The objectives of the study were to improve traditional race-specific intrauterine growth curves and to assess the risk of feto-infant death by gestation-birthweight categories. In the study, we included fetal deaths as well as live births to formulate intrauterine growth curves to make the curves more representative of all pregnancies. All 252,928 single live births and fetal deaths with gestational age 25 to 44 weeks born to Louisiana residents between 1995 and 1998 were used to calculate intrauterine growth curves. Of these, 188,833 live births were birth-cohort linked to death files and 817 fetal deaths were included for risk assessment. The race-specific growth curves showed that after 34 weeks of pregnancy, fetus weight of whites started to exceed that of blacks. The feto-infant mortality rate was 51.1 times higher for pre-term (25-36 weeks) and small for gestation babies than for full-term (37-41weeks) and large for gestation babies. The feto-infant mortality rate was higher for pre-term whites than for pre-term blacks among all birthweight groups. After 37 weeks, the feto-infant mortality rate for blacks exceeded the rate for whites among all birthweight groups except small for gestation babies. The pattern of leading causes of infant death shifted with the increase of gestational age and birthweight from disorders relating to short gestation and unspecified low birthweight to congenital anomalies, and then to sudden infant death syndrome. As the risks of feto-infant death are significantly higher in low gestation-birthweight, inclusion of fetal deaths is essential to the accuracy of intrauterine growth curves.
Learning Objectives: From the study, the participant will be able to: 1. Compare racial differences in intrauterine growth. 2. Assess risks of fetal and infant mortality by using intrauterine growth curves. 3. Map fetal and infant mortality using a two-dimensional map of gestational age and birthweight
Keywords: Fetal Mortality, Infant Mortality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.