Abstract
Among European countries, optimal birth weight at which the mortality is minimal is shown to be different by country. We investigated this difference examining one geopolitical population, the U.S. term live births, born to the five groups of the same ethnic parents; White, Black, Hispanic, North Asian, and South Asian. North Asians and South Asians had more favorable maternal factors for birth weight. Yet, Whites had the highest mean birth weight and South Asians, the lowest. However, neonatal mortality rate in Whites was 0.78 per 1,000 live births, significantly higher than 0.36 and 0.72 per 1,000 live births in North Asians and South Asians, respectively. Other maternal factors hardly explained this ethnic disparity in birth weight or mortality. Optimal birth weight was greatest in Whites (3,890 g), and least in South Asians (3,491 g). However, neonatal mortality at optimal birth weight was significantly lower in North Asians. Adjustment of maternal factors except parental ethnicity changed little of this difference. Optimal birth weight and its mortality differ by ethnicity. On planning the best birth outcome in a population, one should consider the variable mortality risks by ethnicity.
Highlights
Infant mortality is closely related to both birth weight and gestational age[1,2]
Crude neonatal or infant mortality rate is determined by its two components, birth weight distribution, a proportion of smaller birth weight groups, and birth weight-specific mortality rates of individual birth weight groups[9,10]
In the U.S, there is little information on subtle difference in term infants, their birth weight distribution within term gestation and their mortality risk among different ethnic groups. Platt and his associates[15] showed that in the U.S, optimal birth weight was higher and mortality risk at term was less in Whites compared to Blacks
Summary
Infant mortality is closely related to both birth weight and gestational age[1,2]. But the birth weight is a stronger predictor for mortality. Many maternal factors influence birth weight, such as ethnicity, age, parity, education, health conditions and her other socioeconomic status. When comparing birth weights of different populations, maternal ethnicity has the strongest influence on birth weight[4,5]. Graafmans and his associates[6] studied birth outcomes in seven Western European countries, Finland, Sweden, Norway, Denmark, Scotland, the Netherlands, and Belgium. Compared to the U.S, these European countries may have less heterogeneous ethnic composition, but possibly by country more difference in their socioeconomic status and health care systems. We wanted to minimize the impact of different provisions of health care system on mortality among different ethnic groups in different countries. We chose a large birth population of the U.S, where the health care system would have been rather similar across the country
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