Preemies' survival rate tied to race, gender


Published: Thursday, January 19, 2006 at 6:01 a.m.
Last Modified: Wednesday, January 18, 2006 at 11:24 a.m.
Race and gender play a significant role in the survival rate of premature and extremely underweight newborns, according to University of Florida researchers.
Black and female newborns have a better chance of surviving their first year after a premature birth, with black females surviving at more than twice the rate of white males, according to the report. Gender appears to have a greater effect on the survival rates than race, and females are 1.7 times more likely to survive their first year than males, according to the report.
The report, based on an analysis of more than 5,000 extremely low weight births between 1996 and 2000, should help give physicians a better idea of a premature infant's chances of survival, said Dr. Steven Morse, the lead author of the study and an assistant professor at UF.
"Part of what I do is meet with expectant parents," said Morse, who also works as medical director of Community Newborn Services for Shands. "One of the things they always want to know is whether the babies are going to survive."
Generally, extremely low birth weight newborns - those weighing less than about 2 pounds at birth - have about a 60 percent chance of surviving their first year, Morse said.
Lower birth weights and smaller gestational periods decrease the chances of survival.
But the report showed clear differences in survival rates based on gender and race. Black females had the highest chances of surviving their first year, followed by white females, black males and white males.
Experts on premature birth said the study, published in December in the medical journal Pediatrics, confirms observations that have been made for decades about differences in survival rates.
"When I was a resident 20 years ago we saw the same thing," said Dr. Nancy Green, medical director of March of Dimes, a charity dedicated to preventing premature birth, birth defects and infant mortality.
But by providing statistical evidence to support the observations of doctors, the study can open up new avenues of research into the reasons behind these differences, Green said.
"March of Dimes is certainly committed to supporting that kind of research," she said. "These are long-standing observations. It's frustrating not to make more inroads into the problem."
Morse and other experts said it was unclear exactly what caused these differences.
Morse suggested that the answer may lie in how gender and race may impact the speed with which fetuses develop, but no research had been done on that topic.
The lungs of premature females, for example, are more developed than for premature males of the same age, Morse said.
Dr. David Burchfield, chief of neonatology at Shands at UF, said the information in the study should not be used by doctors trying to decide how to treat patients.
But the information is useful because it could spur future inquiries into a topic with many unanswered questions, Burchfield said.
"What these statistics do is make inquisitive minds ask more questions," he said. "They say, 'OK, we've got to believe this now and there must be a reason. What is that reason?'"
Jeff Adelson can be reached at 352-374-5095 or adelsoj@gvillesun.com

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