MedicalResearch.com Interview with:
Emily A. DeFranco, D.O., M.S.
Associate Professor Maternal-Fetal Medicine
Center for Prevention of Preterm Birth, Perinatal Institute
Cincinnati Children’s Hospital Medical Center
University of Cincinnati College of Medicine
Department of Obstetrics and Gynecology
Medical Sciences Building, Room 4553B
Medical Research: What is the background for this study?
Dr. DeFranco: The Infant Mortality Rate in the state of Ohio is higher than many other states. Additionally, there is a large disparity in the IMR with black infants impacted to a higher degree compared to white infants. For this reason, we are particularly interested in identifying factors that contribute to this disparity in order to identify potential areas where public health efforts can be focused.
We know that preterm birth is a major contributor to infant mortality, and that all babies born alive prior to 23 weeks of gestational age, i.e. “previable”, die after birth and contribute to the infant mortality rate. In this study, we wanted to assess whether black women are more likely to have early preterm births at less than 23 weeks, and if so whether that may be part of the explanation of why black mothers are at higher risk of experiencing an infant mortality.
Medical Research: What are the main findings?
Dr. DeFranco: In this study, we found that black mothers were more likely to deliver than white mothers at very early preterm gestational ages, less than 23 weeks. We also found that the earlier the delivery, the larger the disparity with black mothers being at higher risk for the earliest deliveries compared to white mothers. From this data, we estimated that in Ohio, 44% of all infant mortality in black mothers is caused by previable preterm birth, whereas only 28% of infant mortality in white mothers is attributed to the same cause. We concluded that very early preterm birth in black mothers is a large contributor to the racial disparity observed in the infant mortality dilemma here in Ohio.
Medical Research: What should clinicians and patients take away from your report?
Dr. DeFranco: Having a better understanding of the causes of racial disparities in important health outcomes such as previable birth and infant mortality is crucial for the development of interventions to reduce risk and close the racial gap.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: Focused research on interventions to prevent previable preterm birth, with particular focus on high-risk pregnancies in women of black race, is an important step to decrease infant mortality. This could include access to prenatal care, preterm birth screening and medical interventions for high-risk pregnancies. Optimizing pre-pregnancy health is of the utmost importance, as is minimizing harmful exposures to things known to increase risk of preterm birth, like smoking cigarettes in pregnancy.
Emily A. Defranco, Eric Hall, Louis J. Muglia.
Racial Disparity in Previable Birth.
American Journal of Obstetrics and Gynecology, 2015; DOI:
Emily A. DeFranco, D.O., M.S (2016). Very Early Preterm Births More Common In Black Mothers