582 ETHNIC DIFFERENCE IN PERINATAL OUTCOME: BLACKS, HIS PANICS AND WHITES

Abstract

Although urban Hispanics (H), share many socioeconomic disadvantage with the blacks (B), Hispanic perinatal and neonatal mortalities rates (PMR and NMR) are superior to black, and similar to white (W) rates. To delineate contributing factors for these differences between ethnic groups, we compared prenatal, socio-economic, and health status of 6211 H, 8381 B and 17,084 W mothers delivering in our network in 1982-83.

RESULTS: Some variables of significantly different distribution (P<0.0001) were: Medicaid and selfpayment; H=64%, B=81%, W=22%, Teenage pregnancy (<19 yrs), H-14%, B=25%, W=6%, Smoking, H=12%, B=34%, W=26%, Anemia, H=4%, B=13%, W=2%. NMR and PMR (per 1000) were similar between H and W: H=6.05 and 14.2, W=5.2 and 11.7: but higher in black: 11.9 and 22.7 (P<0.0001). Low and very low B.Wt rates (<2500 and <1500 gr), were: H=6.3 and 1.1%, White=6.7 and 1.2%, and B=13.7 and 2.7% (P<0.0001). Since weight specific death rates were similar between groups, we determined the source of NMR, PMR variation using a logit chi-square, which revealed that when all adverse factors, including socio-economic and ethnicity were held constant, the single most influencing factor on NMR was the birthweight distribution (Chi-square 1402, P<0.0001).

Conclusion: Although health and socio-economic status varied widely between ethnic groups their influence on NMR and PMR are indirect; through their influence on birthweight distribution. A better birthweight distribution in H. favored better NMR, and a two fold increase in low and very low b. wt. rates in blacks increased their NMR by two fold.

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