June 24, 2003

BIRMINGHAM, AL — Black twins are 20 percent more likely to die during infancy than white twins, according to a recent study by researchers at the University of Alabama at Birmingham (UAB). Details of the study are published in the April 2003 issue of the Journal of Reproductive Medicine.

“Infant mortality is one of the most important measures of a nation’s health status and overall improvement in health over time,” said Dr. Hamisu Salihu, assistant professor of public health with the Department of Maternal and Child Health at UAB. “This result is especially disturbing because it seems to confirm other investigators’ findings that the gap in black-white disparity in infant mortality is persisting in this country.”

UAB researchers observed that the disparity occurs exclusively during the infants’ first 28 days of life rather than throughout infancy. The study also found that black infants tend to be smaller for their gestational age, which is most likely the reason for the disparity. “Efforts to bridge the gap should focus on this critical period and should target twins who are born small for their gestational age,” Salihu said.

The reason for the significant difference in black infants’ size relative to gestational age is not clear, but findings suggest that anemia among black moms during pregnancy may play a role. “A host of factors may influence an infant’s size at birth — prenatal care and the nutritional health of the mom during pregnancy, and environmental factors such as lead exposure during pregnancy, other pregnancy complications, etc. But we did find that a significant number of black moms were anemic, which certainly is one reason,” said Salihu.

The study analyzed data collected between 1995 and 1997 of twins born to teenage mothers in the United States. “Teen pregnancy and twin births are two significant risk factors associated with infant mortality,” Salihu said. “Analysis of this group allowed us to determine when the black-white disparity in infant mortality is highest.”

While further research is needed to fully understand and best determine how to tackle the problem, researchers say the message is clear: not enough is being done. “More money must be spent to improve the health status of pregnant black women,” Salihu said. “Better prenatal care, community outreach programs and improved postnatal care, especially during the first 28 days of life, are needed to significantly address and impact the problem.”