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Volume 332:69-74 January 12, 1995 Number 2 Next

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ABSTRACT

Background The higher mortality rate among black infants than among white infants in the United States results largely from the greater frequency of low birth weight and prematurity among black infants. Higher rates of low birth weight and preterm delivery have been associated with shorter intervals between pregnancies.

Methods We studied a racially mixed population of women in military families, who had access to free, high-quality health care. A total of 1922 white and black women had two consecutive, singleton pregnancies during the study period. We determined the outcome of the second of each pair of pregnancies and the length of time between the pregnancies.

Results Short interpregnancy intervals (calculated from delivery to the next conception) were more frequent among black than among white women. A total of 7.7 percent of the 298 black women and 3.2 percent of the 1628 white women delivered premature, low-birth-weight infants (P<0.001). Among the black women, an interpregnancy interval of less than nine months was associated with a significantly greater prevalence of preterm delivery and low birth weight in the neonates (11.6 percent, vs. 4.4 percent for longer interpregnancy intervals; P = 0.020). Among the white women, only intervals of less than three months between pregnancies were associated with a greater prevalence of prematurity and low birth weight in the infants (11.8 percent vs. 2.8 percent; P<0.001). Of the black women, 46.3 percent had interpregnancy intervals of less than nine months; 4.2 percent of the white women had interpregnancy intervals of less than three months.

Conclusions A short interval between pregnancies is a risk factor for low birth weight and preterm delivery, and such intervals are more common among black than among white women. The relative frequency of intervals of less than nine months between pregnancies may be an important factor in the wide disparity in pregnancy outcomes between white and black women in the United States.

Source Information

The opinions and assertions contained herein are those of the authors and do not necessarily represent the opinion of the Department of the Army or the Department of Defense.

From the Departments of Pediatrics (J.S.R., V.B.R.) and Obstetrics and Gynecology (J.A.R.), Madigan Army Medical Center, Tacoma, WA 98431, where reprint requests should be addressed to Col. James Rawlings.

Full Text of this Article

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