Pristell Chrystal, Huffstetler Alison, Budd Serenity, Mena Fernando
Robert Graham Center for Policy Studies, Washington, DC, USA.
Medstar Health Research Institute, Hyattsville, MD, USA.
Matern Child Health J. 2025 May;29(5):696-702. doi: 10.1007/s10995-025-04094-7. Epub 2025 May 1.
The prevalence of intrauterine fetal demise (IUFD) in the United States is 5.74 per 1000 live births. In Maryland, the prevalence is 6.75 per 1000 and occurs nearly twice as frequently in Black than in white populations. At MedStar Franklin Square Medical Center (MFSMC), Electronic Medical Records (EMR) show that IUFDs are 2.5 times greater in Black than white women. This analysis aims to identify factors that contribute to this health disparity.
We performed a retrospective chart review of deliveries at MFSMC between 2018 and 2020. Literature-supported variables were collected for all pregnancies that ended in IUFD. Using logistic regression models, these factors were analyzed to isolate predictors for IUFD and association with race. The same predictors were compared to those of women who delivered live infants during this period.
Without adjustment, the odds of having an IUFD are 2.21 times higher for Black mothers than for white mothers at MFSMC. No other unadjusted odds ratios between comorbid risk factors and the chance of IUFD were significant. After adjusting for diabetes, growth restriction, substance abuse, and hypertension, the odds of having an IUFD are 2.31 times higher for Black than white mothers.
Black mothers experience increased risk for IUFD, after controlling for other pertinent factors. This disparity should be addressed by reducing healthcare provider bias, increasing maternal health services, and providing comprehensive patient education.
美国死产（IUFD）的发生率为每1000例活产中有5.74例。在马里兰州，发生率为每1000例中有6.75例，在黑人中发生的频率几乎是白人的两倍。在MedStar富兰克林广场医疗中心（MFSMC），电子病历（EMR）显示黑人女性的死产发生率是白人女性的2.5倍。本分析旨在确定导致这种健康差异的因素。
我们对MFSMC 2018年至2020年期间的分娩进行了回顾性病历审查。收集所有以死产告终的妊娠的文献支持变量。使用逻辑回归模型，对这些因素进行分析，以分离死产的预测因素及其与种族的关联。将相同的预测因素与同期分娩活婴的女性的预测因素进行比较。
未经调整时，MFSMC黑人母亲发生死产的几率是白人母亲的2.21倍。合并症危险因素与死产几率之间的其他未调整比值比均无统计学意义。在调整糖尿病、生长受限、药物滥用和高血压后，黑人母亲发生死产的几率是白人母亲的2.31倍。
在控制其他相关因素后，黑人母亲发生死产的风险增加。应通过减少医疗服务提供者的偏见、增加孕产妇保健服务和提供全面的患者教育来解决这种差异。
