Abstract
To determine the importance of infant factors, maternal prenatal care use, and demographic characteristics in explaining the racial disparity in infant (age <365 days) mortality due to congenital heart defects (chd). in this cross-sectional population-based study, stratified and multivariable logistic regression analyses were performed on the 2003-2004 national center for health statistics linked live birth-infant death cohort files of term infants with non-hispanic white (n =" 3 684 569)" and african-american (n =" 782 452)" us-born mothers. infant mortality rate, including its neonatal (><28 day) and postneonatal (28-364 day) components, due to chd was the outcome measured. the infant mortality rate due to chd for african-american infants (296 deaths; 3.78 per 10 000 live births) exceeded that of white infants (1025 deaths; 2.78 per 10 000 live births) (relative risk [rr], 1.36; 95% ci, 1.20-1.55). the racial disparity was wider in the postneonatal period (2.08 per 10 000 vs 1.42 per 10 000; rr, 1.53; 95% ci, 1.29-1.83) compared with the neonatal period (1.70 per 10 000 vs 1.44 per 10 000; rr, 1.20; 95% ci, 0.99-1.45). compared with white mothers, african-american mothers had a higher percentage of high-risk characteristics. in multivariable logistic regression models, the adjusted or of postneonatal and neonatal mortality due to chd for african-american mothers compared with white mothers was 1.20 (95% ci, 0.98-1.48) and 0.95 (95% ci, 0.77-1.19), respectively. the racial disparity in infant mortality rate due to chd among term infants with us-born mothers is driven predominately by the postneonatal survival disadvantage of african-american infants. commonly cited individual-level risk factors partly explain this phenomenon. the study is limited by the lack of information on neighborhood factors.>
