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Last Edited: 2/20/2009

Infant and Fetal Mortality: Who is at Risk?

What disparities in infant and fetal mortality do we see in California?

Different population groups in the United States and California experience different burdens of infant and fetal mortality. Disparities in any health outcome sometimes provide clues regarding the causes of disease; perhaps more importantly, they enable us to understand patterns of health outcomes as social justice issues.

The ways in which we discuss these patterns are largely determined by the data sources that we have.  Birth certificate records contain two types of information that help us in this regard:  (a) mother’s racial and ethnic identification (although this may be recorded inconsistently), and (b) the location of the mother’s residence at the time of delivery.

Death in the neonatal period is mostly associated with conditions surrounding birth, such as prematurity and growth retardation.  As we discuss elsewhere, substantial disparities exist in California regarding how risk for prematurity and growth retardation vary by race/ethnicity and class, and these disparities are also seen for neonatal mortality.  Distressingly, disparities in postneonatal mortality are also evident, even when conditions such as prematurity and growth retardation are held constant.1-3

1.    Blabey M, Gessner B. Three maternal risk factors associated with elevate risk of postneonatal mortality among Alaska Native population. Maternal and Child Health Journal. 2008;[e-pub ahead of print].
2.    Hessol N, Fuentes-Afflick E. Ethnic differences in neonatal and postneonatal mortality. Pediatrics. 2005;115:e44-e51.
3.    Malloy M. Sudden infant death syndrome among extremely preterm infants:  United States 1997-1999. Journal of Perinatology. 2004;24:181-187.