In New York City from 1996-2000, there were 3,443 fetal deaths (>20 weeks’ gestation), 574,476 live births and 3,188 deceased infants >500 g and were born to city residents. The feto-infant mortality rate among this population was 11.5/1,000 live births plus fetal deaths (Figure 1). Maternal health and prematurity was the largest contributing area to feto-infant mortality (5.9/1,000) followed by maternal care (3.0/1,000), infant health (1.4/1,000) and newborn care (1.2/1,000).
The feto-infant mortality rate varied greatly by racial/ethnic group. Black non-Hispanics experienced the highest rate, at 18.2/1,000 live birth plus fetal deaths, followed by Hispanics with 10.0/1,000, white non-Hispanics with 7.3/1,000 and Asians/Pacific Islanders with 7.2/1,000 (Figure 2). The feto-infant mortality rate for black non-Hispanics was significantly higher than all other racial/ethnic groups (p<0.01).
Figure 1. Feto-infant mortality, New York City, 1996-2000
Although maternal health and prematurity was the largest contributing area to the feto-infant mortality rate for each racial/ethnic group, its proportional contribution varied by race/ethnicity as illustrated by the rates shown in Figure 2. The proportion of deaths contributed by Maternal Health/Prematurity in each race/ethnic group’s overall feto-infant mortality was 56% for black non-Hispanics, 49% for Asians/Pacific Islanders, 48% for Hispanics and 43% for white non-Hispanics. When taking the number of live births in each racial/ethnic group into account, black non-Hispanics had significantly more deaths in each of the categories than any other racial/ethnic group.
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Figure 2. Feto-infant mortality by race/ethnicity. New York City, 1996-2000
The excess feto-infant mortality among black non-Hispanics compared to their white counterparts was 11.1/1,000 live birth plus fetal deaths (Figure 3). Maternal health and prematurity was the largest contributor to this excess (7.1/1,000) followed by maternal care (2.0/1,000), infant health (1.4/1,000) and newborn care (0.4/1,000). When comparing the observed number of deaths among blacks to the expected number of deaths (i.e., if blacks had the same death rate proportional to their births as whites), these rates equate to an excess of 1,817 fetal and infant deaths among black non-Hispanics, 1,175 of these related to maternal health and prematurity, 334 to maternal care, 233 to infant health and 65 to newborn care.
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Figure 3. Excess fetal and infant deaths among black non-Hispanics compared to white non- Hispanics, New York City, 1996-2000