Perinatal Mortality in North Carolina: Risk Factor Analysis by Race

Perinatal mortality continues to be a public health problem in North Carolina. In 1992, there were 1,655 perinatal deaths among North Carolina residents. Blacks comprised only 29 percent of the deliveries, but 48 percent of all perinatal deaths occurred among blacks. Furthermore, the rate of perinatal mortality for blacks was 23.9 per 1,000 deliveries, while for whites it was 10.3 per 1,000 deliveries. The reasons for these discrepancies are not fully understood. This study examines how the risk factors associated with perinatal mortality vary according to race. By using odds ratios and logistic regression, the strongest predictors of perinatal mortality are compared for blacks and whites. The risk factors considered include sociodemographic factors, medical risk factors, and complications of labor that were reported on the birth and fetal death certificates. Results indicate that black women had a higher prevalence of several characteristics associated with perinatal mortality. Furthermore, while the medical risk of a previous preterm or small for gestational age infant, and the complications of labor influenced perinatal mortality strongly for both blacks and whites, several of the sociodemographic variables affected blacks and whites differently. Maternal age 35 or more and maternal age under 18 were the strongest predictors of perinatal mortality in blacks. However, for whites, birth order 5 or more and marital status had the strongest association; and maternal age 35 or more had no association with perinatal mortality. The findings of the study are discussed, as well as strategies for reducing perinatal mortality in North Carolina. Jennifer Bourbina will be a Graduate Student in Biostatistics at the University of North Carolina at Chapel Hill in the Fall of 1995. This project was completed during her internship at the State Center for Health and Environmental Statistics in the Summer of 1995. STUDIES A Special Report Series by THE STATE CENTER FOR HEALTH AND ENVIRONMENTAL STATISTICS P.O. Box 29538, Raleigh, N.C. 27626-0538 NORTH CAROLINA DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES