Maternal Racial and Ethnic Disparities in Neonatal Birth Outcomes With and Without Assisted Reproduction

Details

• Alternative Title:
  Obstet Gynecol
• Personal Author:
  Crawford, Sara ; Joshi, Nikhil ; Boulet, Sheree L. ; Bailey, Marie A. ; Hood, Maria-Elena ; Manning, Susan E. ; McKane, Patricia ; Kirby, Russell S. ; Kissin, Dmitry M. ; Jamieson, Denise J.
• Description:
  OBJECTIVE
  
  To explore disparities in prematurity and low birth weight (LBW) by maternal race and ethnicity among singletons conceived with and without assisted reproductive technology (ART).
  
  METHODS
  
  We performed a retrospective cohort study using resident birth certificate data from Florida, Massachusetts, and Michigan linked with data from the National ART Surveillance System from 2000 to 2010. There were 4,568,822 live births, of which 64,834 were conceived with ART. We compared maternal and ART cycle characteristics of singleton liveborn neonates using χ2 tests across maternal race and ethnicity groups. We used log binomial models to explore associations between maternal race and ethnicity and LBW and preterm birth by ART conception status.
  
  RESULTS
  
  The proportion of liveborn neonates conceived with ART differed by maternal race and ethnicity (P<.01). It was smallest among neonates of non-Hispanic black (0.3%) and Hispanic women (0.6%) as compared with neonates of non-Hispanic white (2.0%) and Asian or Pacific Islander women (1.9%). The percentages of LBW or preterm singletons were highest for neonates of non-Hispanic black women both for non-ART (11.3% and 12.4%) and ART (16.1% and 19.1%) -conceived neonates. After adjusting for maternal factors, the risks of LBW or preterm birth for singletons born to non-Hispanic black mothers were 2.12 [95% confidence interval (CI) 2.10–2.14] and 1.56 (95% CI 1.54–1.57) times higher for non-ART neonates and 1.87 (95% CI 1.57–2.23) and 1.56 (95% CI 1.34–1.83) times higher for ART neonates compared with neonates of non-Hispanic white women. The adjusted risk for LBW was also significantly higher for ART and non-ART singletons born to Hispanic (adjusted relative risk [RR] 1.26, 95% CI 1.09–1.47 and adjusted RR 1.15, 95% CI 1.13–1.16) and Asian or Pacific Islander (adjusted RR 1.39, 95% CI 1.16–1.65 and adjusted RR 1.55, 95% CI 1.52–1.58) women compared with non-Hispanic white women.
  
  CONCLUSION
  
  Disparities in adverse perinatal outcomes by maternal race and ethnicity persisted for neonates conceived with and without ART.
  
  
• Subjects:
  Adult Cohort Studies Ethnic Groups Female Healthcare Disparities Humans Infant, Low Birth Weight Infant, Newborn Infant, Premature Maternal-Child Health Services Middle Aged Population Surveillance Pregnancy Pregnancy Outcome Reproductive Techniques, Assisted Retrospective Studies

  More +
• Source:
  Obstet Gynecol. 129(6):1022-1030.
• Pubmed ID:
  28486370
• Pubmed Central ID:
  PMC5590368
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  129
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:4d5fc244ca502c5ba3276a3bee706484c35fe25ebfd9fbbd759c92f6568d818b212ed01c9ec2872d1f85b2a45478cc0600b98ada9aee4107d3be0411a85a8f62
• Download URL:
  https://stacks.cdc.gov/view/cdc/48036/cdc_48036_DS1.pdf
• File Type:
  [PDF - 350.62 KB ]