Maternal and Infant Contrasts and Comparisons of American Indians and Non-Hispanic Blacks

The purpose of this study was to compare maternal and infant characteristics and risks of adverse birth outcomes between American Indian/Alaskan Native (AIAN) and Non-Hispanic Blacks. Previous studies have compared AIAN to non-Hispanic White populations; however, comparisons between AIAN and non-Hispanic Blacks are important given similar historical and systems-related issues. Using the National Center for Health Statistics 1995-2002 Live Birth-Infant Death Cohort files, singleton live births born to U.S. resident mothers who identified themselves as AIAN (n= 275,506) and non-Hispanic Blacks (n=4,467,568) were selected for analyses. Proportions of maternal and infant characteristics, birthweight-gestational age and cause-specific infant mortality rates were calculated for each group. Adjusted odds ratios with 95% confidence intervals were calculated to determine the risks of adverse birth outcomes. AIANs had lower rates of maternal and infant risk characteristics and adverse outcomes with the exception of hypertension, diabetes, smoking, alcohol use, adequate prenatal care, and high birth weight. Cause-specific infant mortality rates (IMR) were higher among non-Hispanic Blacks with the exception of IMR for SIDS and injuries. AIANs had about a 50% lower risk of low birth weight compared to non-Hispanic Blacks (OR=0.51; 95% CI: 0.50-0.51) and a 30% lower risk of infant mortality (OR=0.70; 95% CI=0.67-0.73). There was no difference in postneonatal mortality or mortality due to injuries. AIANs had more than a 50% lower risk of infant mortality due to perinatal conditions (OR=0.43; 95% CI: 0.37-0.49). Despite similarities in historical and sociodemographic situations, AIANs have consistently better outcomes compared to NHB. Further exploration of systems issues related to both populations should be considered.