Blacks' medical state, premature deliveries tied Better health care found needed during pregnancy

October 01, 1992|By Boston Globe

Black women who give birth to extremely small babies are nearly three times as likely as white women to have had medical conditions that led to the premature delivery, according to a study released today.

The finding may help explain why the black infant mortality rate is about twice the rate for whites in this country and underscores the need for better health care for women before and during pregnancy, researchers said.

"In some measure, our very low birth weight problem is a legacy of poor women's health, period," said Dr. Paul Wise of the Harvard Medical School, one of the authors of the study appearing in today's New England Journal of Medicine.

The study "elevates the importance of comprehensive, preventive strategies, particularly as they relate to women's health in general," Dr. Wise said.

Over the years, researchers have tried to separate the various medical, social and economic factors that could account for the historic racial disparity in infant mortality in the United States. Babies born weighing less than 3.3 pounds account for more than one-third of infant deaths, and researchers have long known black mothers are about twice as likely to give birth to underweight babies as white women are. But the reason for this has remained unclear.

Today's study is the most comprehensive attempt to look at the medical conditions that could explain the higher prevalence of low birth weight babies among black women.

The researchers, from Harvard, three Boston teaching hospitals and other institutions, reviewed medical records for 1,300 infants born weighing less than 3.3 pounds and their mothers. The births occurred in the early 1980s in Boston, St. Louis and two health districts in Mississippi.

Dr. Howard Spivak, a New England Medical Center physician who also reviewed the study, agreed. "Good, early prenatal care can identify certain risk circumstances and can provide some interventions that can minimize those circumstances."

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