Do Racial Disparities Persist in Infant Mortality From Respiratory Distress Syndrome?

Abstract

To examine the subset of the infants who died in 2005 from respiratory distress syndrome to determine if racial disparities persist. A secondary data analysis was performed on the data set of infants who died of respiratory distress syndrome (RDS) in the 2005 period linked birth-infant death data file (N=774). Logistic regression was performed to evaluate the contribution of race to RDS-related mortality. When analyzed independently, Black infants were 1.3 times more likely to die of RDS mortality than White infants. After the known predictors of gestation, birth weight, and gender were added to the model, Black race was no longer a significant predictor of RDS. Despite Black race having been identified as a contributor to RDS mortality in the past, race was not a predictor of RDS mortality in the 2005 cohort. Previous analyses comparing pre- and post-surfactant era mortality assumed that all eligible infants received surfactant, and Black infants did not respond as well as White infants. The 2003 birth certificate revision included surfactant administration, but only 12 states reported that data in the 2005 data set. Only 22% of eligible infants had documentation of surfactant administration. Future research is needed to confirm that eligible infants are receiving surfactant and to evaluate the response of infants by race. If Black infants do not respond to the available surfactant replacement products, genomics research is needed to explore targeted therapies for this group.