Racial Differences in Stillbirth Risk Factors in Women Who Experienced Stillbirth During 2016

Abstract

Non-Hispanic Black women experience twice the risk of stillbirth compared with non-Hispanic White women. In 2005, researchers found several stillbirth risk factors were more prevalent in Black women than White women: younger than 20 years old, low education level, obesity, smoking, hypertension, diabetes, late prenatal care, and previous cesarean. It is not known whether these disparities remain. The purpose of this study was to explore whether the stillbirth risk-factor disparity between White and Black women has changed since 2005. The study used secondary data analysis. The National Center for Health Statistics’ 2016 fetal death data file was obtained and analyzed. The sample included White and Black women who experienced stillbirths in the United States in 2016. Non-U.S. residents, fetal deaths before 20 weeks, and multiple births were excluded. A random sample of 315 Black and White women who experienced stillbirths (from the 2016 fetal death data file) was analyzed and descriptive variables were calculated. Black women were compared with White women for each of the risk factors of interest. Age was evaluated using a t test. Education level, obesity, smoking, hypertension, diabetes, timing of prenatal care, and history of previous cesarean were compared using a chi-square test. Age, hypertension, diabetes, timing of prenatal care, and previous cesareans did not differ significantly between Black and White women, but education, obesity, and smoking did. Black women were more likely to possess less than a high school education (14.7% vs. 8.8%, p < .05). They were also less likely to possess an undergraduate degree or higher (11.6% vs 25%, p < .05). Black women were more likely to be obese (44% vs. 29%, p < .05) and less likely to report smoking during the pregnancy (16.3% vs. 19.0%, p < .05). The previously described racial disparity in stillbirth risk factors has changed since 2005. Among women bereaved by stillbirth, only obesity, education level, and smoking still differ between Black and White women. For smoking, the direction of the disparity has changed; White mothers are now more likely to smoke than Black mothers. These findings may help nurses identify women who are at risk of stillbirth and may benefit from preventative measures.