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[ Recorded presentation ] Recorded presentation

Another Hispanic paradox: Why have gestational age data not benefitted equally from improved prenatal care? A comparison of quality of selected Hispanic and non-Hispanic black natality items: 1990-2002

Sharon W. Kirmeyer, PhD and Joyce A. Martin, MPH. Division of Vital Statistics, National Center for Health Statistics / Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD 20782, 301-458-4418, SKirmeyer@cdc.gov

Vital statistics gestational age data are widely used to measure prevalence of preterm birth, an important covariate of infant health. However, the quality of these data is often questioned. One potential indicator of the quality of vital statistics gestational age data is the degree to which the birthweight distribution for very preterm infants (specifically, 28-31 weeks gestation) has a distinct bi-modal distribution. A variable which is highly related to degree of bi-modality is the timeliness of prenatal care, that is, the earlier prenatal care is initiated, the smaller the proportion of births in the second curve. We found that between 1990-92 and 2000-2002, Hispanic and non-Hispanic black mothers' timing of prenatal care improved similarly, from only about half receiving first trimester care to over two-thirds. However, we also found that over this time period, the percent of infants in the second curve of the bimodal distribution fell by 25 percent for non-Hispanic black, but by only 9 percent for Hispanic infants. Hence the paradox: the improvement of prenatal care was essentially identical for both Hispanic and non-Hispanic black mothers, but the birthweights of infants of non-Hispanic black women showed a much larger decline in bi-modality. This issue is explored using data from the National Center for Health Statistics' natality files for 1990-92 and 2000-2002. Changes in data quality for these two groups for several other items from the birth certificate are also explored.

Learning Objectives:

Keywords: MCH Epidemiology, Minority Research

Related Web page: www.cdc.gov/nchs/births.htm

Presenting author's disclosure statement:

Any relevant financial relationships? No

[ Recorded presentation ] Recorded presentation

Epidemiological Analysis in MCH - Beyond the Basics

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA