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Racial Disparity in Meconium-Stained Amniotic Fluid and Meconium Aspiration Syndrome in the United States, 1989–2000

From the Neonatology Section and Center for Perinatal Epidemiology, University of Chicago Children’s Hospital, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.

Address reprint requests to: Sudhir Sriram, MBBS, MRCP, University of Chicago Children’s Hospital, Department of Pediatrics, MC 6060, 5841 S. Maryland Avenue, Chicago, IL 60637; E-mail: ssriram{at}peds.bsd.uchicago.edu.

OBJECTIVE: To estimate the prevalence of meconium-stained amniotic fluid and meconium aspiration syndrome, as well as the differences in case fatality from meconium aspiration syndrome, between non-Hispanic black and non-Hispanic white infants.

METHODS: We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989–1991, 1995–1997, and 1998–2000. We used logistic regression to estimate the risks of meconium-stained amniotic fluid and meconium aspiration syndrome and to estimate the case fatality of meconium aspiration syndrome by maternal race, birth weight, period, and pregnancy complications.

RESULTS: Risk of meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight–adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of meconium aspiration syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight–adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of meconium aspiration syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989–1991, 1995–1997, and 1998–2000, respectively.

CONCLUSION: Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for meconium-stained amniotic fluid and meconium aspiration syndrome but not for meconium aspiration syndrome case fatality.

This article has been cited by other articles:

				P. A. Dargaville, B. Copnell, and for the Australian and New Zealand Neonatal Networ The Epidemiology of Meconium Aspiration Syndrome: Incidence, Risk Factors, Therapies, and Outcome Pediatrics, May 1, 2006; 117(5): 1712 - 1721. [Abstract] [Full Text] [PDF]