Posted on March 22, 2004 at 11:42 a.m.
BIRMINGHAM, AL — Black triplets are nearly four times more likely to die than white triplets during their first year of life, according to a recent study by Dr. Hamisu Salihu, assistant professor of public health with the department of maternal and child health at the University of Alabama at Birmingham (UAB). Details of the study were published in the February issue of the American Journal of Obstetrics and Gynecology.
“Infant mortality is a powerful indicator of the health of a population and to what extent a society invests in its children,” Salihu said. “Despite the fact that mortality has decreased among all races in the United States during the last two decades, the black/white gap for infant mortality has widened.”
Over the last 20 years, the number of multiple births has increased dramatically. The rate of triplet births alone has jumped by more than 400 percent. “The extraordinary rise in the incidence of multiple pregnancies is a real public health concern,” Salihu said. “Infants born in multiple deliveries are born earlier and smaller than babies born alone, are less likely to survive their first year of life and are more likely to have lifelong disability when they do survive.”
The study analyzed records compiled by the National Center for Health Statistics of live births and fetal deaths in the United States from 1995 to 1997. There were 16,477 triplet births. Of these, 14,364 were to white mothers and 1,317 were to black mothers.
Researchers found black triplets are at least twice as likely to die during the first 28 days of life and are nearly four times as likely to die during the period of 28 days to 364 days following their discharge home. “Despite fewer deaths overall during this period, this is when the widest racial gap occurs,” Salihu said. “This is the most critical time and should be the focus of efforts and resources to address the black/white gap and to enhance survival among black triplets.”
Although the reason for the racial gap is unclear, researchers cite major differences found between the two groups of mothers. “There were significant differences in all characteristics considered except age,” Salihu said. “Black mothers were more likely to have given birth previously, more likely to be unmarried, less likely to be educated and less likely to have received adequate prenatal care than white mothers.”
However, even after adjusting for these factors, a wide racial disparity still persisted, particularly during the period of 28 days to 364 days. “It is worrisome,” Salihu said. “This suggests that other factors — perhaps stress or environmental influences such as secondhand smoke — may play a role. Further research is needed.”
Findings are in keeping with reported black-white disparities among single births and twin births. “Hopefully, this information will be useful to health care providers and health policy makers in planning appropriate and focused interventions needed to narrow the overall racial gap in this country.”