Race, Gender Affect Fate of Low Birth Weight Babies

Study found females and blacks stood better chance of surviving

WEDNESDAY, Jan. 4, 2006 (HealthDay News) -- Race and gender are significant predictors of survival among extremely low birth weight infants, a new study finds.

The report appears in the January issue of Pediatrics.

In the study, researchers led by Dr. Steven Morse, from the department of pediatrics at the University of Florida, looked at the death certificates of 5,076 extremely low birth weight infants.

Morse's team found that approximately 14 percent of the infants who weighed less than 500 grams at birth survived at one year. For those born at 501 to 600 grams, the survival rate was 36 percent, and for those born at 601 to 700 grams the survival rate was 62 percent. For infants who were more than 800 grams, the survival rate jumped to almost 85 percent.

In addition, the researchers found that females had a better chance of surviving compared with males. Also, black infants had a survival advantage compared with white infants. In fact, black female infants had a 2.1 greater chance of survival than white male infants.

"Obstetricians will continue to face difficult decisions regarding the care of mothers in preterm labor at very early gestational ages, and neonatologists will continue to struggle with decisions regarding the initiation and withdrawal of care for extremely premature infants," the researchers wrote. "The data presented here are intended to assist both groups not only in management but also in frank discussions with families."

One expert believes that mortality among low birth weight infants is related to the lack of neonatal care.

"These are the same numbers seen around the country," said Dr. Joshua A. Copel, director of Maternal and Fetal Medicine at Yale University School of Medicine. "We know that the prognosis is bad for extremely small babies."

Why survival is influenced by race and gender is unknown, Copel pointed out. However, women who deliver low birth weight infants often haven't received prenatal care, he noted.

Copel believes that with proper prenatal care there would be fewer low birth weight infants and better survival among those who are born prematurely.

"Get prenatal care early," Copel advised. "We don't know why prenatal care works, but we know it does work. Women who get prenatal care give birth to bigger babies at a more advanced stage of life than women who don't get prenatal care."

Another study in the same journal issue finds that infants in neonatal intensive care units are frequently misidentified, which increases the risk for medical errors.

In this study, researchers from the University of Vermont and Harvard collected data on 1,240 infants in a neonatal intensive care unit.

They found the most common cause of misidentification was confusion of medical records based on similar numbers. Other common causes were infants having the same last names or last names that sounded the same.

"We believe that these findings demonstrate a need to reconsider the methods that are used for neonatal intensive care unit patient identification," the authors noted. "The use of point-of-care bar coding systems is a frequently cited technology for reducing patient identification errors. Similarly, radio frequency identification systems, which do not require line-of-sight access to patient identification bands, may prove valuable," they added.

More information

The U.S. Department of Health and Human Services can tell you more about prenatal care.

SOURCES: Joshua A. Copel, M.D., professor, obstetrics and gynecology and pediatrics, and director, Maternal and Fetal Medicine, Yale University School of Medicine, New Haven, Conn.; January 2006 Pediatrics
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