Background The higher mortality rate among black infants thanamong white infants in the United States results largely fromthe greater frequency of low birth weight and prematurity amongblack infants. Higher rates of low birth weight and pretermdelivery have been associated with shorter intervals betweenpregnancies.
Methods We studied a racially mixed population of women in militaryfamilies, who had access to free, high-quality health care.A total of 1922 white and black women had two consecutive, singletonpregnancies during the study period. We determined the outcomeof the second of each pair of pregnancies and the length oftime between the pregnancies.
Results Short interpregnancy intervals (calculated from deliveryto the next conception) were more frequent among black thanamong white women. A total of 7.7 percent of the 298 black womenand 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 associatedwith a significantly greater prevalence of preterm deliveryand low birth weight in the neonates (11.6 percent, vs. 4.4percent for longer interpregnancy intervals; P = 0.020). Amongthe white women, only intervals of less than three months betweenpregnancies were associated with a greater prevalence of prematurityand low birth weight in the infants (11.8 percent vs. 2.8 percent;P<0.001). Of the black women, 46.3 percent had interpregnancyintervals of less than nine months; 4.2 percent of the whitewomen had interpregnancy intervals of less than three months.
Conclusions A short interval between pregnancies is a risk factorfor low birth weight and preterm delivery, and such intervalsare more common among black than among white women. The relativefrequency of intervals of less than nine months between pregnanciesmay be an important factor in the wide disparity in pregnancyoutcomes 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.
Prevention of Preterm Birth
McGregor J. A., French J. I., Sepkowitz S., Devitt N., Goldenberg R. L., Rouse D. J.
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N Engl J Med 1998;
339:1858-1860, Dec 17, 1998.
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