Published online January 4, 2006
PEDIATRICS Vol. 117 No. 1 January 2006, pp. e106-e112 (doi:10.1542/peds.2005-1286)
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Racial and Gender Differences in the Viability of Extremely Low Birth Weight Infants: A Population-Based Study

Steven B. Morse, MD, MPHa, Samuel S. Wu, PhDb, Changxing Ma, PhDb, Mario Ariet, PhDc, Michael Resnick, EdDa and Jeffrey Roth, PhDa

a Departments of Pediatrics
b Statistics
c Medicine, College of Medicine, University of Florida, Gainesville, Florida

OBJECTIVE. The purpose of this study is to provide a race- and gender-specific model for predicting 1-year survival rates for extremely low birth weight (ELBW) infants by using population-based data.

METHODS. Birth and death certificates were analyzed for all children (N = 5076) with birth weights between 300 g and 1000 g who were born in Florida between 1996 and 2000. Semiparametric, multivariate, logistic regression analysis was used to model 1-year survival probabilities as a function of birth weight, gestational age, mother's race, and infant's gender. Estimated survival rates among different race/gender groups were compared by using odds ratios (ORs).

RESULTS. One-year survival rates for 5076 ELBW infants born between 1996 and 2000 did not change during the 5-year period (60–62%). The survival rate at ≤500 g was ≤14% (n = 716). Survival rates at 501 to 600 g and 601 to 700 g were 36% and 62%, respectively. The survival rate reached >85% for infants of >800 g. Modeling indicated a survival advantage for female infants, compared with male infants (OR: 1.7; 95% confidence interval: 1.5–1.9), and for black infants, compared with white infants (OR: 1.3; 95% confidence interval: 1.1–1.5). Black female infants had 2.1 greater odds of survival than did white male infants.

CONCLUSIONS. This population-based study highlights the significant race and gender differences in 1-year survival rates for ELBW infants, as well as the interactions of these 2 factors. These findings can assist obstetricians and neonatologists not only in the care of ELBW infants but also in frank discussions with families.

Key Words: birth weight-specific mortality rate • low birth weight infant • infant death

Abbreviations: ELBW—extremely low birth weight • OR—odds ratio • CI—confidence interval • SGA—small for gestational age

Accepted Jul 19, 2005.




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