Racial and Gender Differences in the Viability of Extremely Low Birth Weight Infants: A Population-Based Study

Abstract

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 < or = 500 g was < or = 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.