Epidemiology of Infant Death Among Black and White Non-Hispanic Populations in Hampton Roads, Virginia

Abstract

To evaluate the presence of racial disparities in infant mortality rates and assess risk factors for infant death among black and white populations in Hampton Roads, Virginia. A retrospective study with secondary analyses of linked birth/death certificate data was conducted using a sample of 201,610 live-born infants and 1659 infant deaths identified between January 1, 1999 and December 31, 2008 in Hampton Roads. Infant, neonatal, and postneonatal mortality rates were significantly (P < 0.0001) higher among black compared with white populations. Racial disparities were noted whereby black infants were significantly (P < 0.0001) more likely to die of conditions originating in the perinatal period, whereas white infants were significantly more likely to die of congenital malformations, deformations, and chromosomal abnormalities (P < 0.0001) or neoplasms (P = 0.03). Multivariable logistic modeling suggested significantly higher odds of black infants dying in the first year of life than white infants. Among blacks, the odds of infant death were inversely related to maternal education. Among whites, the odds of infant death declined with increasing parity. Among black and white populations, history of child death, presence of maternal morbidities and the Kotelchuck Maternal Utilization of Prenatal Care Index were key determinants of infant death. Black infants are at higher odds of dying compared with white infants in Hampton Roads, Virginia. Continued efforts should target prenatal care, preterm delivery, and low-birth-weight infants and neonates to reduce infant mortality rates.