth weight (<2500 g) were also tested to see if the model could explain variations among groups.
The analysis included approximately 1.6 million live births and 1749 stillbirths. In the unadjusted model, compared with two white parents, black/black and black/white couples had a significantly higher risk of fetal death. When all demographic, social, biological, genetic, congenital, and procedural risk factors except gestational age and birth weight were included, the odds ratios (OR) were all still significant. Black/black couples had the highest level of risk (OR 2.11, CI 1.77-2.51), followed by black mother/white father couples (OR 2.01, CI 1.16-3.48), and white mother/black father couples (OR 1.84, CI 1.33-2.54). Virtually all of the higher risk of fetal death was explainable by higher rates of low birth weight and prematurity.
Mixed race black and white couples face higher odds of prematurity and low birth weight, which appear to contribute to the substantially higher demonstrated risk for stillbirth. There are likely additional unmeasured factors that influence birth outcomes for mixed race couples.
尽管在美国，多民族和多种族婴儿的出生率越来越高，但对于出生结局和不良事件风险知之甚少。我们评估了混血夫妇与同种族夫妇相比，胎儿死亡的风险，并研究了早产和低出生体重作为潜在的中介风险因素的作用。
我们使用 1998-2002 年加利福尼亚出生队列的数据分析进行了回顾性队列分析，以评估母亲和父亲属于相同或不同种族群体的夫妇的胎儿死亡、低出生体重和早产的几率。还测试了早产（妊娠 37 周前分娩）和低出生体重（<2500 克）的风险，以了解模型是否可以解释组间的差异。
该分析包括大约 160 万活产和 1749 例死产。在未调整的模型中，与两个白人父母相比，黑人/黑人夫妇和黑人/白人夫妇的胎儿死亡风险明显更高。当除了胎龄和出生体重之外，所有人口统计学、社会、生物学、遗传学、先天性和程序危险因素都被包括在内时，比值比（OR）仍然都是显著的。黑人/黑人夫妇的风险最高（OR 2.11，CI 1.77-2.51），其次是黑人母亲/白人父亲夫妇（OR 2.01，CI 1.16-3.48），白人母亲/黑人父亲夫妇（OR 1.84，CI 1.33-2.54）。几乎所有胎儿死亡风险的增加都可以通过低出生体重和早产率的升高来解释。
混血黑白夫妇面临更高的早产和低出生体重的几率，这似乎导致了更高的死产风险。可能还有其他未被测量的因素会影响混血夫妇的生育结局。
