Racial Disparities in Stillbirth Risk Factors among non-Hispanic Black Women and non-Hispanic White Women in the United States.
Carrie J Henry, Melinda Higgins, Nicole Carlson and 1 others
PMID 34653033WHAT IT FOUND
Women who experienced stillbirth: non-Hispanic Black women had higher prepregnancy BMI, lower Bachelor’s degree rates, and earlier gestational age than non-Hispanic White women; several other risk factors did not differ.
Key findings
01Among women who experienced stillbirth, non-Hispanic Black women had higher mean prepregnancy BMI (29.7 vs 27.0) and were more likely to be obese (44.5% vs 29.1%) than non-Hispanic White women.
02Non-Hispanic Black women experienced stillbirth at an earlier gestational age than non-Hispanic White women (26.9 weeks vs 29.5 weeks).
03Hypertension, diabetes, smoking, nulliparity before the stillbirth, prior cesarean birth, timing of prenatal care initiation, pregnancy-associated hypertension, gestational diabetes, and SGA neonate rates did not differ between the two groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a retrospective secondary analysis of 2016 national fetal death records, so it cannot show that any risk factor caused stillbirth or that findings apply to current pregnancies. The final sample was small: 315 births, with 215 non-Hispanic White women and 100 non-Hispanic Black women, and the authors noted the sample may have been too small to detect some differences. Missing data threatened validity: 5% to 10% for most variables and 19% for obesity. The dataset did not include all risk factors, such as previous stillbirths, and lacked information on root causes of racial health disparities, including racism, neighborhood crime, food deserts, access to prenatal care, and respectful care during pregnancy, labor, and birth. The analysis included only singleton stillbirths to non-Hispanic Black and non-Hispanic White women and excluded multifetal gestations.
Declared interests
The supplied text states only that the authors declared no conflicts of interest; no funding source is reported.
The easy way to misread this
Do not conclude that obesity, education, or hypertension caused the racial disparity in stillbirth risk. This was a retrospective record analysis of women who had already experienced stillbirth, and the authors state associations cannot be inferred to indicate causality.